Archived: Liphook Road

Improvements had been made to the service following our previous inspection in October 2017 to address concerns and breaches of regulation. The risks to the quality and safety of the service were identified and acted on. People’s records were well organised and checked to make sure they included up to date and accurate information about people’s needs. Information from audits, incidents and quality checks was used to drive continuous improvements to the service people received. People were supported safely.

The provider supported staff in providing effective care for people through person-centred care planning, training, supervision. They ensured the provision of best practice guidance and support met people’s individual needs.

People participated in a range of activities that met their individual choices and preferences. Staff understood the importance of this for people and provided the structured support people required. This enabled people to achieve positive outcomes and promoted a good quality of life.

The registered manager had acted on concerns and complaints received by the service. However, we found some improvements could be made to ensure that when concerns were raised they were responded to more fully in line with the provider’s procedures. The registered manager evidenced they had acted to address this feedback immediately following our inspection. We have made a recommendation about the management of complaints.

More information in Detailed Findings below.

Rating at last inspection:

Requires Improvement (report published 21 December 2017).

About the service:

Liphook Road is a residential care home that accommodates up to two people living with learning disabilities or autistic spectrum disorder. At the time of our inspection there were two people living at the home. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen ' Registering the Right Support’ CQC policy.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found improvements had been made since our last inspection and the service has met the characteristics of Good in most areas. The rating for Responsive is Requires Improvement. The overall rating is Good.

Follow up:

We will continue to monitor the service through the information we receive. We will follow up on our recommendation at the next scheduled inspection.

A registered manager was not in post at the time of our 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. The previous registered manager had left in December 2015. The current manager had recently submitted an application to become the registered manager of the service.

The manager also managed one of the provider’s other services and subsequently divided their time between the two. There was not a clear management structure in place. In the manager’s absence, it was not always clear who the most senior member of staff was and how responsibilities for managing the service were delegated.

Not all staff followed risk assessments and guidance in order to ensure the environment at Liphook Road was safe. The service’s procedures around ensuring the safe storage of sharp objects and electrical equipment were not always followed by staff. This resulted in people potentially having access to these dangerous items.

The service did not always seek feedback in order to make improvements. The manager had identified that improvements were needed and was taking steps in seeking the feedback of people and relatives about the quality and safety of the service.

Other risks associated with people’s health and behaviour were assessed and monitored. People had access to healthcare services as required. However, people’s care plans were not always updated after these appointments to ensure that they contained the most current information. Care plans contained detailed information about people’s likes, preferences and routines. People were supported with a diet in line with their requirements, likes and cultural needs.

The management of the service had completed a series of audits and checks around the quality and safety of the service. Audits and checks had not always been effective in identifying where people’s records did not contain the most current information or embedding staff’s adherence to safety procedures about the safe storage of dangerous items.

People were supported to be active both inside and outside their home. Staff encouraged people to develop their skills, try new experiences and personalise their home environment.

There were sufficient staff in place who had received training that was appropriate to their role. The manager had recently introduced a system to ensure that staff were supported in their role through regular supervision and appraisal. Staff were knowledgeable and caring about people welfare and effective in promoting their choice, dignity and encouraging independence. Staff understood the importance of gaining consent and took steps to ensure that people’s freedoms and rights were respected.

The provider carried out internal quality assurance audits in order to identify areas for development and improvement. The manager was working through a set of actions identified from the provider’s last audit. The manager also made a series of weekly checks to assess the safety of the service.

We identified breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.