Archived: Livability Hanover Drive

Hanover Drive accommodates three people in one adapted residential house on a residential street. 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 27 February 2018 and was announced. 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. We had previously inspected this service in March 2016, at that inspection the service was rated ‘Good’. We found that at this inspection the service had remained ‘Good’.

The was a registered manager. 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 developed positive relationships with the staff who were caring and treated people with respect, kindness 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 the 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 was 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 kind and attentive staff who encouraged them to be as independent as possible. We observed that they were relaxed with staff and they received care and support that met their individual needs. One person received one to one attention from a care worker and they were asking the person where they would like to go for their next holiday. We observed people asking staff to do things for them. Staff responded to the requests promptly and efficiently.

Is the service responsive?

People were involved in many and varied activities including baking cakes and pies, going to the gym and swimming. People also participated in meal preparation and housework duties. Staff had ensured that a person who was using the service had the specialist equipment they needed for their care and support. The service worked well with external professionals such as, doctors and community nurses to make sure people received good standards of care. When changes were made these were recorded in the support plans so that staff had up to date knowledge of people's care and support needs.

Is the service safe?

People were treated with dignity and respect by staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Staff had received appropriate training and received regular supervisions with their line manager. These ensured that staff provided care in a safe environment to prevent people from accidents wherever possible. Any accidents or incidents that did occur were recorded and investigated by the manager. Medicines were checked at the beginning of every shift to ensure that prescribed medicines were administered to people in a safe way.

Is the service effective?

People's health and care needs had been assessed and support plans were in place. There was evidence that people and or their relatives were involved with the development and regular reviews of support plans. People's specialist dietary and mobility needs had been assessed and recorded. People's needs were taken into account with the layout of the premises. Staff supported people in leading interesting and enriched lifestyles that met with their individual preferences.

Is the service well led?

The service had a quality assurance system in place that involved people who lived in the home, relatives and professionals. Regular audits were carried out by staff and managers and records showed us that improvements had been made when they had been identified through monitoring processes. Staff told us they were clear about their roles and responsibilities and the quality arrangements that were in place. This helped to ensure that people received a good quality service.

We found quality assurance checks of the service were carried out and actions identified. We saw that there was a system in place to ensure that actions had been carried out. We saw that regular health, safety and fire checks were being carried out to ensure people's safety.

We spoke with a relative of a person that used the service. They told us 'The care is excellent and the staff are very good.'

We spoke with two staff members who told us that they enjoyed their work and told us that the staffing levels were sufficient to meet people's needs. They told us that they felt able to provide feedback about the service and that they were listened to.

We found that people's care needs were assessed and that people had care plans put in place to ensure that their needs were met. We found that staffing levels were sufficient to meet people's needs and that there was a system in place to protect people from the risks associated with medication.

We found concerns about the way in which people's capacity to consent had been determined and recorded. We also found concerns about the effectiveness of systems that had been put in place to protect people that used the service.

We spoke with two people that worked for the service they both told us that people received a good standard of care and support. One person told us "It's a great all round service that helps to promote people's independence".

We found that there were detailed care and support plans in place. We saw that people's preferences had been recorded and care planned to ensure that these were accommodated. We saw that there were risk assessments in place to ensure people's welfare and safety. We found that there were detailed policies in place for the use, storage, recording and disposal of medication and for complaints.

We had concerns that one person's medication had not been recorded properly and not administered as it should have been on the day of our visit.