21 Potterill Lane is located in the east of the city of Hull and is registered to provide care and accommodation for up to a maximum of four people with a learning disability. Accommodation is provided in a large detached house with parking at the front of the building and a garden to the rear. The service is situated in the village of Sutton, close to local amenities.We undertook this unannounced inspection on 28 November 2016. There were three people using the service at the time of our inspection. At the last inspection on 23 April 2015, the registered provider was compliant in all areas we assessed.
At this inspection we found there was a registered manager in post. The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.
We found improvements were required to ensure monies belonging to people who used the service were held securely. During our inspection we saw a number of safety deposit tins were stored in an unlocked safe.
We found improvements also needed to be made to ensure records were accurately maintained in the service. This included fridge and freezer temperatures and food temperatures not being fully completed. The quality monitoring system had not been effective in identifying these shortfalls.
The majority of people who used the service had complex needs and were unable to tell us about their experiences. We relied on our observations of care and our discussions with staff and relatives involved.
The environment was found to be clean and tidy throughout, but improvements were required to ensure the safe storage of disposable gloves.
We found staff were recruited safely and there was sufficient staff to support people. Staff received training in how to safeguard people from the risk of harm and abuse and they knew what to do if they had concerns.
Staff had access to induction, training, supervision and appraisal which supported them to feel skilled and confident when providing care to people. This included training considered essential by the registered provider and also specific training to meet the needs of the people they supported.
Staff had received training in legislation such as the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and the Mental Health Act 1983. They were aware of the need to gain consent when delivering care and support and what to do if people lacked the capacity to agree to it. When people were assessed as not having capacity to make their own decisions, meetings were held with relevant professionals and other people with an interest in the care such as family members to discuss options and make decisions in the person’s best interests.
Medicines were ordered, stored, administered and disposed of safely. Training records showed staff had received training in the safe handling and administration of medicines.
We found staff had a caring approach and found ways to promote people’s independence, privacy and dignity. Staff provided information to people and included them in decisions about their care and support.
People who used the service had assessments of their needs undertaken which identified any potential risks to their safety. Staff had read the risk assessments and were aware of their responsibilities and the steps to minimise risk.
We found people’s health and nutritional needs were met and they accessed professional advice and treatment from community services when required. People who used the service received care in a person centred way with care plans describing their preferences for care and staff followed this guidance.
Menus were varied and staff confirmed choices and alternatives were available for each meal: we observed drinks and snacks were served between meals. People’s weight was monitored and referrals made to dieticians when required.
People who used the service were seen to engage in a number of activities both within the service and the local community. They were encouraged to pursue hobbies, social interests and to go on holiday. Staff supported people to stay in touch with their families and friends.
There was a complaints process and information provided to people who used the service and staff in how to raise concerns directly with senior managers. Relatives knew how to make complaints and told us they had no concerns about raising any issues with the staff team or the registered manager.