20 July 2016
During a routine inspection
The inspection took place on 20 and 26 July 2016, and was announced. As the service is run similar to a domiciliary care agency we gave 48 hours’ notice of the inspection to ensure that staff would be available in the office to assist us with the inspection.
The service had a registered manager in place. 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 had care plans in place for identified care and supports needs. We found that staff were knowledgeable about people’s needs and risks and what action to take to protect them from these risks. Staff responded to changes in people’s care needs.
Staff understood the importance of promoting independence and this was reinforced in people’s care plans. People were supported to express their views and to be involved in making decisions about their care and support. People told us that staff were responsive in changing the times of their visits and accommodating last minute appointments when needed. People had access to activities that were important and relevant to them.
People and their relatives told us they felt safe at Mitchison Court. Staff had a clear understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.
There were sufficient numbers of staff deployed who had the necessary skills and knowledge to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff started work.
Medicines were managed, stored and disposed of safely. Medicines were administered by competent staff and any changes to people’s medicines were prescribed by the person’s GP.
People lived in a safe well maintained environment. People had access to bathrooms that had been adapted to meet their needs; there was specialist equipment such as adjustable chairs and specialist beds as required. Arrangements were in place for the security of the building and people who lived there.
Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The service had a business contingency plan that identified how the service would function in the event of an emergency such as fire, adverse weather conditions, flooding or power cuts.
The registered manager ensured staff had the skills and experience which were necessary to carry out their role. All new staff completed an induction programme at the start of their employment. Training was provided during induction and then on an ongoing basis. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.
Staff were up to date with current guidance to support people to make decisions. Staff had a clear understanding of the Mental Capacity Act (MCA) as well as their responsibilities in respect of this. People confirmed that they had consented to the care they received. They told us that staff checked with them that they were happy with the support being provided on a regular basis. Mental capacity assessments were completed for people and their capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise.
People were supported at mealtimes to have the food and drink of their choice. The support people received varied depending on people’s individual circumstances. Staff were available to support people to attend healthcare appointments if needed and liaised with health and social care professionals involved in their care if their health or support needs changed.
Positive, caring relationships had been developed with people. Everyone told us they were treated with kindness and respect by the staff who supported them. Staff were respectful of people’s privacy and maintained their dignity.
People and their relatives told us they were aware of the formal complaint procedure and they were confident that the registered provider or staff would address concerns if they had any.
People and their relatives said that staff provided a good service. Staff were motivated and told us that they felt fully supported by the management team. They said that the registered manager and senior staff were approachable and kept them informed of any changes to the service.
People’s care and welfare was monitored regularly to ensure their needs were met. The provider had systems in place to regularly assess and monitor the quality of the care provided.
People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the service.
Senior management liaised with and obtained guidance and best practice techniques from external agencies, professional bodies and experts in their fields.