74 Old Ford End

Updated 10 September 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

One inspector carried out this inspection. The inspector visited the home on 8 March 2019 and spoke with relatives and professionals involved in the service on 11 March 2019 and 15 April 2019.

Service and service type:

74 Old Ford End Road, is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

74 Old Ford End Road accommodated six people in one adapted building. The environment was adapted to enable people who use a wheelchair to easily move about throughout the home. The service was registered to support people with learning disabilities and/or autism.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We did not give any notice as this was an unannounced inspection.

What we did:

Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections and is called a Provider Information Return (PIR).

Before the inspection we:

• Reviewed information we received from the provider on the provider information return (PIR).

• Researched feedback received about the provider to CQC as well as online.

• Reviewed information about incidents that have occurred since the last inspection.

• Reviewed any complaints and compliments received since the last inspection.

• Reviewed the providers own website.

• Looked at notifications we received from the service. Notifications are reports about serious incidents that the provider is legally obliged to tell us about.

During the inspection we:

• Spoke with two people receiving care from the service, one relative, the operations manager and with three staff members.

• Gathered information from two care files which included all aspects of care and risk.

• Looked at two staff files including all aspects of recruitment, supervisions, and training records, health and safety records, records of accidents, incidents and complaints.

• We also looked at audits and surveys and complaints and compliments.

After the inspection, we:

• Spoke with the registered manager (as they had been away on annual leave at the time of the site visit).

• Reviewed further evidence sent to us by the provider.

• Spoke to three further relatives.

• Spoke to two health and social care professionals.

Updated 10 September 2019

About the service: 74 Old Ford End Road is a residential care home that was providing personal care to six people aged between 18-65 at the time of the inspection. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons. The service was not able to support people to have person centred, individual and meaningful activities. People did not always have choice and control over their lives and there was limited evidence of promoting independence and meaningful activities.

People had the opportunity to go out and do activities but these were often task based and not always person centred or regular. Goals were not very meaningful, not always implemented and relatives did not always feel involved in the planning and assessing of people’s care needs. Improvements were needed in this area.

The provider had documented risks but these did not always contain enough information to tell staff how to support the risk. This could mean less experienced staff would not know what to do to keep people safe.

Staff and relatives spoke well of the registered manager and the staff team, however relatives, staff and management felt that the provider did not support them or implement agreed plans.

The registered manager did not have a good oversight of the service or knowledge of their responsibilities. Improvements were needed in this area.

Staff supported people with choices of meals and drinks and accessed specialised healthcare when needed. However, staff did not always support people during meals in a dignified manner and the provider needed to make some improvements in this area.

Staffing skills and experience were suitable to meet the needs of people. However, there were several staff changes which meant relatives had concerns about the continuity of care.

Care provided by the staff team and staff interactions with people was good and encouraged positive relationships.

Staff had a good knowledge of how to keep people safe and received training in this area. People and relatives told us they felt safe and thought that staff were kind and caring.

One relative said, “My family member is happy and gets on well with all the staff and really enjoys it, they come home for a weekend and are desperate to get back, they are laughing. They are really happy and the staff are all very good and seem to know what my relative wants with hand signs and everything.”

The provider implemented safe systems for the management of medicines which included staff training and assessments of staff competency checks.

People decorated their rooms in ways they preferred and which met individual tastes. The provider suitably adapted the environment to meet individual physical and mental health needs of people.

Enforcement: We found three breaches of the Health and Social Care Act 208 (Regulated Activities) Regulations 2014. The service met the characteristics of Good in Safe and Caring. The service met the characteristics of Requires Improvement in Effective, Caring, Responsive and Well-Led.

Please see the action we have told the provider to take section towards the end of the report.

Rating at last inspection: At the last inspection (published 07 April 2016) the service was rated Good. Overall the rating has worsened since the last inspection.

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will discuss improvements with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.