Archived: Lowther Street

Lowther Street is both a ‘care home’ and the location for the delivery of community based services. The service has three distinct functions. 81 Lowther Street is a care home which provides short term, crisis intervention for people who need support due to mental health issues. The provider also delivers personal care to people in supported living services and to people living in their homes in the community who may be living with mental ill health.

The home can accommodate up to six people for short term care. Two people were in residence when the inspection started. A further five people were identified as receiving personal care in the supported living services and in the wider community. Other people did not need this level of care. We only looked at the care and support of people in receipt of personal care.

The service had a suitably qualified and experienced registered manager. 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.

Staff had received training on ensuring people were kept free from harm and abuse. The Richmond Fellowship had suitable arrangements for staff to report any concerns.

Good risk assessments and emergency planning were in place. Accidents and incidents were monitored and analysed and action taken to reduce risks. People had contingency plans to support them in a mental health crisis.

We saw that staffing levels were suitable to meet the assessed needs of people in the service. Staff recruitment was thorough with all checks completed before new staff had access to vulnerable people. The organisation had suitable disciplinary procedures in place.

Medicines were appropriately managed. Some people were supported to take their own medicines. People had their medicines reviewed by their GP and specialist health care providers.

Staff were trained in infection control and supported people in their own environment. The care home was clean and orderly as was the environment for two people we met in supported living.

The staff team had been supported to develop appropriately. Staff were keen to learn and we saw that induction, training and supervision had helped them to give good levels of care and support. All staff had received updates to their training in line with the policies of the new provider.

Staff received good levels of training around principles of care in relation to people living with mental ill health. They were trained in specific techniques to support people with varied disorders. Restraint was not used in this service.

Consent was always sought from individuals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to get good health care support from their own GP, specialist nurses and consultants. Staff worked with people to support and encourage them to visit health care providers.

Staff supported people to shop, budget and cook. People were helped to take good nutrition and were encouraged to eat healthily.

The care home was an older property that people felt met their needs. An upgrade to the building was being planned to reconfigure shared spaces and to provide ensuite facilities to bedrooms.

Staff we spoke to displayed a caring attitude. Staff understood how to support people to maintain their dignity and privacy. Staff showed both empathy and respect for people living with mental health issues. People in the service had access to advocacy.

Everyone supported by the service had been appropriately assessed. Person centred assessments and plans were in place. These were created in an electronic format and staff changed them when needs and wishes changed. Reviews of care were in place. In the crisis intervention house reviews were conducted by staff and the care co-ordinator during and after the stay. People living in the community or in supported living were reviewed internally and from time to time by social workers and other mental health professionals.

People were encouraged to go out and to engage, where possible with varied activities. The staff 'sign posted' people to community opportunities but were aware that people in crisis might find this difficult. We saw some good outcomes for people who were able to engage more with activities in the community.

Complaint procedures were in place. There had been no complaints received about the service.

The service had a suitably trained, qualified and experienced registered manager. Staff told us he was very visible in the service and easy to approach.

We judged that the registered manager had created a culture of openness and that staff worked in a non-discriminatory way. The atmosphere was one of enthusiasm and eagerness to continue to develop the service.

The Richmond Fellowship had a suitable quality monitoring system. We saw internal audits and records of visits by senior officers of the provider. Good monitoring and analysis of the service was in place.

Staff and other people involved with the service were satisfied that the management arrangements were appropriate and that matters of governance were being followed to give good levels of care and support.

The local mental health teams were satisfied with the joint work they did with the service.