Archived: Snowdon

People’s experience of using this service:

People were supported to develop the skills they needed to move on to more independent living. The support people received was tailored to their individual needs and wishes. With the support of staff, people had become independent in areas such as cooking, budgeting and managing their medicines.

Staff also supported people to identify and work towards individual goals they wished to achieve. These goals included obtaining independent accommodation, gaining employment and maintaining relationships.

Staff supported people to maintain good physical and mental health and worked effectively with other professionals involved in people’s care. This included supporting people to attend appointments to express their views and to understand information about their care and treatment.

Staff had an induction when they joined the service and received the training and support they needed to carry out their roles. They understood their responsibility to keep people safe from abuse and felt able to speak up about any concerns they had.

There were enough staff deployed to meet people’s needs and keep them safe. Potential risks to people had been assessed and plans put in place to mitigate these. If accidents or incidents occurred, staff took action to reduce the risk of similar incidents happening again. Medicines were managed safely.

Staff treated people with dignity and respected their decisions about their support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had opportunities to give their views about the service and the support they received. House meetings took place regularly and people were encouraged to contribute to their reviews and meetings with their keyworker.

The service had effective leadership and management. The registered manager was available to people and provided good support to staff. The registered manager and the provider maintained an effective oversight of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection in 1 December 2016 the service was rated Good. The report of this inspection was published on 8 February 2017.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The inspection took place on 1 December 2016 and was unannounced.

The home had a registered manager who was present on the day of inspection. 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 told us that they felt safe. Support was provided to people by a sufficient number of staff who were appropriately trained. Staff had received training in safeguarding adults and were able to describe the procedures to follow should they have any concerns. Robust recruitment processes were in place to ensure that staff were suitable to work in the service. All staff underwent an induction prior to working alone and staff had access to regular supervision and support.

Risks to people’s safety and well-being were assessed and people were supported to develop plans to mitigate risks. Accidents and incidents were monitored by the registered manager to minimise the risk of them happening again. There was a contingency plan in place to ensure people would continue to receive a service in the event the building could not be used. Processes were in place in relation to the correct storage and audit of people’s medicines. People were supported to manage their own medicines in a safe way.

People were supported to maintain and develop their independence by planning, shopping and cooking their own meals with support from staff where required. People had access to health care professionals and were encouraged to book appointments with staff support. Health information was recorded to ensure people were receiving the support they required.

People’s legal rights were protected as staff understood their responsibilities under the Mental Capacity Act 2005. People were supported in the decisions they made and staff asked for people’s consent and opinions.

People were treated with kindness, and respect. Staff took time to speak with the people who they supported and interactions were positive and friendly. Staff had a clear understanding of the aims of the service and promoted people’s independence at every opportunity. However, the service hosted a management meeting in communal areas of the service which did not demonstrate that the provider respected people’s home. We have made a recommendation regarding this.

People were fully involved in the assessment and support planning process. Reviews of people’s care plans were completed monthly or more frequently if required. This enabled people to monitor their own progress at regular intervals. People were supported to maintain and develop hobbies and interests with the support of staff where required.

People and staff spoke highly of the management of the home. Staff told us that they felt supported and knew that there was always someone available to help them when needed. Regular audits were completed to monitor the quality of the service provided and action was taken where shortfalls were identified. People and staff told us they were able to contribute to the running of the home and were able to describe the values of the service clearly.

Records were well-maintained to ensure staff had easy access to the information they required. There was complaints policy in place and people told us they were aware of how to make a complaint.

We found that people who used the service were generally able to give their consent to all aspects of their care and treatment, and make informed decisions. All the people we spoke with said they had never had care or treatment forced upon them.

We found that generally people were happy with their level of care but did raise concerns about the actions of the previous manager. One person said that whilst the previous manager had been in post 'it had felt like a prison'. However they all said they felt things were a lot better now. We also found that people's needs were being properly assessed, managed and reviewed.

We found that people were being properly protected against abuse and staff were able to identify, respond to, and report abuse in an appropriate manner. All the people we spoke with said they felt safe from harm in the home.

We found that there were enough suitably qualified staff to provide proper staffing cover at all times. However, both staff and people who used the service expressed concerns over the lack of permanent staff, which provided a sense of discontinuity.

We found that the provider was regularly obtaining feedback from people who used the service and staff. We also found that the provider monitored and assessed the whole service on a regular basis.

We observed that people had their individual needs assessed before admission and that they or their relatives had been involved in planning their care and support. We also saw that staff supported people's needs and development.

We saw that people looked well cared for and they were treated with courtesy and respect by staff. Those who wished to were able to engage in community activities of their choice. One person told us, 'There is so much help available I feel very positive. The staff here are great.'

We saw that guidance regarding safeguarding people from abuse was available to staff and they had received recent relevant training. One person that we spoke with told us, 'I never give my safety a second thought'.

We saw that staff recruitment processes were thorough and that required checks had been carried out before staff were engaged.

We saw that there was an effective complaints system in place and that complaints and comments were sought from people who used the service and their relatives. A person we spoke with told us, 'I can't be happy all the time but if I had a complaint I'm sure they'd sort it out'.