Background to this inspection
Updated
21 September 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 checked 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 comprehensive inspection took place on 2 August 2017 and was unannounced.
The inspection team consisted of one inspector and an expert by experience. The expert by experience had personal experience of using similar services.
Before the inspection, we looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to decide which areas to focus on during our inspection. We spoke with the local authority who commissioned the service for some people who lived there. We also sought feedback from Healthwatch Leicestershire (the consumer champion for health and social care.)
We spoke with a relative of a person who used the service. People were not able to give us their feedback due to communication difficulties, but we observed care and support offered to people throughout the day. We spoke with the operations manager, the manager, a peripatetic manager and two support workers.
We looked at the provider’s records. These included both people’s support plans, health records, risk assessments and daily records. We looked at three staff files, a sample of audits, satisfaction surveys, staff rotas, and policies and procedures.
Updated
21 September 2017
The inspection was carried out on 2 August 2017 and was an unannounced inspection.
Greenmoor Road is a registered care home providing care and support for two younger adults with learning disabilities or autistic spectrum disorder. At this inspection, there were two people living in the service.
There was a manager in post who was applying to become the registered manager. They had been working at the service since June 2017. 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.
Relatives told us they were not sure people were safe when receiving support from staff at Greenmoor Road. People were protected against the risk of abuse. Staff recognised the signs of abuse, what to look out for and knew how to report any concerns. Medicines were managed safely. However some medicines were not dated when they were open to ensure they were not open for longer than the manufacturers recommended timescales. People received their medicines as prescribed.
Staff followed guidance to minimise identified risks to people's health, safety and welfare. There were enough staff to keep people safe. The provider had appropriate arrangements in place to check the suitability and fitness of new staff.
The service was not always kept clean or well maintained. The operations manager had plans to address this.
Staff received regular training and supervision to help them to meet people's needs. Their understanding of this was not checked. There were plans to introduce checks on staff understanding. Staff completed an induction to enable them to get to know the service.
People were encouraged to follow a balanced diet. Where someone had a specific diet that they followed guidance was in place for staff to follow. People received the support they needed to stay healthy and to access healthcare services. Not all healthcare appointments were recorded although they had taken place.
People were supported in line with the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). The provider and staff understood their responsibilities under the MCA
Staff were caring and treated people with dignity and respect. They ensured people's privacy was maintained. People were supported to have choice and control of their lives.
Staff who knew people well understood how they communicated. The guidance about how people communicated in their support plans was limited.
Each person had an up to date support plan that was centred on them as an individual. This provided staff guidance on how to meet people’s support needs and their likes, dislikes and preferences. These had been reviewed recently with relatives to gather their input.
People were encouraged to participate in activities. However these were not always tailored towards supporting people's independence. People were supported to maintain relationships with people that mattered to them.
People and their relatives’ had access to a complaint’s procedure and felt confident to raise any concerns that they may have. However, complaints were not always responded to.
There had been a number of changes in the management of the service that had impacted on the quality and consistency of support that people received.
Staff told us that they could approach the manager and felt supported by them. Team meetings had not been held regularly.
There were systems and processes in place to monitor and review the quality of the service that people received. Where areas for improvement were identified an action plan was put in place to address these. The manager had not been in post long enough to implement the changes that had been identified.
People and their relatives were encouraged to provide feedback about how the service could be improved. They felt this was not always listened to.
Further information is in the detailed findings below.