A comprehensive inspection of Cross Heath Drive, took place on 22 October 2018. This was announced as we needed to make sure the manager was available and people were home.Cross Heath Drive is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. We spoke with the manager regarding the name of the service and they told us the service was actually called Cross Heath Grove.
At the time of registration, the care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The service was working in line with these principles, which included choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Cross Heath Drive is a short break residential care service which aims to provide a holiday style atmosphere for up to five people who have a learning disability. Accommodation is in a purpose-built house with five bedrooms, each with en-suite facilities. Communal lounges, kitchen and dining areas are provided.
There was a registered manager in post at the time of our inspection, but they were moving to a new post within the company. A new manager was in the process of registering with Care Quality Commission (CQC). It was the new manager who I spoke with during this inspection. 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 2008 and associated Regulations about how the service is run.
Areas of people’s medicines were not well managed. Although, the evidence suggested this did not negatively impact on people’s well-being and the manager made immediate changes to rectify this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did not support this practice, as decision specific mental capacity assessments were not in place.
Quality management systems were in place but these were not always effective. The audits did not identify the concerns found during this inspection, which included, making sure areas of people’s support plans were up to date and accurate recording of people’s medications administration.
Accidents and incidents were analysed in a way which enabled trends to be identified. People and staff had opportunity to comment on the quality of service and influence service delivery. Complaints were welcomed and there was a system in place for handling complaints.
People received appropriate support for their nutrition and hydration needs. People had access to local healthcare professional, when needed, to make sure their health needs were met. Although, records regarding any unplanned admissions to hospital had not been updated for some time. Advocacy services were available if people, so wished.
Relatives told us their family member was safe when during their stay. There were systems and processes in place to protect people from the risk of harm. Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe.
The building was well maintained and regular safety checks took place. Plans were in place to safely evacuate people in the case of emergencies, although, these had not been reviewed for some time. We found the home was clean, tidy and well maintained. People had brought items from home to personalise their bedroom. Communal areas were comfortably furnished. The home was small with ramp access and wide door areas. People were familiar with the layout of the building.
We found people were supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment procedures were in place to make sure suitable staff worked with people who stayed at the service. Staff completed an induction when they started work. Staff received the training and support required to meet people’s needs.
People had access to a range of activities, both within the home and in the local community such as, going to day centres, events and nights out. Activities and daily pastimes were planned in a way to match people’s interests and preferences. People were encouraged and enabled to maintain contact with those important to them.
Prior to each stay, changes to people’s health and support needs were obtained. Support plans were person-centred and identified how care and support should be delivered. Throughout our inspection people were treated with kindness and staff had a good rapport with people. Staff clearly knew people well and worked together as a team to provide appropriate support. Support plans recorded if people had specific communication needs.
People’s dignity and privacy were respected and they were encouraged to maintain their independence and relationships with people who were important to them. We saw relevant information was shared between the staff team which, helped to ensure people received continuity of care. The home did not support anyone who was approaching the end of their life.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report. This is the first time the service has been rated Requires Improvement.