7 April 2016
During a routine inspection
The Warren provides accommodation and support for up to three people. Accommodation is provided in two semi-detached houses at the end of a residential cul-de-sac. There were two people living at the service during our inspection, each had their own defined living space. There were also areas which were communal, such as a lounge, kitchen and garden. The age range of people living at the service was 29 – 39.
The service provides care and support for people living with autism and other learning disabilities.
People presented behaviours that could challenge along with self-harming behaviour. Both people had been living at the service for over six years. The provider leased the properties from a third party and had not renewed this arrangement. Therefore the service was scheduled to close at the end of June 2016. There were transition plans in place for the two remaining people to move to other services the provider ran locally.
A registered manager was 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 and associated Regulations about how the service is run.
Records identified an occasion when guidance put in place to keep a person safe had not been followed by a staff member; this failing had resulted in the person presenting behaviours that challenged which may have been avoided.
Not all hazards associated with fire had been considered in the providers risk assessment in regard to an emergency exit.
People’s mental capacity had been assessed for a range of daily living requirements, however not all restrictive practice had been considered in accordance with the principles of the Mental Capacity Act (MCA).
Although there were a range of quality assurance processes designed to assess and improve the effectiveness of the service these had not consistently identified shortfalls in administration. For example in regard to historic information in care plans not being updated or removed.
Risk assessment had been completed for a broad range of areas. These provided clear descriptions and guidance for staff to deal with perceived and apparent risks. Appropriate checks and routine servicing to the building and equipment were undertaken to keep people safe.
There were sufficient numbers of suitably qualified, competent staff deployed to meet people’s needs. These staff had the skills and experience to support people effectively.
Medicines were managed safely in accordance with current regulations and guidance. Medicines had been stored, administered and reviewed appropriately.
People had access to healthcare professionals when required. This included GP’s, dentists, opticians and chiropodists. Staff were aware of their responsibilities to monitor people’s changing health care needs.
Care was responsive and met people’s individual care needs. There was clear guidance and strategies in place for staff to support and manage people’s behaviours that challenged.
People were provided with opportunities to take part in their chosen activities ‘in-house’ and to regularly access the local and wider community. People were supported to take an active role in decision making regarding their own routines and those of the home. Staff offered clear explanations to people in ways they understood. Staff were seen to be kind and caring to people.
Relatives and staff spoke positively of the leadership of the service. Staff had regular supervision and told us the registered manager listened and responded to their concerns and they felt supported.