Shenehom Housing Association

Shenehom Housing Association is a residential care home providing personal care for up to 13 people in one adapted building. The service provides support to those with a mental health diagnosis. At the time of our inspection there were 11 people using the service.

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

The management team were well thought of amongst staff, people and relatives. Quality assurance systems were in place to support oversight of the running of the home.

However, we have made a recommendation that management ensure audits are addressed in more detail. The provider worked with a range of professionals to meet people’s presenting needs.

People felt safe living at the home and felt that staff treated them well. Risk management was clear in enabling staff to support people as safely as possible. Infection control processes were followed in line with government guidance. Medicines were managed safely

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.

Some staff training required updating, the service had a plan in place to ensure staff received refresher sessions. Staff were supported through regular supervision and appraisal. People were supported to eat and drink, as well as access healthcare professionals.

People felt well cared for, and that staff respected them. People were supported to be as independent as they could be. Where people had any religious or cultural needs these were accommodated, as well as the service celebrating a range of diverse events.

Care plans were clear and specific in guiding staff as to how they needed to meet people’s individual needs. People were encouraged to engage in activities that felt personalised to them across the home and in the community. Complaints processes were clear and managed appropriately.

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

Rating at last inspection and update

The last rating for this service was good (published 12 January 2018).

Why we inspected

This was an inspection based on the providers previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shenehom Housing Association on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection in September 2015 the service was rated Good. At this inspection we found the home remained Good and demonstrated that they continued to meet the regulations and fundamental standards.

The home had a manager in post who was in the process of applying for registration by the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 using the service at Shenehom were positive about the care and support provided. They told us that staff treated them in a kind and caring manner and felt their needs were being met.

Staff had continued to receive training and support which enabled them to carry out their role effectively. Staff were confident in their ability to raise concerns, were satisfied that their views were listened to and that their practice was supported through supervision.

People continued to have their health needs met, and their prescribed medicines were stored securely and managed safely. People received their medicines as prescribed. Records of medicines were accurate and well managed.

People continued to be protected against the risk of harm, abuse and identified risks. The service had embedded systems and process in place that gave staff clear guidance on how to mitigate identified risks. Staff knew how to identify, report and escalate suspected abuse. Staff received safeguarding and whistleblowing training.

People were supported by sufficient numbers of staff to keep them safe. Rotas were flexible to ensure people’s changing needs were reflected in staffing levels.

People were protected against the risk of cross contamination because the service had implemented systems and processes to ensure infection control was managed safely. People’s dietary needs and requirements were met. People continued to be supported to make healthy choices and were given access to a wide range of healthcare professionals.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. Staff had an adequate understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

The service ensured people’s needs were being met by the design and adaption of the premises. Changes to the environment were done in consultation with people as far as practicably possible.

People continued to be treated with compassion and kindness and to receive person-centred care. People had their right to privacy and dignity maintained. Staff supported people to be involved in decisions about their care and support and people were given information in a manner they understood to enable them to make decisions.

People were able to raise their concerns and complaints and the home had systems in place to ensure that people who found it difficult to speak up, had the opportunity to make their views known. People views about the service continued to be sought through regular house meetings and keyworker meetings with individuals. This enabled the home to act on any issues in a timely manner.

The service continued to be well led, with policies and procedures suited to the needs of people, regular communication between staff and people living in the home and secure maintenance of records and information.

Further information is in the detailed findings below.

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

Is the service safe?

During our visit we saw that the home safeguarding procedures were robust, staff were trained in how to use them and they were appropriately used. Staff understood how to safeguard people individually and as a group. Areas of concern including specific circumstances were recorded in the four support plans we looked at. People told us that they felt safe living at the home and we also saw that staff treated them with dignity and respect.

The home had systems that enabled the manager and staff to learn from events such as accidents, incidents, complaints, concerns, whistleblowing and investigations. These events were regularly reviewed and discussed during staff meetings, 1-2-1 supervision sessions and this reduced the risks to people and helped the home to improve.

There were policies and procedures that appropriate staff understood and used in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Training was provided for relevant staff to understand when an application should be made and how to submit one. There were no current applications submitted. This meant that people were safeguarded.

We toured the home and saw it was safe, clean and hygienic with well maintained equipment that was regularly serviced. This meant people were not put at unnecessary risk.

The staff rotas took people's care needs into account when decisions were made regarding how many staff were required on duty, their qualifications, skills and experience. This ensured that people's needs were met.

No staff were currently subject to disciplinary action and policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People had access to an advocacy service as required. This meant that people could access additional support.

The home assessed people's support needs with them and those that wished to contributed to their support plans. Any individual specialist input was identified in the support plans as required. Some of the four support plans we examined contained evidence that people had contributed to them and they confirmed this when we spoke with them. People told us "If I wanted something it would be provided" and "I'm interested in activities and like the bingo, quizzes and the music group".

The layout of the service enabled people to move around freely and safely.

The visiting policy and visitors' book demonstrated that people were able to see their visitors in private and that visiting times were flexible.

Is the service caring?

We saw that people were supported by professional, knowledgeable and attentive staff. The staff were patient and gave people encouragement when supporting them. One person said, "Staff are very supportive'. People's preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with this information.

People using the service and staff completed an annual satisfaction survey and there was a suggestion box, although the manager said this was not utilised often. Where shortfalls or concerns were identified they were addressed by the home.

Is the service responsive?

People regularly completed a range of activities in the community and at home. During our visit people went out for coffee and there was a computer training session taking place. We were told that there were a range of group activities that people could attend if they wished. People's support plans identified that they were enabled to be involved in activities within their local community and further afield such as holidays.

People said they knew how to make a complaint if they were unhappy.

Is the service well-led?

We saw that the manager and staff listened to people's needs, opinions and acted upon them. The service worked well with other agencies and community based services to ensure people received their care and support in a seamless way. This was demonstrated by the relationship the home had with the local authority 'Community Mental Health' and other teams and community based health services.

Appropriate notifications to the Care Quality Commission were made.

We saw that people were involved in the day to day running of the home, planning menus, cooking meals, doing their washing and choosing activities.

A person we spoke with said "I like the staff here; they are nice and help you".

We saw that the building was well maintained, some areas had been recently refurbished and people were able to personalise their own rooms. The communal areas were clean and provided enough room for people to do different activities including yoga, cooking, using a computer and watching television.

The staff we spoke with said they had received enough training for their role and felt supported by the senior staff.

People we spoke with said "I have been on five holidays this year", "I went shopping to Hammersmith with my keyworker" and "I like my room, I can have it how I like".

One person we spoke with said "I like it here" and "the other residents are very nice". Another person we spoke with said "I go and buy the newspapers and I disinfect the door handles".

We saw the communal areas were clean and tidy and the two lounges were comfortable and inviting. People were encouraged to use the kitchen and be involved in the food preparation.

A member of staff said "I think there is enough staff to support residents" and another person said "This is probably the best place I have worked in".