Sheffield City Council -136d Warminster Road provides short stay respite accommodation for up to seven adults with learning disability. The service is on one level and provides a range of single room accommodation. It is situated in a quiet residential area of south west Sheffield close to local amenities. There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.
The last full inspection took place on 18 June 2013; the registered provider was compliant in all areas assessed. We undertook this current unannounced inspection on 20 July 2016.
The CQC had not received all notifications for incidents which affected the safety and wellbeing of people who used the service as required by registration regulations. This had been a misunderstanding by the registered provider and registered manager and they told us they would forward all required notifications in future. We have written to the registered provider to remind them of their responsibilities in this area.
We found people who used the service were protected from the risk of harm and abuse. Staff had received safeguarding training and knew what to do if they witnessed abuse or if it was disclosed to them. Staff knew what to do in cases of emergencies and each person who used the service had a personal evacuation plan.
People had risk assessments in place for specific concerns, such as falls and choking and these contained detailed information to guide staff in how to minimise risk. Some areas of the environment had been risk managed but not all and the registered manager confirmed they would review this. Incidents and accidents had been analysed to help find ways to reduce them.
There had been no recent recruitment of new staff to the service although staff had been transferred to work from other services within the organisation. The staffing levels had recently been reviewed and increased to ensure sufficient numbers were on duty to meet the needs of people who used the service.
Staff supported people to take medicines as prescribed. Staff had received training in medicines management.
We observed kind and caring approaches from the staff team. People’s privacy and dignity were respected and staff provided people with explanations and information so they could make choices about aspects of their lives. Staff were overheard speaking with people in a kind, attentive and caring way. There were positive comments from relatives about the staff team.
Staff received training that enabled them to support people safely and to meet their assessed needs. We found staff received guidance, support, supervision and appraisal. This helped them to be confident when supporting people who used the service.
People who used the service received person-centred care based on their wishes and preferences, although some of the person centred records had been archived. People and their relatives were involved in the formulation of plans of care. Staff were aware of people’s health care needs and the support they provided helped to maintain them. Staff liaised with health professionals for advice and guidance when required.
We found staff supported people to maintain their nutritional needs. They assisted people to make choices about their meals in line with their care plans.
We found people were supported to make their own decisions and to contribute to their planned activities. When people were assessed as lacking the capacity to make their own choices, decisions were made in their best interest but, how the assessments and decisions were recorded could be improved. We have made a recommendation about this.
People who used the service accessed a range of activities within the service and in the wider community; these provided them with stimulation and a feeling of inclusion.
We found there was a good organisational structure and a culture aimed at person-centred care, inclusion, involvement and valuing people who used the service and the staff who worked for the service.
There was a quality monitoring system that ensured people’s views were listened to, any complaints were addressed, audits were completed and checks carried out on staff practices and performance. There was an ethos of learning to improve practice, and the service provided to people.