Archived: Livability Remus Gate

Remus Gate accommodates three people in one adapted residential house on a residential estate. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection took place on the 22, 23 and 28 February 2018 and was announced. We had previously inspected this service in March 2016, at that inspection the service was rated ‘Good’. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The was 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.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the polices and systems in the service supported this practice.

People developed positive relationships with the staff who were caring and treated people with respect, kindness, dignity and compassion. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive. Information was available in various formats to meet the communication needs of the individuals.

The service had a positive ethos and an open culture. The registered manager was approachable, understood the needs of the people in the home, and listened to staff. There were effective systems in place to monitor the quality of the service and drive improvements.

There was a registered manager in post at the time of our inspection. 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.

People felt safe in their own home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There were sufficient staff to meet the needs of the people and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Care plans were written in a person centred approach and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People had caring relationships with the staff that supported them. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to. There was a stable management team and effective systems in place to assess the quality of service provided.

Is the service caring?

People were supported by staff who were attentive to their needs. We observed staff discussing options available to people to enable them to make decisions. Staff gave people time to make their decisions about what activities they wanted to do. We overheard staff talk with people in an encouraging and sensitive way, which evidenced their knowledge of people's individual needs. People's preferences, interests, personal objectives and diverse needs had been recorded and care provided in accordance with their wishes. We found that whenever possible people had been involved in the planning of their care and support requirements and their wishes had been respected.

Is the service responsive?

We observed a care worker offering people support in carrying out tasks in the kitchen when they could not fully manage. People had chosen the activities and staff had made arrangements for them to be fulfilled. For example, food shopping, going to clubs, accompanying people to take walks. Care and support plans had been developed with the person who was using the service or their representatives. The service worked well with external professionals such as, social workers and psychiatrists to make sure people received appropriate standards of care. Changes in people's needs had been recorded in the care and support plans. This ensured that all staff had been made aware of any changes in people's care and support needs.

Is the service safe?

People were treated with dignity and respect by staff. People were protected from abuse. Staff understood the signs of abuse and demonstrated that they knew how to respond to them. We found that the provider had ensured that there were adequate staffing levels to ensure that people received appropriate care and support. Senior staff monitored and reviewed staffing levels that enabled them to ensure that staffing levels remained consistent with people's needs. We spoke with staff and found that they were knowledgeable about their responsibilities and the ethos of the service. People had individual risk assessments in place. We found generic risk assessments for areas such as, the premises, fire and health and safety. These ensured that staff provided care in a safe environment to prevent accidents wherever possible.

Is the service effective?

People who used the service had been given appropriate information and support regarding their care and support needs. We saw that individual care and support plans had been put in place which ensured people's health and well-being needs were met. Other health needs had been assessed such as, nutrition and skin care. Arranged medical appointments were discussed with people beforehand to relieve any anxiety they had. Staff supported people in leading interesting and enjoyable lifestyles that met with their individual preferences.

Is the service well led?

Staff demonstrated that they had a good understanding of people's needs and the ethos of the service. We found that the people who used the service, family members and professionals had been asked to comment about the standards of the service. Regular audits had been carried out regarding health and safety within the home. Records showed us that when improvements had been identified that staff acted upon them. Monthly meetings were held with staff and team leaders (home managers). The minutes from these were shared with senior managers as part of the quality assessment programme.

We spoke with a relative of a person that used the service who told us they were happy with the service their relative received.

We spoke with a staff member who when asked about the service told us 'It's a good service, there's great staff morale, we get a lot of support and up to date training'.

We found people's needs were assessed and a care and support plan was put in place to ensure their needs were met. We saw that where risks had been identified control measures had been put in place to ensure people's welfare and safety.

We found there were appropriate arrangements in place relating to medication and appropriate checks had been carried out on equipment used within the service. We saw that before staff started work appropriate pre-employment checks were undertaken and we found that people were made aware of the complaints procedure.

A staff member told us " I get a lot of pleasure from my work and enjoy working with the people who use the service".

We found that there were detailed care plans and assessments for people who used the service in easy read formats. This made it easier for the people who used the service to understand the information about how their care needs were being met. We saw that people were involved in reviewing their care and support needs and their views were acted on by the service.