The Care Quality Commission
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Archived: Carwood Residential Home

Overall: Requires improvement read more about inspection ratings

16 Carwood, Stirchley, Telford, Shropshire, TF3 1YA (01952) 381490

Provided and run by:
Telford & Wrekin Council

All Inspections

13 January 2015

During a routine inspection

We carried out this unannounced inspection on 13 January 2015. When we last inspected the home on 2 January 2014 we found the provider was meeting all the requirements.

Carwood Residential Home provides care and accommodation for up to 13 people who have a learning disability. At the time of our inspection there were 10 permanent people and one person on emergency placement with their own support living in five separate flats across the home. The registered manager was no longer in post and had recently submitted an application to CQC to deregister. A service leader was employed and was responsible for the day to day management of the home closely supported by a group 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.

Staff had received training to keep people safe and knew their responsibility to protect people from harm or potential abuse. They knew how to recognise abuse and how to report it. Improvements had been made to ensure people received their medicines as prescribed. We found staffing levels and the deployment of staff needed to be reviewed to ensure the safety of the people using the service at all times.

People were positive about the care and support they received. We found people were supported by an established staff team who were trained and supported to do their job. We observed positive engagement between staff and people living at Carwood. Staff were kind, respectful and attentive to people's needs. They worked alongside people, helping them with tasks, rather than doing things for them. People’s privacy and dignity was respected and their independence was promoted. People took part in some social and recreational activities in the local community however, opportunities were limited during evenings and weekends due to insufficient staffing. People were supported to access a range of healthcare services and their individual communication needs were understood and met.

We found a person’s ability to make decisions had not been assessed. Staff training records showed that less than half the staff team had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Not all the staff we spoke with had a clear understanding of possible factors that could contribute to a deprivation of liberty. Improvements were needed to ensure that people’s rights were protected.

People were aware of the changes in the management and leadership of the home following a recent restructure of the provider’s services. People considered the home was well managed and told us the service leader was open and approachable. We saw the provider had elements of a quality assurance framework in place. However, we found this required improving and more formal ways of capturing people’s views and decisions assessed and recorded.

We found three breaches in Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 .You can see what action we told the provider to take at the back of the full version of the report.

2 January 2014

During a routine inspection

We met 11 of the 12 people who currently lived at the home. People who were able to share their views and experiences told us they liked living at Carwood. Comments included, 'I like it here, the staff are quite nice people' and, 'I'm fine and happy here'. Everyone else we met appeared comfortable with the staff and their surroundings.

We found each person had an enablement plan in place. These provided staff with detailed guidance about each person and how they preferred their care and support needs to be met. We saw these were regularly reviewed and updated as people's needs changed. We found people's health was closely monitored and specialist advice was sought when required.

People told us they felt safe living at Carwood. We observed that staff had good relationships with the people they supported. Staff we spoke with were confident to recognise and report any concern or possible abuse.

We found the provider had an effective system for supporting people with the management of their medication. Any errors were swiftly identified and acted upon. This meant that people's health and welfare was protected against the risk associated with the handling of medicines.

Staff sickness had continued to present challenges to the service. Staff reported planned activities and events over the festive period had been fulfilled. This was through the use of permanent staff working additional shifts, agency staff and staff from the provider's other services helping out. However, staffing shortages had meant that some people experienced less opportunity to lead individualised lifestyles, particularly during evenings and weekends.

The provider had a complaints procedure in place although an easy read format was not available. People who were able to told us they would speak to the staff if they had any concerns.

17 July 2012

During a routine inspection

We visited Carwood late afternoon, early evening, on 17 July 2012. We met with people living at the home and a relative. Most people were unable to share their views and experiences with us about the service that they received. We therefore spent time observing routines and interactions. We spoke with staff who were working at the home on the day of our visit and with the registered manager. We reviewed the care and support plans of two people and additional information as detailed within this report.

People's likes, dislikes, preferences and goals were considered in relation to the care and support people received. Everyone was treated with dignity and respect.

People were involved in making decisions about how they lived their lives. One person said they were fully consulted in relation to what they did. People gave us examples of hobbies that they enjoyed. Everyone was supported to make choices as far as they were able. Staff met people's care and support needs in ways that they preferred. We saw that detailed records that gave staff the information that they required to do this.

Plans were in place to support people to enjoy their lives and staff were aware of risks, people's rights and their responsibilities in order to enable them to do this.

The majority of the people who lived at Carwood attended structured day opportunities. People told us that they enjoyed their day time activities. People currently had fewer opportunities for evening and weekend activities due to staffing levels, although staff said that they worked flexibly to ensure people did attend planned events.

Staffing levels were currently being reviewed by the home's registered manager. The manager and the staff on duty told us that they had experienced staff shortages over recent months and that these had impacted on people's opportunities to enjoy individualised services and activities outside of the home. The home had used regular agency staff to cover shortfalls and we were told that staff were working long hours to ensure that people received consistency.

People were supported by a knowledgeable and well trained staff team who knew their care and support needs well. Staff were offered a range of training opportunities that were specifically designed to meet the needs of the people that they supported.

People were protected because staff were confident to recognise and report abuse. The home had implemented changes in response to incidents to keep people safe.

The home effectively ensured that people's views were considered and listened to in relation to the running of the service. Staff responded to verbal and non verbal communication methods to identify and respond to people's requests. The organisation had comprehensive quality monitoring tools to ensure that they maintained good quality care.