Archived: Bramble Close Supported Housing

The service had a registered 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.

At the last inspection this service was rated Good. At this inspection we found the service remained Good.

The service was safe. Staff were knowledgeable about identifying abuse and how to report it to safeguard people. Recruitment procedures were satisfactory. Detailed risk assessments were in place for people using the service to support their safety. There were also processes in place to manage any risks in relation to the running of the service. Staff deployment was suitable for people’s needs and people’s medicines were safely managed.

The service was effective. People were supported by experienced staff to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and the practices and systems in the service supported this approach. People were supported to maintain good health and nutrition and they had access to healthcare services.

The service was caring. We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. People’s dignity, privacy and independence was respected.

The service was responsive. People’s needs had been assessed with them and they told us they received the flexible support they needed from the service. Care plans were person centred and reflected what was important to the person. The service had a complaints policy in place and people felt able to complain if they needed to.

The service was well-led. The service had a positive open culture. The registered manager had systems in place to check on the quality and safety of the service provided and to put actions plans in place where needed.

Further information is in the detailed findings below.

We thought about what we found and asked the questions that we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service we were asked to sign the visitor's book and our identity was checked. This meant that people were protected from unwanted visitors to the complex where they lived.

The manager had carried out regular health and safety checks and had dealt with issues appropriately. This meant that systems and practices were safe for people who used the service.

Staff had received training in safeguarding vulnerable adults from abuse (SOVA), This meant that staff had been given the information that they needed to help ensure that people were cared for safely.

Is the service effective?

People who used the service told us that it met their needs. People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. They had been regularly reviewed and updated.

Is the service caring?

We saw staff interacting with two people throughout our visit on 09 July 2014 and they did so in a respectful, kind and caring way.

Is the service responsive?

People were encouraged to remain as independent as possible. Staff were responsive to their needs and supported them in a way that suited them.

Is the service well-led?

The registered manager had set up a new quality assurance system to ensure that people's views and opinions were gathered. Regular checks on the services systems and practices had been carried out. Staff told us that the registered manager was very supportive and the records confirmed that regular supervision had taken place.

This showed that there was an effective quality assurance system in place and that the service was well-led.

As the manager and deputy manager were out of the office, we were shown documents by the most senior member of staff on duty. In this report they are referred to as, 'the provider's representative.'

We found that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We saw that meals and drinks were served in an appropriate manner to allow people to eat and drink independently. Sensitive support and encouragement was provided by staff. People indicated that they had enjoyed their meals. People were supported to eat and drink adequate amounts of nutritious food and drink.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff told us that they did not feel supported to perform their roles. Staff had not received appropriate appraisal or supervisions to enable them to deliver safe care and treatment to people who used the service.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received. Effective systems were not in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.

We found improvements to the content and accuracy of people's care records. These records told staff what support the person needed and wanted and how to provide this safely.

We also found that the provider had improved the manager's access to staff recruitment records. This meant the manager had copies of records to show that all of the required checks had been completed before staff began working at the service.

People were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines.

People told us that they were treated with dignity and respect. We saw that they were supported to maintain their independence and right to make everyday choices and decisions. People we spoke with were said they felt able to raise concerns or complaints. One person said, 'I would tell [Manager]. She would listen to me.'

Staff we spoke with were aware of people's current care needs and how to meet these safely in practice. People who used the service told us that staff gave them the support they needed with their medicines. We looked at the the way the service managed medicines and found that medicines were not always safely stored or disposed of safely.

People we spoke with knew about their care records and had copies in their own home. We looked at record keeping within the service. We found that improvements were required by the provider in keeping records accurate, to a good standard and to be available when they were needed. This included records about people's care and well being, their medicines and about staff recruitment.