12 January 2017
During a routine inspection
The service is in the process of being decommissioned (withdrawn)by the local authority and on the day of our inspection only 13 people lived at the service The judgement in this report is based on the service meeting the requirements of the fundamental standards for those 13 people.
This inspection took place on 12 January 2017 and was unannounced.
The home was run by a registered manager, who was present on the day of the inspection visit. ‘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.
Staff had written information about risks to people and how to manage these. We found the registered manager considered additional risks to people in relation to community activities and changes had been reflected in people’s support plans. People who may harm themselves or displayed behaviour that challenged others had shown a reduction of incidents since being at the home.
Staff had received training in safeguarding adults and were able to evidence to us they knew the procedures to follow should they have any concerns. One staff member said they would report any concerns to the registered manager. They knew of types of abuse and where to find contact numbers for the local safeguarding team if they needed to raise concerns.
Care was provided to people by a sufficient number of staff who were appropriately trained. Staff were seen to support people to keep them safe. People did not have to wait to be assisted.
People received their medicines safely. Processes were in place in relation to the correct storage of medicine. All of the medicines were administered and disposed of in a safe way. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm. Staff understood their responsibilities in relation to capacity and decision making. This was in line with the Mental Capacity Act (2005) Code of Practice which guided staff to ensure practice and decisions were made in people’s best interests.
People were provided with homemade, freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. We were told by the registered manager that people could go out for lunch if they wished.
People were treated with kindness, compassion and respect. Staff took time to speak with the people who they supported. We observed positive interactions and it was evident people enjoyed talking to staff. People were able to see their friends and families as they wanted and there were no restrictions on when people could visit the home.
People were at the heart of the service; and took part in a wide range of community activities on a daily basis; for example trips to the shops, and attending an external day centre. The choice of activities was specific to each person and had been identified through the assessment process and the regular meetings held.
People had individual support plans, detailing the support they needed and how they wanted this to be provided. We read in the support plans that staff ensured people had access to healthcare professionals when they needed. For example, the doctor, the community learning disability team or the optician. People’s care had been planned and this was regularly reviewed with their or their relative’s involvement.
The registered manager told us how they were involved in the day to day running of the home. It was clear from our observation that the registered manager new the people very well and that people looked at them as a person to trust. Staff felt valued under the leadership of the registered manager.
The provider had a robust system of auditing processes in place to regularly assess and monitor the quality of the service or manage risks to people in carrying out the regulated activity. The registered manager had assessed incidents and accidents, staff recruitment practices, care and support documentation, medicines and decided if any actions were required to make sure improvements to practice were being made.
The registered manager kept up to date with any changes in legislation that may affect the service, and participated in monthly forums with other managers from other services where good practice was discussed. They pro-actively researched specialised publications and websites to identify innovative ways to enhance people’s quality of life and introduced these to the service.
The service notified the Care Quality Commission of any significant events that affected people or the service and promoted a good relationship with stakeholders.
Complaint procedures were up to date and people and relatives told us they would know how to make a complaint. Confidential and procedural documents were stored safely and updated in a timely manner.
Staff were aware of the home’s contingency plan, if events occurred that stopped the service running. They explained actions that they would take in any event to keep people safe.
People’s views were obtained by holding residents meetings and sending out an annual satisfaction survey which staff supported people to complete using different methods of communication.