This was an announced inspection carried out on 07 February 2017. The registered manager was given one hour notice as we needed to be sure that someone would be in to assist with the inspection. This is the first inspection since the service was registered with us in June 2016.Colenso House provides accommodation and support with personal care for up to five adults with learning disabilities who may also have mental health needs. At the time of our visit, there were two people using the service.
The service had 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.
The provider had measures in place to ensure the environment was suitable and safe for people using the service, as well as staff. However, people were at risk of drinking contaminated water because the shower heads in the bathrooms could drop below the water level or could reach the bottom of the shower trays.
We also noted people did not have a Personal Emergency Evacuation Plan (PEEP) to guide staff about how to safely evacuate them in the event of a fire. We advised the registered manager of this and also made a recommendation for the provider to update risk assessments for people.
People were supported to eat and drink enough and were given choices when planning the menus. Where they had any special dietary requirements, this was catered for. However, their medicines were not managed safely as they did not always receive their medicines at the required times and in the way they had been prescribed.
There were sufficient staff available to meet people's needs. Staff received training in a variety of areas to ensure they had the skills to meet people's needs. However, staff did not receive suitable inductions when they started their employment.
The management team did not always demonstrate effective quality assurance of the service and the registered manager was being supported by an external consultant.
Staff had access to relevant safeguarding guidance and contact numbers. They were aware of their roles and responsibilities to report any potential safeguarding incidents. Risks to people had been assessed and there was guidance in place on how to manage them safely.
Staff and people told us the management team were supportive, approachable and friendly. There were systems in place to routinely monitor the safety and quality of the service provided but they were not always effective.
People had access to other healthcare professionals and staff had a good understanding of their needs. They were supported to express their views and to make decisions about their care. We found the staff interacted well with people and respected their privacy and dignity. People were encouraged to take part in household chores and their independence was promoted.
People's consent was sought as appropriate and where people lacked the capacity to consent to decisions, legal requirements were met. People’s records reflected their current health needs including any advice given by other healthcare professionals. This enabled staff to deliver safe care.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we have asked the provider to take at the back of the report.