Mercury House is a new service which was opened as a respite centre for up to three people who are living with autism and/or learning disabilities. Respite centres offer people temporary accommodation and support for a period of time. One person had been living at the home soon after it opened in 2016 and two others had moved in to the home in 2017. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home is a semi-detached, three bedded house on a housing estate. There is a lounge with dining area, kitchen, office and shower room downstairs and three bedrooms and a bathroom upstairs. The back garden is laid concrete paving.
This was the first inspection of Mercury House and took place on 23 and 25 January 2018. The inspection was undertaken by one inspector and was unannounced.
There was 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 and associated Regulations about how the service is run.
The provider did not have a robust recruitment procedure in place and did not always gain satisfactory evidence of conduct and reasons for staff leaving previous care related employment.
Risk assessments identified when people were at risk from every day activities, but for one person an identified risk had not led to a risk assessment or care plan being put in place to protect the person. There was not a risk assessment for the building and garden which meant potential risks to people’s health and safety when accessing these areas had not been identified.
Medicines were not managed safely. Records were not complete and did not accurately detail how much medication there should be for each person. Care plans were not in place for medicines prescribed as “when required.”
The provider had policies and procedures in place designed to protect people from abuse but some staff had not completed training in safeguarding people. This meant staff may not be aware or identify any safeguarding concerns.
The registered manager said staff received an induction to the home but there was not a record of this on file. Training was available, but not all staff completed relevant training to support the needs of the people they worked with. Staff were supported in their work through regular supervisions.
The home appeared clean but the registered manager was not aware of current guidance relating to infection control. However, there were cleaning schedules in place and the home appeared clean.
People’s needs were assessed and their preferences understood before they moved to the service. People were supported by suitable numbers of staff who developed caring relationships with people. People were supported to maintain family relationships and friendships.
We checked whether the service was working within the principles of the Mental Capacity Act (2005) and whether any conditions on authorisations to deprive people of their liberty were being met. We found they were.
Although staff knew people’s needs well, care plans varied in the relevance of the information. People were supported to be actively involved in making decisions about their care. Staff offered to support people and waited for consent before they did so. Staff respected people’s privacy and dignity when supporting them with personal care. Staff cooked meals for people, who chose when and where they wanted to eat.
The provider had not established an accessible system for identifying, receiving, recording, handling and responding to complaints by people using the service or their representatives. There was not a complaints procedure in place.
There was a quality audit system in place which included weekly checks, for example, health and safety and fire equipment. However, this was not effective as it did not identify the concerns we found.
The service was open and inclusive and promoted a positive culture for people to live in. The service informally sought the views of people, their family members and staff. The service had started to learn, improve and innovate and worked in partnership with other agencies. The registered manager ensured improvements were made to systems when things had gone wrong or were identified as having the potential to go wrong. The registered manager and staff worked together within and across organisations to deliver effective care and support
We identified breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.