UBU - 67 Elland Road

UBU – 67 Elland Road is a residential care home providing regulated activity/activities (e.g. personal care) to up to 7 people. The service provides support to people who have learning disabilities and complex needs. At the time of our inspection there were 6 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

Staff supported people to have the maximum possible choice, control and be as independent as possible. Staff promoted people having control over their own lives. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to achieve their aspirations and goals. The service gave people care and support in a safe, clean, well-equipped environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines to ensure the best possible health outcome. We have made a recommendation about management of medicines.

Right Care

Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood, responded to and advocated for their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people's needs and keep them safe. Staff understood people's individual communication needs. People's care, treatment and support plans reflected their range of needs and this promoted their wellbeing and fulfilment of life.

Right Culture

People received good quality care, support and treatment with the support of trained staff and specialists. Staff knew and understood people very well and were responsive, supporting their wishes to live a quality life. People’s relative and those important to them were involved in planning their care. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. Relatives and staff felt well supported by the management team and able to raise concerns with them. They felt concerns were acted on and lessons learnt when things went wrong. There were systems to monitor and audit the service to help improve quality and people's experiences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service Choose an item this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good 26 June 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home had a range of policies and procedures to manage any risks associated with the COVID pandemic.

There were sufficient supplies of personal protective equipment (PPE) available for people. Hand sanitiser and hand washing facilities were readily available throughout the home. Staff had been trained in infection prevention and control (IPC) and the use of PPE.

Daily cleaning schedules were in place. All cleaning was undertaken by the day and night staff, which included touch point and deep cleaning.

A programme of COVID testing for both people living in the home and staff was undertaken in line with current government guidance. Appropriate procedures were in place should anyone display any symptoms or test positive. All visitors, including healthcare professionals, were subject to a range of screening procedures. This included showing evidence of vaccination, an up to date negative COVID test, temperature check and completion of a COVID-19 visitor form. Visitors were also asked to complete the visitors’ book.

Staff supported the social and emotional wellbeing of residents and had done so throughout the pandemic. Due to the complex needs of the residents, the staff had adapted the environment to take into account the residents’ sensory needs, whilst maintaining infection prevention and control measures.

UBU - 67 Elland Road is registered to provide accommodation and personal care for up to seven people who have learning disabilities.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection took place on 16 and 17 May 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.

At the last inspection we found the provider did not always keep accurate and up to date health action plans and were rated requires improvement in the effective domain. At this inspection we found health action plans were accurate and updated to ensure people’s needs were met.

There was no registered manager in post at the time of our inspection. However; the area manager was in the process of applying as a temporary measure until the manager could apply. 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.

Care plan records were not always accurate to show when actions had been taken, therefore we have made a recommendation about records management.

The provider had robust systems and procedures in place to keep people safe and staff were competent in their knowledge of what constituted abuse and how to safeguard people. There was a whistleblowing policy in place and staff knew how to raise concerns should this be required.

Medicines were managed safely although we did find gaps in recording when medicines had been administered. ‘As required’ medicines were administered when needed.

Risk assessments had been completed and reviewed regularly. Accidents and incidents were managed effectively and actions taken to mitigate future risks.

Staffing levels were sufficient to meet people’s needs and robust recruitment processes were in place to ensure people were of suitable character. Training was mandatory for staff to ensure they had adequate skills and knowledge to meet people’s needs. Staff were supported with supervisions and appraisals for further development.

Safety checks were completed regularly and the premises was clean, tidy and action plans showed continuous improvements were being made within the home.

The provider followed the Mental Capacity Act 2005 (MCA) guidance with capacity assessments and Deprivation of Liberty Safeguards (DoLS) applications made. Staff also understood MCA guidance and people were able to provide consent in a variety of ways including through facial expressions and body language.

People’s nutritional needs were met and health professionals were involved in people’s care when required. Health action plans were used when people had health appointments and records showed the improvements made to people’s health.

We observed positive and friendly interactions between the staff and people living in the home. Staff were caring, kind and respected peoples wishes. We saw people were encouraged to remain as independent as possible using alternative communications to allow people to make choices about their care.

