The inspection took place on 5 January 2015. Edward Gibbons House is a 24-hour supported housing project and recovery hub. It provides personal care, support and temporary accommodation for single homeless men with complex support needs linked to poor physical and mental health due to alcohol or drug misuse.
The project has 30 bedrooms and five bedsits and catering is provided. Referrals come from the London Borough of Tower Hamlets.
The service had a registered manager in post. 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.
Safeguarding allegations were not reported to the CQC as required. However, staff were able to explain the possible signs of abuse.
Risk assessments contained some detailed information on some known risks to people, but we saw one set of risk assessments was incomplete. Staff told us they had not received any guidance or training in how to handle the known risks to this person.
Staff received first aid training and were able to correctly explain how they would respond to a medical emergency. There were enough, safely recruited staff available to meet people’s needs. Staffing numbers were adjusted depending on people’s individual requirements.
Medicines were managed safely. Records were kept when medicines were administered, and appropriate checks were undertaken by staff. Records were clear and accurate and regular auditing of medicines was undertaken.
The service was not meeting the requirements of the Mental Capacity Act 2005 which is a law to protect people who do not have the capacity to make decisions for themselves. We did not see evidence of mental capacity assessments being completed for two people with fluctuating capacity.
Recruitment procedures ensured that only people who were deemed suitable worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with a range of ongoing training, but we noted that some training was out of date. Staff received regular supervision to support them to meet people’s needs. However, the registered manager confirmed they were delayed in conducting annual appraisals of staff performance to carry out their role.
People were supported to eat and drink a balanced diet that they enjoyed and appropriate advice regarding their nutritional needs had been obtained from their GP where required. People were supported effectively with their health needs and had access to a range of healthcare professionals. Healthcare professionals spoke positively about their working relationship with staff at the service.
People told us staff treated them in a caring and respectful way. People’s privacy and dignity was respected and we observed positive interactions between people and staff throughout our visit. Staff demonstrated a good understanding of people’s life histories and their individual preferences and choices.
Staff and people who used the service felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was an effective complaints policy and procedure in place. We found complaints were dealt with appropriately and in accordance with the policy.
The registered manager had not followed CQC reporting requirements in relation to safeguarding incidents and the completion of a Provider Information Return.
The service carried out regular audits to monitor the quality of the service and to plan improvements. Where concerns were identified action plans were put in place to rectify these. However we did not see evidence of care plan audits which could have identified the shortfalls we found in these records during our inspection.
Staff worked with other organisations to implement best practice. We saw evidence of multi- disciplinary team working and this was monitored to ensure best outcomes were achieved for people. The service also had good links with the local community. People told us they participated in activities at local recovery teams and that they enjoyed doing so.