The inspection took place on 2 February 2016 and was unannounced. Touchstones provides care and accommodation for up to 19 people and there were 18 people aged 35 to 80 years living at the home when we inspected. The service specialises in the care of adults with a mental health need.
The service had 11 single bedrooms and four doubles. There were two communal lounges and a conservatory as well as two kitchens, one of which people could use to prepare their own food and drinks between meals. The home had two shower rooms and two bathrooms; two of these also had a toilet. There were also four additional toilets.
The service did not have a registered manager and was being managed by the provider who had applied to the Commission for registration as 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.
Whilst risks to people were assessed, and, there were care plans to mitigate those risks, we found two areas where greater detail was needed to show all relevant information had been considered.
The environment was in need of attention in certain areas and action had not been taken regarding risks from hot water, falls from first floor windows and from hot surfaces such as radiators.
Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.
There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.
People received their medicines safely.
The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People at the service had capacity and the staff sought people’s consent about arrangements for their care.
There was a choice of food and people were involved in planning the menus. People’s nutritional needs were assessed so the right action could be taken if people were at risk of malnutrition.
Staff were skilled in working with people who had mental health needs although we identified staff training needed to be improved so staff had a more thorough knowledge base of specific illnesses.
People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular health checks.
Staff were caring and acknowledged people’s privacy. People commented that staff were understanding of people’s mental health needs and provided support during periods of distress. Staff had positive working relationships with people and offered informal counselling and listening to support people. The staff promoted people’s independence.
Care was provided to people based on their individual needs which we call person centred care. People were fully involved in the assessment of their needs and in care planning to meet those needs. Staff had a good knowledge of people’s changing needs and action was taken to review care needs.
Staff listened and acted on what people said and there were opportunities for people to contribute to how the service was organised. People knew how to raise any concerns.
The views of people, relatives and health and social professionals were sought as part a quality assurance process. The culture and ethos of the service was focussed on people being involved in the running of the service which in turn empowered people and helped build their confidence.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.