Archived: Maryfield

The inspection was announced. We gave the registered manager 48 hours notice of the inspection. We did this to ensure key staff and people who were supported with personal care, were available for the inspection. At the time of the inspection the service was providing personal care to two young people – the other eight ‘tenants’ received housing and social support only.

The last inspection of the service was in September 2016. At that time the service was rated as Requires Improvement. There was one breach of the regulations : Regulation 18 Care Quality Commission (Registration) Regulation 2009 – Notification of other incidents.

Following the inspection we told the provider to send us an action plan detailing how they would ensure they met the requirements of that regulation. At this inspection we saw the provider had taken action as identified in their action plan and improvements had been made. In addition they had sustained previous good practice. As a result of this inspection the service has an overall rating of Good.

Why the service is rated Good.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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. The registered manager is also responsible for registered services run from two other nearby care services.

The service people received was safe. There were effective safeguarding systems in place and all staff had received safeguarding training. Staff knew what to do if safeguarding concerns were suspected or witnessed. Safe recruitment procedures ensured unsuitable workers were not employed. Any risks to people’s health and welfare were assessed and management plans put in place to reduce or eliminate that risk. There were sufficient numbers of care and support workers employed to meet people’s needs.

Where people were supported with their medicines this was done safely. Staff received safe administration of medicines training and their competency to support people properly was reviewed. The staff took appropriate measures to prevent and control any spread of infections.

The service was effective. People’s care and support needs were assessed prior to taking up tenancy at Maryfield. This was to ensure the supported living environment and care services were appropriate to meet care and support needs. The care and support workers were well trained and had regular supervision sessions with the registered manager.

People were supported with meal preparation where this had been identified as one of their care and support needs. In order to assist people to gain life skills, the care and support workers helped them undertake these tasks independently. People were supported to access any health care services they required.

People’s capacity to make decisions for themselves regarding their care and support was assessed and kept under review. The staff were aware of the principles of the Mental Capacity Act 2005 and understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a caring service. The care and support workers were passionate about supporting the people they worked with. People were treated with kindness, respect and dignity. People were including in making decision about their care and in planning the care and support they received.

The service was responsive and provided each person with a person centred service. Each person had a person centred plan of care and support and the staff team were able to provide this support flexibly. There was continuity of care as the staff team was small. Feedback was gathered from people regarding their views and experience of the service they received. Action was taken if people had complaints or concerns. The service used feedback to improve care delivery in response to people’s views and opinions and drive forward improvements.

The service provided was well led because of the good leadership and management in place. The quality and safety of the service people received was assessed and monitored and any areas needing improvement were identified and addressed.

The inspection took place on 27 and 28 September 2016.. This was an announced inspection, which meant the provider was given notice. This was because the location provides a supported living service to people in their own flats and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf. The service had not previously been inspected.

A registered manager was employed by the service. 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.

People told us they felt safe and staff were responsive to their needs. Systems were in place to protect people from abuse. Staff had a good understanding of safeguarding and whistleblowing procedures. They knew how to report concerns and had confidence in management that these would be fully investigated to ensure people were protected.

Risks to people’s personal safety had been assessed and plans were in place to minimise these risks. This had been regularly reviewed and was signed by the person concerned to show their agreement.

The training record showed not all staff had received updated medicine training, and there was confusion over if staff had recently attended. The registered manager took action by booking these staff members onto the next available course and removing them from administering medicines until this training had been completed.

Documentation relating to mental capacity assessments and best interest decisions had not been kept on people’s files at the service to ensure that staff acted in accordance with decisions made. The registered manager sourced this paperwork from the relevant authorities and we were able to ensure people were being appropriately cared for.

People’s changing needs were monitored to make sure their health needs were responded to promptly. Health action plans were in place which recorded any medicines people were taking and health appointments attended.

People told us they were happy with the care they received. One person commented “I would not have had the confidence to speak to you before I came here". Staff encouraged people to be independent and take responsibility over their daily activities. Relatives also commented that their loved one’s had become more independent.

Information relating to people’s needs in care plans had not always been fully completed or documented. We saw examples of inappropriate terminology and systems in place to describe and monitor people’s behaviour.

The service had good links with the local community. Staff were proactive and made sure that people were able to maintain relationships that matter to them.

Not all reportable incidents about significant events had been notified The Care Quality Commission (CQC). This information is used to monitor the service and ensure they responded appropriately to keep people safe. Notifications that had not been received included incidents of abuse, incidents with police involvement and events that stop the service from running as it should be.

We found one breach of the regulations. You can see what action we told the provider to take at the back of the full version of the report.