Archived: Cliddesden Road

Updated 16 June 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 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.

This inspection took place on the 26 and 27 April 2017 and was unannounced. The inspection was completed by one adult social care inspector.

Prior to the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed the provider’s website.

During the inspection we spoke with five people who used the service, the registered manager, two deputy managers, four regular staff, one member of bank staff, the provider’s operational development manager and the provider’s peer support coordinator.

A peer group support meeting was held on the first day of our inspection. We spoke with the peer group support coordinator who was not employed by the provider but had recent experience of using the service and had progressed into independent living. We also spoke with two people who had moved on from the service as part of their progression but still visited regularly as part of their continued support.

We reviewed each person’s support plans and medicines administration records (MARS). We looked at five staff recruitment files, four agency staff profiles, the induction process for new staff, training and supervision records. We reviewed the provider’s policies, procedures and records relating to the management of the service. We considered how comments from people, staff and others, as well as quality assurance audits, were used to drive improvements in the service. During the inspection we spent time observing staff interactions with people.

Following the inspection we spoke with three people’s relatives and nine health and social care professionals, including psychiatrists, community psychiatric nurses, specialist nurse practitioners, social workers and care commissioners.

This service was last inspected on 14 October 2014 where no concerns were identified.

Updated 16 June 2017

This inspection was unannounced and took place on the 26 and 27 April 2017. Cliddesden Road provides accommodation and personal care for up to seven adults who have a mental health diagnosis, with associated physical and psychological support needs. People are supported to reach their potential, moving towards independent living and social inclusion within the community. The provider believes that people experiencing mental distress can direct their own journey towards improved mental health and to living independent, fulfilling lives. The provider refers to this concept as the ‘Together Progression Model’ and services providing this care and support as ‘projects’.

The home is a large Victorian house with three floors, comprising seven large bedrooms with a bathroom on each floor. The staff office and spacious communal areas are situated on the ground floor, with a staff sleep in room on the top floor. This is a bedroom used by the night staff who sleep at the home overnight. There is a communal TV lounge, dining room and kitchen and a quiet sensory room on the first floor. To the rear of the house is a large garden and patio, together with a small enclosed courtyard to the side of the house, which currently houses a table tennis table.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. Since our last inspection the registered manager had also become the registered manager at another service within the provider’s care group. Two deputy managers had been appointed to support the registered manager.

People were protected from the risks of potential abuse by staff who knew what actions to take if they felt people were at risk. The registered manager and staff protected people from harm by identifying risks associated with their support and managing these effectively.

Staff underwent robust pre-selection checks to assure the provider they were suitable to support people with mental health needs. The registered manager ensured there were always sufficient numbers of staff with the necessary experience and skills to support people safely. People’s medicines were administered safely by staff who had completed safe management of medicines training and had their competency to do so assessed.

Staff had the appropriate knowledge, skills and experience to carry out their roles and support people effectively. Staff had completed the provider’s induction programme and completed their required training. The management team completed six weekly supervisions, annual appraisals and held regular staff meetings. Staff received effective supervision, appraisal and support to carry out their roles and responsibilities.

People were supported by staff who understood the principles in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Consent to people’s care was always obtained in line with legislation and guidance and staff enabled and supported people to make their own decisions.

People were supported to have enough to eat and drink and to maintain a healthy, balanced diet.

Staff were alert and responsive to changes in people’s needs and ensured people accessed health care services promptly when required. People were supported to maintain their mental health and well-being.

People consistently valued their relationships with the staff team and felt that they often went ‘the extra mile’ for them. Staff were highly motivated and inspired to offer care that was kind and compassionate and were determined and creative in overcoming any obstacles to achieving this. The project had a strong, visible person centred culture and was exceptional at helping people to express their views so they understand things from their points of view. Staff were exceptional in enabling people to become and remain independent and had an in-depth appreciation of people’s individual needs around privacy and dignity.

People received personalised care that was tailored to meet their individual needs. Staff responded effectively to meet people’s changing health needs. Staff promoted people’s confidence and independence to empower them to live their lives as they wanted. There were processes in place to seek feedback from people, relatives and supporting health and social care professionals about the quality of the service. Complaints were managed in accordance with the provider’s policy.

The registered manager and management team had developed an open, positive culture within the project, which was person centred, inclusive and empowering. Staff demonstrated a well- developed understanding of equality, diversity and human rights in the day to day support they provided for people. The registered manager and deputy managers demonstrated good management and leadership. Staff demonstrated a clear understanding about their roles and responsibilities and how they related to other stakeholders. Quality assurance systems were in place to monitor the quality of service being delivered, which were effectively operated by the management team. The registered manager consistently recognised, encouraged and implemented innovative ideas and strategies to drive a good quality service.