14 April 2016
During a routine inspection
The service provides accommodation and personal care for up to three adults with learning disabilities. At the time of this inspection there were three people living there. The service was last inspected on 11 and 20 May and 2 June 2015. At that inspection we found the service not safe, effective, responsive or well-led. The overall rating was ‘requires improvement’. At this inspection we found all breaches of compliance had been addressed. The management of the service had improved and the service was fully compliant with the Regulations.
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.
Two people living at 49 Regents Park had limited verbal communication skills and were unable to answer detailed questions about the service, although they appeared happy and relaxed. One person told us “I like living here.” We spoke with two relatives during and after the inspection who told us they were entirely happy with the care people received. Comments included “I am happy they are in safe hands. The staff at the moment are excellent” and “They look after all of them really well. They are happy.” They also told us the staff went “above and beyond” their duties by showing care and support for the whole family. The relatives were involved and consulted in all aspects of the service and told us “It feels like we are all part of an extended family.”
The provider had introduced new monitoring systems since the last inspection to ensure the home ran smoothly and to identify where improvements were needed by the provider. While we saw many examples of improvements to the service, for example the care plans were regularly reviewed and up to date, we also found some areas that needed to be improved such as their recruitment procedures. The provider and registered manager took prompt action to address these during the inspection as soon as the issues were brought to their attention. The provider also began to adjust their monitoring and quality improvement systems to ensure that in future they are pro-active in identifying and addressing all issues promptly.
On the whole, safe procedures had been followed when recruiting new staff. Checks and references had been carried out by the provider before new staff began working with people. The manager and provider gave assurances that where checks highlighted the possibility that applicants may not be entirely suitable, they took a range of actions to monitor and support new staff. However, these actions were not evidenced by clear risk assessments.
Medicines were stored and administered safely.
Staff rotas showed there were sufficient staff on duty each day to meet the needs of the people living there. This was confirmed by staff and relatives we spoke with. Staff received training, supervision and support to enable them to effectively support each person’s mental and physical health needs. New staff received thorough induction training before they began working with people. All staff received ongoing training on topics covering all aspects of their jobs.
Staff showed caring and understanding of each person’s individual needs. People were treated with kindness and respect. Staff had an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely. Applications had been submitted for people living in the home and were waiting for assessment by the local authority. Staff understood the importance of seeking consent before carrying out care tasks. We saw staff offering choices and seeking consent before carrying out any tasks for each person.
People had been involved and consulted in drawing up and agreeing a plan of their support needs as far as they were able. Their care plans were comprehensive, well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were regularly reviewed and updated. The care plans and daily notes provided evidence to show that people were supported to maintain good health.
On weekdays two people attended a day centre where they were able to participate in activities including cooking, gardening, arts and crafts and animal care. They also went out on shopping trips and outings. One person had chosen not to attend the day centre and therefore they received individual support from staff to do whatever they wanted to do each day, such as going for walks, shopping trips and visits to their family.
The home was well maintained, clean, warm and comfortable.