Archived: Trinity Vicarage Road

Updated 21 June 2017

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, 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 3 April 2017 and was unannounced. The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of caring for someone who used this type of service.

Before our inspection, we reviewed the Provider Information return (PIR). The PIR is a form that asks the provider to give some key information about what the service does well and improvements they plan to make. We also reviewed information we held about the service and information we had received about the service from people who contacted us. We contacted the local authority that had funding responsibility for some of the people who used the service. We also contacted Healthwatch (the consumer champion for health and social care) to ask them for their feedback about the service.

We reviewed a range of records about people’s care and how the service was managed. This included two people’s plans of care and associated documents including risk assessments. We looked at four staff files including their recruitment and training records. We also looked at documentation about the service that was given to staff and people using the service and policies and procedures that the provider had in place. We spoke with the team leader, a registered manager from another service, three care workers and a visiting health professional. The registered manager was on leave at the time of the inspection. We spoke with them following the inspection. We also spoke with the chief operating officer and the managing director following the inspection.

We spoke with three people who used the service, however due to communication needs it was not possible to seek detailed feedback from them. We also spoke with relatives for all three people who used the service. This was to gather their views of the service being provided. We observed staff communicating with people who used the service and supporting them throughout the day.

Updated 21 June 2017

This was an unannounced comprehensive inspection that took place on 3 April 2017.

Trinity Vicarage Road is a registered care home providing care and support for up to four younger adults with learning disabilities or autistic spectrum disorder. Trinity Vicarage Road is a detached two bedroomed house with an adjoining bungalow and self-contained flat, all of which share a small back garden. The property is located in a residential cul-de-sac within walking distance of the town and other facilities. At the time of our inspection there were three people using the service.

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.

People were protected from the risk of harm at the service because staff knew their responsibilities to keep people safe from avoidable harm and abuse. Staff knew how to report any concerns that they had about people’s welfare.

There were systems in place to manage risks and this helped staff to know how to support people safely. Where risks had been identified control measures were in place. However, these were not consistently followed.

There were enough staff to meet people’s needs based on the staffing rota. Staff told us that these staffing levels were not always provided. Relatives told us that there was a high use of agency staff and this concerned them. The provider has safe recruitment practices. This assured them that staff had been checked for their suitability before they started their employment.

There were plans to keep people safe during significant events such as a fire. Equipment such as fire extinguishers were checked to ensure that they were safe to use. Evacuation plans had been written for each person to help support them safely in the event of an emergency.

People received their medicines and were supported with this. We found that medicines were not always stored safely and creams were not consistently dated when they were opened. Staff had been trained to administer medicines and had been assessed for their competency to do this.

Staff received support through a structured induction. There was an on-going training programme to ensure staff had the skills and up to date knowledge to meet people’s needs. Staff had not been supervised regularly. However, most staff felt that they could approach their manager.

People did not always receive sufficient nutrition and hydration. Where one person had been identified as being at risk of malnutrition, supplements that had been prescribed were not given. Guidance from health professionals was not recorded accurately to ensure that all staff were following this. People accessed health professionals. Where monitoring of a health condition was required this took place. However, where guidance suggested that medical advice was sought this had not been done.

People were supported to make their own decisions. Staff and managers had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found that assessments of mental capacity had been completed. Staff told us that they sought people’s consent before delivering their support.

People were involved in decisions about their support. We saw staff treating people with respect. Staff treated people with kindness and compassion.

People were not always supported by staff who knew them well. They had care plans that provided information about them so staff knew what they liked and enjoyed. However, not all staff knew this information as they had not read the care plan. People were encouraged to maintain and develop their independence. People took part in activities.

People and their relatives knew how to make a complaint. The provider had a complaints policy in place and a system called ‘See something, say something’ to encourage people to raise concerns.

People’s relatives and staff felt that a lack of consistency in the management team had impacted on communication and staffing. Feedback had been sought in relation to the quality of the service. However, relatives and staff felt that they were not always listened to.

Systems were in place which assessed and monitored the quality of the service and identified areas for improvement. Some areas of concern that we found during our inspection had not been identified.

The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.