People’s privacy and dignity was respected and staff provided explanations when carrying out any personal care to ensure people knew what was happening at all times.

Care plans were person centred and reviewed regularly with people living in the home and their relatives. Care plans included people’s preferences, likes and dislikes.

Complaints were managed and actions taken to prevent future occurrences. The provider had also received a number of compliments about the care provided by staff.

Relatives and staff told us the team were supportive of each other and the manager was visible and approachable. The staff had recognised improvements that had been made by the manager and felt these were positive.

Regular meetings took place with people living in the home, staff and relatives to obtain feedback and inform people of changes within the home.

The provider had quality assurance systems in place to recognise and rectify issues which included audits. Surveys were used to gather people’s views and ensure actions were taken to improve the quality of care being provided.

UBU - 67 Elland Road is registered to provide accommodation and personal care for up to seven people who have learning disabilities.

At the time of this inspection the home had a registered manager. 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.

Staff identified recent staffing levels had been difficult to manage due to absences. The registered manager identified two new members of staff were joining the team pending satisfactory background checks.

Staff were able to identify types of abuse and knew who to report their concerns to if they suspected a person was being harmed. Recruitment practices were safe with appropriate checks having been carried out. People’s individual risks had been identified and assessed and this was reviewed on a regular basis.

Health action plans did not capture the person’s current health needs and.did not match information recorded in care plans. Peoples’ care plans showed health professionals such as PEG nurses, community nurses, neurology and occupational therapists were involved in their care.

People were encouraged to be part of the meal planning process and daily intake notes were completed as required. Staff were supported through an induction process and there was a programme of refresher training sessions which most staff had completed. Staff received regular supervision sessions which were effective, although not all staff had received an appraisal.

This service acted within the principles of the MCA and DoLS and staff were aware of how this affected their role. Positive interactions between staff and people were seen during the inspection. Staff were aware of how to protect people’s privacy and dignity.

People’s care plans were sufficiently detailed and staff agreed these were a good reflection of people’s needs. Care plans were reviewed on a regular basis with the involvement of relatives. People accessed a number of activities both in the community and in the home. Where one person had become dissatisfied with a particular activity, the service had responded by changing to a different type of support which the person enjoyed.

Appropriate systems were in place to manage complaints, although none had been received since the last inspection which concerned the care provided. There was a positive culture within the service and staff felt the registered manager was approachable and listened to them. This was reflected in the quality of supervisions and staff meetings.

The service had quality management systems in place, although we saw identified actions were not always followed up. The registered manager completed weekly and monthly checks and followed up on any concerns. The area manager regularly visited the home and carried out their own audits.

We found a single breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.

The manager of the service was on leave at the time of the inspection. We therefore spoke with the deputy manager.

We found the provider had addressed all the issues raised at the last inspection.

The broken tiles in the downstairs bathroom had now been replaced. This ensured the tiles could be cleaned to a sufficient standard to prevent the risk of infection. We saw the underside of the chair seat, which assisted people into the bath, was free from dirt and grime.

A daily routine cleaning checklist was in place. We saw evidence the cleaning schedules were being completed. Daily records of the fridge and freezer temperatures had been recorded the majority of the time. Where they had not been recorded, we saw evidence the management team had picked up on this and had addressed the issue with the member of staff concerned.

Overall, we found people were protected from the risk of infection because appropriate guidance had been followed.

People experienced care, treatment and support that met their needs and protected their rights. We saw good examples of interactions between staff and people using the service. One member of staff we spoke with told us: 'We have a really good and supportive team.'

People were not protected from the risk of infection because appropriate guidance had not been followed. We looked around the premises to determine cleanliness and management of infection control. We found there were not effective systems in place to reduce the risk and spread of infection.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We observed that people looked well cared for and staff were attentive to their needs. The atmosphere within the home was relaxed and friendly and people were smiling and looked happy. Staff we spoke with had a good understaning of each individual and were able to taell us about their personal prefernces and what they enjoyed doing. .