Archived: UBU - 7 Fairmile Drive

Updated 13 July 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 8 and 11 April 2016 and the first day was unannounced. The inspection team consisted of one inspector and an inspection manager.

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 reviewed the information in the PIR, along with other information that we held about the service, including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We contacted various teams within Manchester City Council to find out what information they held about the service. Contracts compliance and commissioning teams told us that they had no concerns about this service and we received a copy of their most recent monitoring visit to the service. The infection control team conducted an audit in September 2015 and had no major concerns with how the service managed infection control. We also contacted Manchester Healthwatch who told us they had no information about this service at this time. Healthwatch is an organisation responsible for ensuring the voice of users of health and care services are heard by those commissioning, delivering and regulating services.

We spoke with two people who used the service, two relatives, two senior managers, including the registered manager and three care staff. We observed the way people were supported and looked at records relating to the service, including four care plans, two staff recruitment files, daily record notes, medication administration records (MAR), maintenance records, service policies and procedures and quality assurance records.

Updated 13 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. Our inspection took place on 08 and 11 April 2016 and the first day was unannounced.

The previous inspection took place in 8 July 2013. At this inspection, we found that the service had met all regulatory requirements.

UBU - 7 Fairmile Drive provides respite care services to people with a learning disability and other associated needs and can accommodate up to four people at a time. Respite care is planned or emergency care provided to a person in order to provide temporary relief to family members who are caring for that person. People staying at the service were referred to as “guests” and usually stayed for two to three days. At the time of this inspection there were three people staying at the service; one person was staying on a more long term basis and the others were due to return to their own homes on that day. Two additional people were scheduled to arrive, both for a three-day stay.

The service, located in a large detached house within a quiet residential area, has four bedrooms. The bedroom on the ground floor has been adapted to accommodate people with mobility issues and contains a ceiling track hoist and an adapted toilet and shower area. There are three bedrooms on the first floor; each room has a wash basin. Also on the first floor, there is a bathroom and toilet, a separate shower room, laundry and a bedroom used as an office/staff sleep over area. On the ground floor, there is a lounge, a toilet, the kitchen and dining room which leads into a conservatory that looks out onto a reasonably sized garden.

The service had a registered manager who had been registered with the Care Quality Commission (CQC) since December 2015. 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.

We found breaches in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. You can see what action we have told the provider to take at the back of the report.

During our visit we noted that there were only two staff on duty and three people using the service at the time, two with complex needs. One person could potentially be left unattended if both staff were busy assisting or supporting other people. This meant that staffing levels were not always adequate to ensure that people were kept safe at all times.

We looked at the service’s administration of medication and found that there were areas that required improvement. Medicines including controlled drugs were stored safely in lockable cabinets. During our inspection there was an audit of medicine administration by the regional manager. This audit highlighted a discrepancy with how medicines were being accounted for and raised questions about the service’s current practice and staff understanding and competence.

Risk assessments were done to ensure that people were kept safe during the time they spend at the service; these included risk assessments in relation to people’s personal care, moving and handling and medication. We found that the service did not always have up-to-date and clear guidance to help staff support people safely at the service and when they were participating in extracurricular activities facilitated by the service.

Staff had received safeguarding training and were able to explain what safeguarding was, give examples of the various types of abuse and knew what action to take if they suspected abuse was taking place. We saw that safeguarding was discussed at the weekly house meetings held between people using the service and support staff and we saw that Easy Read documentation on the subject was available for people using the service.

We saw that the service had undertaken the appropriate health and safety checks of its fire alarm and fire equipment systems, hoists, and utilities and the records indicated they were all up to date.

The service did not always work within the principles of the Mental Capacity Act 2005 (MCA). The service did not undertake assessments on people known or suspected to lack mental capacity. Not all care workers were aware of the MCA and Deprivation of Liberty Safeguards and the impact this legislation could have on the delivery of care and support.

Newly recruited support workers were enrolled for the Care Certificate. This is a nationally recognised set of standards to be worked towards during the induction training of new care workers; it helps care workers develop the values, behaviours, capabilities and skills needed to provide high quality and compassionate care.

People told us and we saw positive relationships between people using the service, their relatives and the staff working at the service. Staff were familiar with people using the service and could tell us about people including their preferences, hobbies and interests.

The service encouraged people and their relatives to share their views about the service. One of the ways in which this was achieved was through weekly house meetings. The registered manager told us that they planned to reintroduce relatives meetings later in April 2016 and we saw the letter that had been sent to people and relatives informing them about this.

People were treated with dignity and respect and those who needed assistance with personal care were attended to discreetly. We noted that some staff were not always attentive to people using the service who were unable to communicate verbally.

People and their relatives told us the service was responsive to their needs and that the registered manager always tried to accommodate them.

The care plans we looked at were person-centred and contained detailed descriptions of people’s care and support and their preferences, indicating that people and their relatives had been involved and consulted in the care planning process.

The service encouraged people and their relatives to give feedback about the service provided in several ways including weekly house meetings, quality review questionnaires and informally in person or by telephone.

People and their relatives spoke well of the service and during our inspection we observed that there was a good relationship between people and the staff and management of the service.

There were gaps in how the service assessed and monitored the quality of its provision. While there were some quality assurance mechanisms in place, not all aspects of the service were being effectively monitored. We could not be sure that the registered manager had complete oversight of the service’s operations.

The registered manager felt supported by the wider network of colleagues within the organisation. Staff we spoke with also told us that they felt supported by the management team, helping them to function well in their caring role.