Archived: Tresleigh

Updated 29 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 December 2015 and was unannounced. The inspection was carried out by one inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed previous inspection reports and other information we held about the home including any notifications. A notification is information about important events which the service is required to send us by law.

Due to people’s health care needs we were not able to verbally communicate with people who lived at the service to find out their experience of the care and support they received. Instead we observed staff interactions with people. We spoke with the deputy manager, Spectrum’s deputy head of operations, a divisional manager and four care workers. Following the inspection visit we spoke with the registered manager and contacted two relatives to hear their views of the service.

We looked at detailed care records for two individuals, staff training records, staff rotas, three staff files and other records relating to the running of the service.

Updated 29 January 2016

We inspected Tresleigh on 15 December 2015, the inspection was unannounced. The service was last inspected in January 2014, we had no concerns at that time.

Tresleigh provides care and accommodation for up to five people who have autistic spectrum disorders. At the time of the inspection four people were living at the service. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was not available on the day of the inspection visit. However we spoke with them at a later date.

During the day people were supported by sufficient numbers of staff to allow them to take part in activities in the community. When there were unexpected staff absences there were systems in place to minimise the effect of this. At times the service required two waking night members of staff to support people when they were unsettled. One waking night role was often swapped for a sleep-in member of staff. Management said it was not always necessary to have two waking nights as people’s needs fluctuated.

Recruitment practices helped ensure staff working in the home were fit and appropriate to work in the care sector. Staff had received training in how to recognise and report abuse, and all were confident any concerns would be taken seriously by the manager and organisation.

People were assessed in line with the Deprivation of Liberty Safeguards (DoLS) as set out in the

Mental Capacity Act 2005 (MCA). DoLS provide legal protection for vulnerable people who are, or may become deprived of their liberty. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals when appropriate. Staff demonstrated a good understanding of the main principles of the Mental Capacity Act (MCA).

The building was well maintained and decorated to a good standard. There were plenty of shared rooms to enable people to spend time together or on their own as they wanted. There was a TV lounge, a large dining area sometimes used as a games room, a well laid out and modern kitchen, a sensory room and another quiet sitting area. People had free access to all the shared areas and we observed people using different parts of the premises throughout the day.

Staff valued people’s privacy and dignity. Cultural differences were recognised and respected. Spectrum had arranged additional training for staff to improve their understanding of people’s cultural needs.

People’s support plans included clear and detailed information about their health and social care needs. Although care plan reviews were held regularly information was not always up-dated. Some information was repeated and the content varied. This could have caused confusion for staff leading to people not receiving support in line with their plan of care.

Roles and responsibilities were well-defined and understood by the staff team. The registered manager was supported by a deputy manager who had a clear set of responsibilities. There was a key worker system in place. Key workers are members of staff with responsibility for the care planning for a named individual.