On the 19 and 26 May 2016 we inspected Three Sisters and Bronte View. At the time of our inspection, there were 16 people living at the service. This was an unannounced inspection.The service was last inspected in October 2014 and was fully compliant with the outcome areas that were inspected against.
Three Sisters and Bronte View is a care home for up to 17 younger adults with a learning disability who may also have challenging behaviours. Three Sisters can accommodate up to 10 people in en-suite bedrooms and Bronte View can accommodate seven people in self-contained flats. There is a small farm and training facility for the people who live at the home and in the local area. The home is in easy reach of Haworth and the local facilities.
The service had a registered manager in place 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 and associated Regulations about how the service is run.
Potential risks to people were assessed and recorded. There was full guidance on how to safely manage risks in each person’s support plan so that people received the interventions they needed to keep them as safe as possible. The assessments identified people’s specific needs, and measures were in place to reduce the risks, without restricting people’s activities or their lifestyles.
People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns, both within the organisation and to the local authority safeguarding team.
Accidents and incidents were reviewed and action was taken to reduce the risk of re-occurrence. Each person had a personal emergency evacuation plan in the event of an emergency.
Health and safety checks on the equipment and the environment were carried out regularly to make sure the premises were safe. Routine maintenance was carried out on a regular basis as part of maintenance plan.
Some people living at the service needed one to one staffing support and there were appropriate levels of staff on duty and deployed throughout the service to meet people’s needs. Additional staff were on duty throughout the day to ensure that people were supported to enjoy activities of their choice.
There were safe recruitment practices in place and appropriate recruitment checks were conducted before staff started work.
New staff were given a detailed induction, and completed a probationary period to make sure they were suitable to work with vulnerable adults. The on-going training programme ensured that staff had the right skills, knowledge and competencies to carry out their roles.
Staff received regular one to one supervision from their line manager, together with an annual appraisal, to discuss their training and development needs and for any support required.
Care and support plans were designed around people’s individual interests and needs. These were written in a way people could understand, and included pictures and photos.
Deprivation of Liberty Safeguards (DoLS) authorisations were in place for people as required. Guidelines were being followed by staff to ensure there were no unnecessary restrictions to people’s lifestyles.
Staff supported people with their health care needs and when it was necessary, health care professionals were involved to make sure people remained as healthy as possible.
People were supported to eat and drink suitable healthy foods and sufficient amounts to meet their needs and ensure well-being.
Medicines were managed safely and stored securely, and people’s medicines were reviewed regularly by their doctor to make sure they were still suitable.
There was a strong emphasis on person centred care and care records covered people’s preferred daily routines and lifestyle. The plans were not always reviewed on a regular basis but updates were added.
The registered manager ensured that staff had a full understanding of people’s support needs and they had the skills and knowledge to meet them. Staff skills and knowledge were monitored in different ways including spot checks to make sure they knew people well and how to support them in a way that suited them.
People were treated with kindness and compassion. Interactions between staff and people using the service were positive and staff had developed good relationships with people. People were treated with dignity and respect.
People were encouraged to take part in activities and events to enrich their lifestyle. There was a wide range of activities accessible at the service.
People or their relative /representative had been involved in writing their care records.
Comprehensive quality monitoring was in place, with detailed checks regularly undertaken to identify any shortfalls so that appropriate action could be implemented and the service could be continuously improved. There was a culture of openness and inclusion within the service.