Background to this inspection
Updated
4 June 2015
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.
The inspection visit took place on 29 April 2015. Our visit was unannounced and the inspection team consisted of one adult social care inspector.
The provider had not completed a provider information return (PIR), as we did not request this on this occasion. 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 all of the information we held about the service including statutory notifications we had received from the service. Notifications are changes, events or incidents that the provider is legally obliged to send us.
During our inspection we spent time with five people who lived at the service, four support staff, a senior support worker and the registered manager. We observed care and support in communal areas. We looked at the support plans of three people at the service including one person who had recently moved there. We also looked at records that related to how the service was managed, looked at three staff records and looked around all areas of the home including people’s bedrooms with their permission.
Updated
4 June 2015
The inspection visit took place on 29 April 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the service on 26 May 2014 and found the service was not in breach of any regulations at that time.
West Villas consists of two inter-connecting bungalows, which provides accommodation and personal care and support for up to six people with complex needs such as learning and physical disabilities. There are three lounges, two dining rooms and six bedrooms. Each bedroom is individually decorated.
There is a registered manager in post. 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.
Three people we spoke with told us they felt safe at West Villas and we observed the care and support other people received who could not communicate directly with us. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.
There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. Staff had also had training and support and those we spoke with clearly understood the five principles of the Mental Capacity Act. This meant people were safeguarded.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with epilepsy and providing person centred support. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that three staff routinely provided support to six people during the day with two staff being available if needed throughout the night.
There was a regular programme of staff supervision in place and records of these were extremely detailed and showed the service worked with staff to identify their personal and professional development. We noted the excellent practice of staff receiving 360 degree feedback from colleagues, people using the service and relatives or other healthcare professionals as to their conduct, behaviour and team working on a regular basis. We also saw a regular programme of staff meetings where issues were shared and raised.
The service encouraged people to lead a safe and active lifestyle. People were supported to be involved in the local community as much as possible. People were supported to access facilities such as the local G.P, shops, social clubs and leisure facilities as well as to use the facilities in the service such as the kitchens for cooking meals.
There was a system in place for dealing with people’s concerns and complaints. Three people told us they would talk to staff if they were unhappy with anything. The staff we spoke with all told us they could recognise if people they supported weren’t well or were unhappy and what measures they would take to address any concerns.
People were encouraged to help prepare food with staff support if they wished and on the day of our visit one person prepared themselves, another person and staff a ham salad with staff support. We saw people had nutritional assessments in place and people with specific dietary needs were supported. We saw from support records and talking with staff that specialist advice was sought quickly where necessary not only for nutritional support but any healthcare related concerns.
We saw staff supporting people with dignity and respect. People told us that staff were caring and helped them in all aspects of their daily living. We saw staff encouraging people to do tasks for themselves such as washing dishes and making lunch but staff were quick to intervene and offer support if people were struggling. There was lots of laughter and caring physical interaction that was appropriate between staff and people using the service.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create support plans which were detailed and person centred. Everyone had undergone a person centred review in the last month where themselves, staff, family and social workers were involved in reviewing their support and planning actions and outcomes for the future. This was done using an easy read format and photographs and people told us about how they were involved in all aspects of this process.
We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow. People were encouraged to manage their medicines themselves with staff support if they were able, and secure cabinets for these were fixed in each person’s bedroom.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure the service and equipment was safe for people and staff. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.
We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.
Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.
We saw that staff members were recruited safely using appropriate identity checks and people who used the service were involved in the recruitment process. We discussed the interview process and induction training with one staff member who had been in post since January 2015 and they were very positive about the level of support they received.