Trescott Road

Trescott Road is a residential care home providing personal care to up to seven people with complex disabilities. At the time of the inspection there were five people living at the home.

Trescott Road accommodates five people in one adapted building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Some people living at the home were unable to share their experiences with us, however relatives and visiting professionals told us they were confident people were safe. Staff knew how to identify and report concerns relating to people’s safety. Risks were assessed and managed to reduce the risk of avoidable harm. People received support to take their medicines safely. Staff were safely recruited.

Staff received training relevant to their role and understood people’s individual needs well. People were offered a choice of food and drink and where people had specific dietary requirements these were managed safely. People received support to manage their healthcare needs and staff worked proactively with other professionals to ensure people’s needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Decisions about people’s care and treatment were made in line with law and guidance.

People were supported by a caring staff team who respected people’s diverse needs and individual preferences. Staff supported people to make day to day decisions and understood the importance of maintaining people’s daily routines and choices. People were supported to maintain their independence and their dignity was valued and respected.

People were supported by a staff team who knew them well and understood their needs and preferences. People and their relatives were involved in the assessment and planning of their care. People were supported to participate in activities and follow their own interests. Relatives and visiting professionals knew how to raise a concern if they were unhappy about the care people received. The registered manager had responded appropriately to recent complaints.

Relatives, visiting professionals and staff felt the home was well managed. The registered manager had made improvements since the last inspection and were looking to further develop the quality of care people received. People and staff were given opportunities to share feedback about the service. The registered manager and senior staff undertook regular auditing to ensure the quality of care provided.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Trescott Road is a care home without nursing for up to seven people who live with learning disabilities and autism. At the time of our visit there were six people living at the home. The property is a purpose built home with accommodation on two floors and a stair lift to facilitate access.

There was a registered manager in place who was present throughout our inspection. 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 and their relatives told us that they felt safe living at the home. Staff we spoke with were aware of the types of abuse people were at risk of and how to report allegations or suspicions of abuse.

People’s risks were managed safely with the support of staff who had a good understanding of people’s support needs. Fire safety procedures had been discussed and practiced with people using the service.

Although action was taken to prevent the reoccurrence of accidents and to monitor risks to people using the service, records did not always reflect this practice. People could not be confident that they would always receive their medicines and prescribed creams safely.

People were supported by sufficient numbers of staff who had been suitably recruited, to meet people’s needs and participate in activities with them.

People were supported by staff who felt supported in their roles and demonstrated a good understanding of people’s needs and preferences, although not all staff had received required training for their roles. Staff meetings and handovers provided staff with the opportunity to receive and share updates about people’s needs.

People were supported in line with the principles of the Mental Capacity Act (2005). People were encouraged to make their own choices and decisions.

People were supported to eat and drink in line with their needs and preferences. Staff helped people to access healthcare support as and when required.

People were treated with dignity and respect and empowered by staff to express their views. People and staff enjoyed positive relationships and good interactions with one another. People were involved in their care planning and decisions about the home.

People were supported to participate in a range of activities in the home and community of interest to them and to promote their wellbeing. People were supported to have their needs met and additional guidance was sought from relevant healthcare professionals as required.

The registered manager was aware of areas of development at the home and was addressing these, including for example medicines audits and record keeping. Staff felt supported in their roles and able to share their concerns with the registered manager. The registered manager had taken care to create a home environment that was comfortable and person-centred for people using the service.

Trescott Road is a care home without nursing for up to seven people who have learning disabilities and autism. At the time of our visit there were seven people using the service. The property is a purpose built home with accommodation on two floors. There is a stair lift to facilitate access. People who live there help to look after a pet cat in the home.

The person who was named as the registered manager had left the service over a year ago. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a new manager at the home who had been in post since August 2015.

The provider had not ensured that the registration of the former manager had been cancelled. Although a new manager was in post their application to CQC to become registered as the manager was still outstanding and the provider had failed to ensure that a complete application had been submitted. You can see what action we have asked the provider to take at the back of the report.

People who used the service and their relatives told us that the home was safe. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice.

People were protected from possible errors in their medication because the arrangements for the storage, administration and recording of medication were good and there were robust systems for checking that medication had been administered in the correct way. The manager had taken the appropriate action when errors had been identified so people did not come to harm.

