Archived: High Street

During the inspection we spoke with the provider, the administrator and the staff member on duty in the home. We also spoke with three of the people who lived in the home.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We looked at the safeguarding policy and the whistle blowing policy. They were available in the office used by the staff. The staff member we spoke to was aware of the policies and how to access them. There was also a copy of the local authority safeguarding procedure. The staff member described to us a number of issues where the staff had developed strategies to manage concerns to minimize the risk of abusive incidents occurring.

We spoke with staff and asked about their understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and what they would do if a person was not able to give their consent. The staff member was clear about the processes that would need to take place to support the person safely.

Is the service effective?

We spoke to three people who lived in the home. They told us that they were very happy with the support they received and the staff who provided it. People's needs were assessed and care and treatment was planned and delivered in line with their individual support plan. We looked in some detail at the care and support provided to three people who lived in the home.

These records included the person's support plan, risk assessments, and records about the support they had received from professional people outside of the home. We found the information in people's support plans was detailed and they clearly reflected people's individual wishes and choices. Support plans also included detailed pieces of information and guidance about particular aspects of people's care. We saw that some people had very clear wishes about how they wanted staff to support them in particular situations. We saw that this was documented and that staff were aware.

Is the service caring?

We spoke to three people who lived in the home. They all told us that they liked living at the home and staff assisted them in the way they wanted. Comments included; "staff were very nice and very helpful" and "Staff help me with appointments." They told us they were informed and consulted on changes to their care and treatment. One person told us how they were involved in their care and were supported to do their own shopping and to go out on visits to places they liked.

From our discussions with staff and our observations it was evident that staff knew people well and were providing support based on people's individual needs and choices. Staff were able to tell us about how they communicated with people living in the home and they were able to describe people's skills, needs, likes, dislikes and lifestyle choices.

Is the service responsive?

We saw that risks were very clearly identified and that risk management plans were discussed and agreed with the individual person. We saw that staff had drawn up an action plan in conjunction with the person to agree how the staff would support them during difficult periods. We saw that other health professionals had also been part of these discussions. We saw that the home worked very closely with a variety of health professionals including social workers and community psychiatric nurses.

Upon reviewing records we noted that the provider had not always notified CQC of notifiable incidents. For example, we highlighted that we had not been notified of an incident when the police had been called to deal with a situation of concern. Failure to inform the Care Quality Commission of a notifiable incident is an offence under the Care Quality Commission (Registration) Regulations 2009 and may place the welfare of vulnerable people at risk. We discussed our concerns with the provider and they told us they would take immediate action to ensure that future incidents were correctly reported.

Is the service well led?

We looked at the training records and saw that all staff were receiving regular training. We also noted that training had been planned and booked for the coming year to ensure that all mandatory updates were completed and staff had been informed of the dates they need to attend in advance. We saw that specific training was provided for staff in order to meet the needs of the people they were supporting such as dealing with deliberate self harm, dual diagnosis and violence and aggression.

We were told by the administrator that senior support workers were also provided with clinical supervision every two months by a health care professional outside of the organisation to enable them to seek confidential support. We also spoke with one support worker who told us that the provider and registered manager had arranged for them to receive clinical supervision outside of the organisation, as they recognised that this staff member was supporting a person who used the service through a very stressful period. The staff member told us that they felt supported in their role and the demands of their job were recognised by the management team.