Archived: Fortis Care Hertfordshire

Updated 24 December 2015

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

This inspection took place on 02 December 2015 and was carried out by one inspector. The inspection was unannounced. Before our inspection we reviewed information we held about the service including statutory notifications relating to the service. Statutory notifications include information about important events which the provider is required to send us.

During the inspection we spoke with two people who used the service, two staff members, a team leader and the registered manager. We talked to one health care professional and we contacted one relative to ask their views on the service provided to people.

We reviewed two people’s support plans and risk assessments. We looked at three employment files. We looked at the systems that were in place to monitor the service and the audits relating to various aspects of the service including support plans and health and safety checks.

We observed staff interaction with people who used the service to assess how staff and people who used the service interacted and to see if people were treated in a kind, caring and compassionate way.

Updated 24 December 2015

The inspection took place on the 02 December 2015 and was unannounced. This was the first inspection of this service since registration in August 2014.

Merrick Close is a supported living service for up to four people who live with mental health needs, learning disabilities or autistic spectrum disorders. At the time of our inspection four people were using the service.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We checked whether the service was working in line with the principles of the MCA.

At the time of the inspection we found that one person may have been Deprived of their Liberty and the appropriate application had been submitted to the Court of Protection by the manager to ensure this was being done lawfully. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

People’s needs had been assessed, and personalised support plans detailed people’s individual needs, preferences, and choices. There were risks assessments in place for all aspects of people’s daily living and these were positively managed to enable people to live as independently as possible, without restrictions.

People were involved in decisions about their care and their opinions and feelings were listened to and valued by staff who supported them. They developed meaningful relationships with the support staff who knew how to support them effectively and enabled them to live an active life.

There were processes in place to safeguard people from the risk of avoidable harm and staff were knowledgeable about safeguarding procedures. Staff had a good understanding of their roles and responsibilities and had clear lines of accountability.

People signed individual tenancy agreements and they were supported to understand the house rules, their responsibilities and their rights whilst they were living at Merrick Close. They were involved in decisions about their lives, they discussed their aims and objectives with staff, what they wanted to achieve and staff supported them through their journey to accomplish what they wanted.

The manager had a good understanding of people’s specific needs and they accepted new people into the home after a thorough assessment. They ensured people were familiar with at least one staff member before they moved in the house. On occasions this meant staff travelled and stayed in paid accommodation for several weeks until they managed to build a relationship based on trust with the person who might potentially move to Merrick Close.

Staff knew people well, they were able to recognise and avoid triggers which could have provoked behaviours which were challenging to manage. People`s physical and mental health needs were monitored and reviewed regularly by staff, psychiatrists and health and social care professionals.

Staff were trained and skilled to ensure they had the abilities and knowledge to understand and meet people`s needs at all times. Newly employed staff had comprehensive induction training, they were given time to learn about people`s mental health and physical needs. The manager allocated key workers for people after they analysed and assessed people`s and staff`s personalities and skills to ensure a good relationship between them.

People told us they were happy in Merrick Close and their life had a positive turn after they moved into the home. They were confident to raise concerns and discuss with management and staff if they had any issues.