Archived: Care Management Group - 374 St Helier Avenue

At our last inspection in July 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing 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. At this inspection we found the service remained Good.

Relatives told us they felt their family members were safe living at the home and spoke positively about the care provided and the commitment of staff. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage identified hazards to help keep people safe from harm or injury.

Appropriate staff recruitment processes helped to ensure people were protected. We saw there were enough properly trained and well supported staff to meet people’s needs and staff confirmed they were happy with the training and support they received.

People received their medicines as prescribed and staff knew how to manage medicines safely.

Relatives told us people received effective care. Staff had access to a wide range of training and they were supported with regular and structured supervision.

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

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. The service ensured local authorities had carried out the appropriate assessments for people who might have been deprived of their liberty. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People were supported to have a varied and balanced diet and food that they enjoyed, were consulted about their choice of meals and were enabled to eat and drink well and stay healthy.

Staff supported people to keep healthy and well through regular monitoring of their health and wellbeing.

Relatives told us staff were kind and caring. We saw that staff treated people with dignity, respect and compassion. Staff understood people’s needs and helped them to express their views and wishes wherever possible.

People were encouraged to maintain relationships that were important to them. Relatives told us they were made to feel welcome when they visited the home and that the staff were supportive in enabling people to visit relatives.

Care plans were in place which reflected people’s specific needs and their individual choices. Relatives of people were involved in reviewing their relations’ care plans and we saw people were supported to make decisions about their care and support.

People had access to their local community and could choose to participate in a variety of in-house and community based social activities. Staff encouraged and supported people to be as independent as they could and wanted to be.

People and their relatives were encouraged to give feedback on the service and there was an effective complaints system in place.

People told us they liked the staff and registered manager. Staff told us they felt supported by the good leadership of the senior staff and relatives told us that the registered manager encouraged feedback and sought to develop and improve the service for people.

Staff told us they enjoyed working in a home which encouraged openness and teamwork. Staff were clear about their roles and responsibilities and they had a good understanding of the ethos of the service.

Systems were in place to monitor the safety and quality of the service and to gather the views of people about the quality of the service. These measures of monitoring the service has helped to make improvements were necessary.

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.

Further information is in the detailed findings below.

374, St Helier Avenue provides care and accommodation for up to eight people and there were seven people living at the home when we inspected. These people were all living with learning disabilities some of whom were unable to communicate with us due to their complex needs.

The service had 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 and relatives told us they felt safe at the home.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse.

Care records showed any risks to people were assessed and there was guidance to staff of how those risks should be managed to prevent any risk of harm.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

People received their medicines safely.

People’s capacity to consent to their care and treatment was assessed and decisions were made in their best interests and in line with relevant legislation. We saw appropriate applications were made for people to the local authority for assessments under the Mental Capacity Act 2005 and for Deprivation of their Liberty where it was necessary.

People’s support plans described the support they needed to manage their health needs. People had regular health checks with their GPs and other healthcare professionals.

People and their relatives told us that staff were caring and kind to them. Staff were observed to treat people with kindness and dignity. People were able to exercise choice in how they spent their time. Staff took time to consult with people before providing care and showed they cared about the people in the home.

Care was arranged to meet people’s needs and provided in a way they preferred. Care plans were individualised and they reflected what support each person needed and what they were able to do for themselves. We saw people were assisted with engaging in their chosen social activities. Care plans were reviewed as people’s needs changed or every three months.

There was in place an appropriate complaints procedure that people and their relatives knew about and felt confident to use. We reviewed the home’s complaints records and we saw the provider responded to concerns and complaints and learnt from the issues raised.

There were good systems in place to monitor the care provided and people's views and opinions were sought regularly. Suggestions for change were listened to and actions taken to improve the service provided.

At the time of this inspection there were seven people living in this home. All of the people had learning disabilities and did not have the ability to communicate verbally except in a limited capacity. We met four people and to two relatives; two support workers or staff; the manager and area manager. We reviewed four people's care plans and four staff files.

Was the service safe?

People told us that they felt safe living at 374, St. Helier Avenue. The two relatives of the people who we spoke with said that they thought people were safe, that they were protected from abuse and that their rights were respected and upheld. One person said, 'I have no issues with this at all, they are safe and I have never seen anything to make me concerned.' Another person said, 'Yes they are safe and sound'.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported. There were mechanisms in place to help to safeguard people from the risks of abuse. People were treated with respect and dignity by the staff.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made.

Staff recruitment procedures were robust to ensure that only suitable people were employed.

Is the service caring?

People were assisted by kind and supportive staff. We saw that staff showed patience and professionalism and gave appropriate encouragement when supporting people. Those people who were able to said the staff treated them well and respected their wishes, dignity and privacy. Relatives of people living in the home were very positive about the care given to people. One person (talking about their relative and the staff) said, 'They understand each other and they care for him. They listen to what he indicates he needs. They do not force him to do anything he does not want to do; if he wants to spend the day in his room that's fine with them. They let him have choices; he is involved in planning his activities and in planning the menu'. We observed that staff knocked on doors before entering people's rooms and asked if it was convenient for them to go in. This reflected the caring environment that we found on the day of the inspection.

Is the service responsive?

The way in which care should be provided was set out clearly in care plans and we saw that care was delivered in line with this. Relatives of people who use the services told us that if a person's needs changed, their care and support was tailored to those changed needs. We saw that care plans were reviewed regularly and changed appropriately. This was important as this helped staff understand what people wanted or needed or how they were feeling.

All the people we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and discussions we had with relatives and staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service effective?

People's needs and potential risks were regularly assessed. Care plans were "person-centred" focusing on people's individual needs. We found that care was delivered in line with these care plans.

People's health and care needs were assessed together with them or their relatives or representatives and they were involved in their care and support planning. All the risk assessments and care plans that we saw had been signed by people indicating their agreement with what was written down. People told us that they had been involved in the planning of their care and support and that it reflected their needs. One person said, 'Staff explained to me what was in my care plan'. We inspected four people's care files. They included essential information about the person, needs and risk assessment information, care plans and records of health care appointments.

Is the service well-led?

Systems were in place to effectively assess and manage risks in relation to people's health, safety and welfare. There was an effective quality assurance process in place to regularly assess and monitor the quality of services that people received.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance processes that were in place. This helped to ensure that people received a good quality service at all times.

The manager told us that they have applied to the Care Quality Commission (CQC) to be registered as the manager for this home and that they have already had the "fit person" interview. This indicates the process of registering as a manager is well underway.

We used a number of different methods to help us understand the experiences of people using the service because most of the people who lived at this care home had complex needs, which meant they were not always able to communicate with us. The people who did speak with us all said that they were happy living at the home. We received positive responses from people about the staff who cared for them, one person told us 'the staff are nice, I like living here'.

We were able to observe that people's experience of the service was a positive one. During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. We also gathered evidence of people's experiences of the service by speaking to the registered manager and other staff who worked in the home and reviewing various records the provider is required to keep.

We saw that polices and procedures had been put in place to ensure the safety and well being of people using the service and we saw evidence of a robust quality assurance system regularly monitored by the provider.