The inspection took place on 24 & 25 October 2017and was announced. Our last inspection of Bowersdale Resource Centre took place in October 2016. During this inspection we found the service was in breach of regulations relating to person centred care, safe care and treatment and the governance of service. The service was rated as Requires Improvement. Following our inspection in October 2016, the provider sent us an action plan detailing what steps they were going to take to ensure the breach was met. We checked this during this inspection and found that the service had made the required changes.
Bowersdale Resource Centre provides personal care and support to people in their own homes and in supported living in the Sefton and Liverpool areas of Merseyside. At the time of our inspection 96 people received Outreach support and 56 people were living in 24 hour support living settings.
During our last inspection in October 2016 we found the service in breach of regulations relating to person centred care. This was because people’s care was not planned so it was personalised to reflect their current and on-going needs and was not regularly reviewed. We checked this during this inspection and saw that the registered manager and acting manager had Implemented new care planning documentation which contained personalised care plans.
Also at the last inspection in October 2016 we found the service in breach of regulations relating to safe care and treatment. This was because Medication Administration records (MAR) were not always completed in line with the service’s policies and good practice guidance and staff were not checked to ensure they were competent to administer medicines. We checked this during this inspection and saw that the provider had introduced an improved MAR and appraised staff of the new requirements. We looked at the new process and found it promoted safe administration of medication. The service was also found to be in breach because risk assessments were not always in place to minimise risk .We checked this during this inspection and saw that the provider had introduced new care planning documentation which included risk assessments, which meant individual risk assessments were completed.
At the last inspection in October 2016 we found the service in breach of regulations relating to governance. This was because we found key areas of quality and safety required further development so that people being supported were not exposed to potential risk. We checked this during this inspection and saw that the provider had formulated a new checking and auditing system which helped ensure people received support which met their needs and kept them safe. A new checking and auditing system helped assure managers that staff had administered medication; regular reviewing of people’s support now took place and care records were regularly checked to ensure support plans and risk assessments were completed. The service was no longer in breach of these regulations.
The service has two registered managers in post. A registered manager oversees the Outreach service and another oversees the supported living service. The role of the registered manager for the Outreach service was being covered for the period of maternity leave by another manager in 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.’
Some people received staff support with their medicines. They told us they received it at the right time. Staff administered medicines safely.
Risk assessments had been undertaken to support people safely and in accordance with their individual needs.
Staff spoken with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.
The provider had robust recruitment procedures in place to ensure staff were suitable to work with vulnerable adults. Staff received an induction when starting their employment.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.
Staff were trained to ensure that they had the appropriate skills and knowledge to meet people’s needs. They were well supported by the registered manager.
People told us the staff had a good understanding of their care needs and people’s individual needs and preferences were respected by staff.
People at the home told us they were listened to and their views were taken into account when deciding how to spend their day.
Care plans provided information to inform staff about people's support needs, routines and preferences.
An electronic system was used to allocate staff to calls and informed of staff unavailability because of holiday leave, days off or sickness. The system showed when staff had arrived at a call. People in the main received the same staff to support them.
People told us staff were kind and polite. We observed positive interaction between the staff and people they supported.
A process for managing complaints was in place. People we spoke with knew how to raise a concern or make a complaint. However the service had not received any complaints since the last inspection.
People receiving the service and relatives told us they were able to share their views and were able to provide feedback about the service. Feedback we received was mainly complimentary regarding the service.
Systems and processes were in place to assess, monitor and improve the safety and quality of the service.