Background to this inspection
Updated
27 November 2018
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 comprehensive inspection took place on 6 November 2018 and was unannounced. One inspector and an expert by experience undertook the inspection visit. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert by experience on this inspection had experience of learning disabilities services.
Prior to our inspection visit, we reviewed the information we held about the service. We reviewed statutory notifications sent to us from the provider. A statutory notification is information about important events which the provider is required to send us by law.
The provider sent us their completed Provider Information Return (PIR), as requested. This is information that we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan out inspection visit.
Some people were unable to verbally tell us about their experiences of living in the home, so we spent time with them and we observed how their care and support were delivered in the communal areas. This helped us judge whether people’s needs were appropriately met and to identify if people experienced good standards of care.
During the inspection visit we had telephone conversations with three people’s relatives and four care staff. We spoke with four care staff, the registered manager and operations manager.
We reviewed two people’s care plans, daily records and medicine administration records. We also looked at the management records of the checks the registered manager and provider made to assure themselves people received a safe, effective quality service.
Updated
27 November 2018
We inspected this service on 6 November 2018. The inspection was unannounced and carried out by one inspector and an expert by experience.
The service is a ‘care home’ operated by Individual Care Services. The service, 1 Dexter Way provides accommodation with personal care for up to five adults. People cared for at the home are living with learning disabilities, and complex health and physical disabilities. People in care homes receive accommodation and 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. At the time of our inspection visit, there were five people living at the home.
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.
There was a registered manager in post. 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.
At the last inspection in March 2016 all five key areas were rated as Good. At this inspection we found the overall quality of care had been maintained and people continued to receive a service that was caring, effective and responsive to their needs. However, we found some improvements were needed in relation to the safety of the service. The overall rating continues to be Good.
There were enough staff on shift with the appropriate level of skills, experience and support to meet people’s needs and provide effective care. Staff knew what action to take in the event of an emergency and had been trained in first aid.
Staff understood their responsibilities to protect people from the risks of abuse. Staff had been trained in what constituted abuse and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.
Overall risks of harm and injury to people had been assessed and management plans were in place. However, risks of falls had not consistently been mitigated by the provider. Risks of cross infection had not been minimised by staff or the provider.
People were encouraged and supported to maintain good health. Staff frequently liaised with other healthcare professionals. People received their prescribed medicines in a safe way.
Staff worked within the principles of the Mental Capacity Act 2005. The registered manager understood their responsibilities under the Act. Four people had authorised deprivation of liberty safeguards in place when their care and support included restrictions in the person's best interests.
Staff supported people in a kind and compassionate way. Relatives felt staff were caring. People had varying levels of communication which were largely through gestures and non-verbal communication. These had been assessed so staff knew the appropriate communication methods to use to enable people to express themselves non-verbally, and make choices about day to day things such as what to wear.
People had detailed individual care and support plans which provided staff with the information they needed to respond to people’s needs. Staff recognised people as individuals and care was given in a person-centred way. This included people being supported with various activities both inside and outside the home.
The registered manager checked the quality of the service to make sure people's needs were met. Feedback about the service was encouraged.
Further information is in the detailed findings below.