People who lived in this home and their relatives, told us that they were very happy with the care provided. People had opportunities to participate in a range of activities in the home and community which they said they enjoyed. Many activities people engaged in promoted their independence. People were supported to keep in touch with their families and friends.

People and, where appropriate, their relatives, were consulted about their preferences and people were treated with dignity and respect.

Staff working in this home understood the needs of the people who lived there and how to engage with people who could not communicate verbally. We saw that staff communicated well with each other and spoke highly of the management and leadership they received.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills. The manager had a good support network of manager’s from the provider’s other locations when they needed advice and guidance.

The manager and staff we spoke with understood the principles of protecting the legal and civil rights of people using the service. The appropriate actions were taken to ensure decision about people’s health care needs were made in their best interests

People were supported to have their mental and physical healthcare needs met and were encouraged to maintain a healthy lifestyle. The manager sought and took advice from relevant health professionals when needed.

People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs and suited their preferences.

There was effective leadership from the manager and senior members of staff to ensure that staff in all roles were well motivated and enthusiastic. The manager and provider assessed and monitored the quality of care through observation and regular audits of events and practice.

The manager consulted people in the home and their relatives to find out their views on the care provided and used this information to make improvements, where possible.

We spoke with four members of staff and the acting manager. People using the service had limited verbal communication skills. We observed how people were cared for and how staff interacted with them to get a view of the care they experienced. We spoke with two relatives of people living in the home and one regular visitor to the home.

We considered all of the evidence we had gathered under the outcomes that we inspected. Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that people's individual needs had been assessed and that there were enough suitably trained staff to support and care for people. We observed the interactions between the people who lived in the home and staff. People looked at ease in their surroundings. Staff spoke with them in a calm and friendly manner.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. No applications had been made. The acting manager understood how this legislation applied to people and protected their rights.

The service had robust safeguarding procedures in place. Staff were alert to the signs of abuse or potential abuse. They understood their obligation to report any concerns.

The provider monitored the quality of service provision.

We found that equipment was serviced at regular intervals to ensure it was safe to use.

Is the service effective?

People's care and health needs were assessed and planned for with the involvement of their relatives and professionals acting on their behalf if they were not able to express their opinions. Specialist mobility and equipment needs had been identified in care plans where required. This meant that people's care was planned and delivered in line with their individual needs.

It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and knew them well. We saw people's care plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

People living in the home were encouraged to maintain and develop their independence.

We saw the menus reflected the foods liked by the people who lived in the home and that choices were available.

Staff training was sufficient to meet all the needs of people using the service.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Staff told us how they communicated with people to ensure they could enable people to make choices and decisions on a daily basis.

People appeared settled and happy. The relatives we spoke with told us the home offered a good service. One relative told us, 'He is very calm and contented. They (the staff) pay attention to him. They (the staff) let me know if he is unwell.' Another relative said, 'The care staff give is excellent. They (the staff) always seem to try really hard with the people living there.'

We saw that people were supported to take part in a range of activities of their choice. This ensured people led fulfilling lives. People were supported to maintain relationships that were important to them. People's preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw people's care plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

People regularly completed a range of activities in and outside the service. The home had access to transport which helped keep people who were unable to use public transport involved with their local community.

Records showed that staff responded quickly to changes in people's health. We saw people had access to a variety of health care providers to ensure their needs could be met.

Is the service well led?

There was an acting manager in post since at the time of the inspection. The acting manager was experienced and caring and provided good leadership based on how best to meet the needs of people in an individualised way.

Staff were supported to meet the needs of people through the provision of regular training, supervision and staff meetings that enabled good practice to be developed.

There was a system in place to monitor the quality of the service provided. This included audits of all aspects of the care and support given to people and the views of relatives and other people who visited the home. The acting manager was able to give us examples of actions taken and changes that had been made as a result of listening to the relatives of the people who lived in the home.

The design and layout of the premises were suitable for people who used it. The home was warm and clean and the communal rooms were large and spacious with sufficient room for people's wheel chairs to move around. We found that there were good systems in place for staff to carry out regular health and safety checks around the premises including the fire safety equipment and installations. The provider had contracts in place to regularly test, inspect and service installations such as the central heating systems, the fire detection system and lifting equipment.

Most people who used the service at the time of our inspection required specialist equipment. We found that people had the equipment they needed and it was kept clean and regularly inspected and serviced.

We found the service being delivered to people was consistent with what the provider's statement of purpose offered.