Background to this inspection
Updated
5 October 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We carried out our inspection on 1 September 2016. The inspection was unannounced. It was carried out by a single inspector.
Before our inspection we reviewed information we held about the service. This included previous inspection reports and the action plan that followed the last comprehensive inspection, as well as notifications sent to us by the provider. Notifications tell us about important events which the service is required to inform us by law. We also reviewed the Provider Information Return (PIR). This is a form completed by the provider, where the provider gives key information about the service, what the service does well and improvements they plan to make.
We spoke with one person who used the service, two relatives of people who used the service, three members of staff, the person responsible for maintenance, the registered manager and the operations manager. We also spoke with a social care professional. We looked at the care records of three people who used the service, three staff files and records associated with the provider's monitoring of the quality of the service.
People who use the service had complex needs. To understand their experiences of using the service we spent time observing staff and people’s interactions and how staff supported people.
Updated
5 October 2016
The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in November 2015. At that time we gave the service an overall rating of ‘requires improvement’. We also found that the provider was in breach of the regulation in regards to the safe care and treatment of people. In March 2016 we carried out a focused inspection and found the provider was meeting legal requirements they were previously breaching but we did not change the overall rating of the service as we wanted to see consistent improvements at the service. At this inspection on 1 September 2016 we found the provider was meeting the regulations we looked at and had maintained the improvements made in March 2016. The inspection was unannounced.
The service provides accommodation and care for up to seven people living with complex needs and learning disabilities. There were seven people using the service at the time of our inspection.
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 who used the service were safe. The home’s equipment was well maintained. Staff understood the importance of people’s safety and knew how to report any concerns they may have. Risks to people’s health, safety and wellbeing had been assessed and plans were in place which instructed staff how to minimise any identified risks to keep people safe from harm or injury. The provider ensured these were kept up to date so that staff had access to the latest information about how to minimise identified risks. The premises and equipment were regularly serviced and checked to ensure these did not pose unnecessary risks to people. Staff were well informed about how to safeguard people from abuse and knew what actions to take if they had concerns.
There were enough staff on duty to keep people safe and meet their individual needs. The provider had a safe recruitment process to ensure they employed staff who had the right skills and experience and as far as possible were suited to supporting the people who used the service.
People received their medicines as prescribed. The provider had relevant protocols for the safe management of people's medicines.
Staff had the relevant skills they required to meet people's needs. They had access to effective training that equipped them with the skills they required to look after people. They had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They supported people in accordance with the relevant legislation and guidance.
People had access to a variety of healthy and well balanced meals. Staff provided appropriate support to people so they had timely access to health care services.
Staff supported people in a kind and compassionate manner. They treated people with dignity and respect. They were knowledgeable about the needs of the people they supported and ensured that wherever possible people or their relatives were involved in decisions about their care. Relatives told us they were always made to feel welcome when they visited the home.
People's care plans reflected their individual needs and preferences. Their care was provided in a person centred manner. They had access to social activities of their choice. The provider encouraged feedback from people using the service and their relatives. There was an appropriate complaints procedure in place that people knew about and felt confident that the provider would respond appropriately to any concerns they raised.
The service had good leadership. There was a shared ethos of providing person-centred care. The registered manager supported staff to meet the standards expected of them which enabled them to deliver a good standard of care.
The provider had effective procedures for monitoring and assessing the quality of service that people received. The registered manager listened to people's feedback and used it to improve the quality of the service.