Background to this inspection
Updated
4 October 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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.
This inspection took place on 25 July 2017 and was announced. The provider was given 24 hours’ notice because the location is small and we needed to be sure that the registered manager and other staff were available to speak to us on the day of the inspection. The inspection team consisted of one inspector.
Before the inspection we reviewed information we held about the service including previous inspection reports, any notifications, (a notification is information about important events which the service is required to send to us by law) and any complaints that we had received. The provider had submitted a Provider Information Return (PIR) before the inspection. A PIR asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. This enabled us to ensure that we were addressing any potential areas of concern at the inspection.
We spoke to two people who used the service and two relatives. We interviewed three members of staff and spoke with the registered manager. We spoke with one health care professional. We looked at a range of documents including policies and procedures, care records for four people and other documents such as safeguarding, incident and accident records, medication records and quality assurance information. We reviewed staff information including three recruitment records, supervision and training information as well as team meeting minutes and we looked at the providers systems. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
The last inspection of 8 June 2015 identified one breach of the regulations. The overall rating for the service was Good.
Updated
4 October 2017
The inspection took place on 25 July 2017. We gave the registered manager 24hours notice of the inspection to ensure that there would be staff available to talk with us. 1 Charmandean Road is a small care home registered for up to eight adults living with physical and learning disabilities, sensory impairments and complex health needs including epilepsy. People have different communication needs; some people were able to hold conversations independently and others needed support from staff to express their views, thoughts and feelings. The home is located in Worthing, close to shops and a short distance from the seafront. At the time of the inspection there were eight people living at the home.
The home 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. At the last inspection undertaken on the 8 and 9 June 2015 we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014 in relation to inadequate processes for assessing and monitoring the quality and safety of services provided. The provider sent us an action plan stating they would have addressed all of these concerns by 30 September 2015. At this inspection we found that the registered manager had made improvements and this breach of regulation had been addressed.
Staff understanding of their responsibilities with regard to the Mental Capacity Act 2005 was not consistent and embedded within practice. Some staff did not have a clear understanding of Deprivation of Liberty Safeguards (DoLS) and some mental capacity assessments and best interest decisions were not always completed in line with legal requirements. This was identified as an area of practice that needed to improve.
People told us they felt safe living at the home and relatives said they felt their relations were safe. One relative said, “I have seen very good, safe practice.” People were receiving their medicines safely and risks to people had been assessed and plans were in place to manage risks. There were enough staff to care for people safely and the provider had a robust recruitment system to ensure that suitable staff were employed. Staff were able to explain how they would recognise signs of abuse and knew what action to take.
Staff told us that they felt well supported and received the training and support they needed to carry out their roles effectively. Training provided was relevant to the needs of people living at the home.
People told us they enjoyed the food at the home and a relative told us, “The food is very much home cooking and it looks really good.” Risks associated with eating and drinking had been assessed and were managed effectively. Advice received from specialist, such as speech and language therapists (SALT), had been incorporated into people’s care plans and staff were following these instructions carefully. Some people were living with complex health conditions and staff were proactive in supporting them to access the health care services that they needed.
People and their relatives spoke highly of the staff and the caring relationships that had developed. Staff knew people well and supported them to be involved in planning their care and support. One person told us, “All the staff are nice, they help me.” A relative said, “The care is amazing.” People were treated with dignity and their privacy was respected.
People were leading full and busy lives. Staff supported people to follow their interests with a range of activities and people accessed the local community regularly. People were supported to maintain relationships that were important to them.
Care plans were personalised and enabled staff to provide care in a person centred way. Staff were observant and noticed small changes in people’s needs. One relative said, “Staff have to watch for changes daily, sometimes hourly. They are very responsive.” Any concerns or complaints were dealt with promptly and people and their relatives told us that they would feel comfortable to raise any issues with staff.
The registered manager was approachable and provided clear leadership. Staff were clear about their roles and knew what was expected of them. One staff member told us, “It’s a good place to work, and morale is very good.” People and their relatives also spoke highly of the management of the home. One relative told us, “From what I have seen I would rate the manager very highly.”
There were effective systems in place to monitor the quality of care and the registered manager had oversight of the running of the home. Incidents and accidents were monitored and analysed to ensure that care plans were adapted and updated to prevent further occurrences. Staff described an open culture where they felt able to raise any concerns and where their views and ideas were welcomed. Relatives described a good relationship with staff and the manager. One relative said,
“The management of the home is more consistent and thorough now and the staff take personal pride in the care they provide.”