Background to this inspection
Updated
28 November 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 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.
The inspection took place on 19 and 21 September 2017 and was announced. We gave the provider 24 hours’ notice of our inspection as we needed to be sure that people would be available to speak with us and that the provider could give them notice, as not to cause any distress or disruption to their routines. The inspection was carried out by one inspector.
Before the inspection we reviewed the information the Care Quality Commission (CQC) held about the service. This included notifications of significant incidents reported to the CQC and the report for the last inspection that took place on the 24 November 2014, which showed the service was rated as ‘Good’. We contacted the local authority and used their comments to support our planning of the inspection. The provider also submitted a provider information return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with four people using the service, two relatives and 13 staff members. This included the branch manager, the service manager, the assistant director, the scheme coordinator, the activities and volunteer coordinator, the administrator, the care quality and compliance coordinator, a senior care and support worker and five care and support workers. We also spoke with two health and social care professionals who were visiting who worked with people using the service. We looked at four people’s care plans, seven staff recruitment files, staff training files, staff supervision records and audits and records related to the management of the service.
Following the inspection we spoke with another health and social care professional who worked with people using the service for their views.
Updated
28 November 2017
This inspection took place on 19 and 21 September 2017 and was announced. The provider was given 24 hours’ notice because the location provides extra care housing and we needed to be sure that people would be available to speak with us. We told the manager we would be returning on the second day. At the last comprehensive inspection in November 2014, with the inspection report being published in April 2015, the service was rated as ‘Good’.
James Hill House provides extra care housing for up to 30 older people with mental health problems, physical or other disabilities. At the time of our visit the service was supporting 28 people, but only providing personal care to 24 of them.
There was a manager in post at the time of our inspection who had recently been recruited and was in the process of completing their application to be a registered manager. They had been a registered manager previously with another provider. A registered manager is a person who has registered with the Care Quality Commission (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.
People were supported to follow their interests and maintain relationships with friends and family to increase their well-being. There were opportunities for people to take part in a wide range of activities, day trips and events, which included working in partnership with local organisations. There was evidence that cultural requirements were considered when discussing this and making sure these needs were met.
People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. The provider made sure people were confident their complaints would be taken seriously and encouraged them to raise any issues or concerns.
An initial assessment was completed from which care plans and risk assessments were developed. Care records were person centred and developed to meet people’s individual needs and discussed regularly during key work sessions. Staff had carried out unique training which helped them to understand more clearly the needs of people living with dementia.
People who required support with their medicines received them safely from staff who had completed training in the safe handling and administration of medicines. Staff completed appropriate records when they administered medicines and these were checked by staff and audited monthly to minimise medicines errors.
People and their relatives told us they felt safe using the service and staff had a good understanding of how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with.
The service had a robust recruitment process where applicants were assessed against the organisation’s values. Staff had the necessary checks to ensure they were suitable to work with people using the service. People using the service were also involved in the recruitment of staff.
People’s risks were managed effectively and care plans contained appropriate risk assessments which were updated regularly when people’s needs changed.
People were supported to have a healthy and balanced diet, which took into account their preferences as well as medical, cultural and nutritional needs.
Staff received the training and supervision they needed to meet people’s needs and were knowledgeable about their jobs.
People had regular access to healthcare services and other health and social care professionals, such as GPs, dentists and social workers. Concerns about people’s health were discussed at monthly multidisciplinary team (MDT) meetings.
People were spoken with and treated in a respectful manner. We saw that staff treated people with respect and kindness, respected their privacy and dignity and promoted their independence.
People and their relatives felt comfortable approaching the service manager, who had a visible presence throughout the service. Staff spoke highly of the working environment and the support they received from management, particularly during a recent restructure.
There were effective quality assurance systems in place to monitor the quality of the service provided and understand the experiences of people who used the service. The provider followed a monthly, quarterly and annual cycle of quality assurance checks and learning took place from the result of the audits.