Archived: Royal Mencap Society - 8 St Winifred's Road

The service is registered to provide care and accommodation for up to eight people who have a learning disability. At the time of our inspection seven people were living at the service. 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.

People told us, “The staff are good fun” and we saw that people were happy and comfortable within the service and enjoyed the company of their care staff. Staff told us “People are happy here” and, “It’s a lovely place really. It is really really brilliant. You look forward to coming to work.” While professionals commented, “[Person’s name] seems very happy.”

The registered manager and staff knew people well and staff spoke warmly of the people they supported. Staff told us, “the people are lovely” and, “my service users are fantastic, it can be hard work but it is worth it.” Staff understood local procedures for the safeguarding of vulnerable adults and their responsibilities in relation to protecting people from possible abuse.

People’s care plans were detailed, informative and up to date. Each person’s care plan provided staff with detailed guidance on how to meet their individual care needs. This including information on the level of support the person normally required with specific activities. People, relatives and care staff met regularly to review and updated people care plans. During these meeting people’s individual goals were discussed and plans developed to support people to achieve these objectives.

Risks had been clearly identified and people’s care plans provided staff with guidance on the actions staff must take to protect people and themselves from identified risks.

Staff did not use physical restraint and we observed them successfully using techniques described within people care plans to help people to manage their anxiety.

People were supported to lead full and varied lives and staff supported people to engage in a wide variety of activities they enjoyed. People told us they enjoyed living at the service and one person said, “I work on Thursday in the kitchen, I enjoy it.” People were able to choose which activities they engaged in each day and staff responded promptly when people wished to engage with individual activities. For example, one person decided they wanted to go out for a picnic lunch in a local park, staff supported the person to prepare sandwiches before leaving for the walk. Staff told us, “This is a very busy house, no two days are the same.”

To ensure people did not become socially isolated the service regularly hosted events in local community centres and a public house. These included a weekly craft and social evening, disco nights and other evening activities. Some people had expressed an wish to vote during the general election. Easy to read campaign materials had been sourced and parliamentary candidates invited to an event to help people choose who they wished to vote for.

People’s privacy and dignity was consistently respected. Staff supported and encouraged people to make decisions and respected their choices. Staff told us, “There is lots going on, people have free choice of what they want to do. Real freedom of choice. People are supported to live rather than carers doing things for people.”

Although the service was short staffed there were enough staff on duty to on the day of our inspection to ensure people’s care needs were met. The service was actively recruiting to fill four staff vacancies and agency staff had been used appropriately to ensure all planned staff shifts were covered. The services recruitment processes were safe and robust. Visits to the service formed part of the interview process to provide people with an opportunity to meet prospective members of staff.

All new staff received formal induction training designed to ensure staff understood their new role and felt confident they could meet people’s needs before they provided care and support independently. Staff told us, “One new member of staff has been shadowing for at least three months. It is quite a long time”, “I think the training is well organised” and “I have had lots of training.”

The staff team were well motivated and focused on enabling the people they supported to be as independent as possible. Staff told us they were well supported by the registered manager and that their feedback was listened to and valued. The registered manager valued the staff team’s commitment to supporting people to be as independent as possible and told us, “I think I am really lucky with the team in general.” Records showed staff received regular supervision, annual performance appraisals and that staff meetings were held regularly at the service. .

Weekly menu planning meetings were held at the service and people were involved in the planning of the service’s menu, shopping for ingredients and preparing meals.

Accidents and incidents were appropriately recorded and had been fully investigated by the service’s registered manager. Regular audits of the service’s performance had been completed by the registered manager to assess the service’s performance and identify any areas where improvements could be made. In addition the provider’s quality assurance team had visited the service in January 2016. Recommendations made as a result of this visit had been addressed by the registered manager.

People knew how to make complaints and information about the service’s complaints procedure was displayed in an easily understood format in the kitchen. A survey of people’s views on the service’s performance had recently been completed and the feedback people had provided was entirely positive.

We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The manager was aware of their responsibilities under the Mental Capacity Act (MCA). There was no one accommodated at the home under this safeguard at the time of our inspection. No applications had been made under the Deprivation of Liberty Safeguards (DoLS) however, the manager knew the procedures to follow and was making applications in light of changes in recent national guidance.

The manager had taken action to review policies and procedures for the safe management an control of infection risks. Staff were aware of their roles and responsibilities and kept the home clean and hygienic. The manager had procedures in place to monitor practices.

Policies were in place and procedures were followed by staff to management people's medicines safely. This included, handling , storage, administration and recording. Systems were in place to train staff and monitor staff practices and ensure they supported people with prescribed medicines correctly.

There was an on-going programme of redecoration or to upgrade the environment to ensure the premises was safe and met the needs of people accommodated

Is the service effective?

Daily records of care and monitoring charts for individuals for specific issues showed people were cared for according to their care plan and assessed needs. Staff we spoke with were fully aware of people's care requirements and how to meet them. Staff and the manager told us staffing levels were organised to provide adequate staff to effectively meet people's individual needs on a day-to-day basis.

People told us they received the care they required. For example, one person said they could make choices on a day to day basis, had the help they needed and had plans to do things they liked doing.

Is the service caring?

We saw the staff were friendly and caring towards the people living in the home. Staff were attentive to people's needs and for example supported them to use the garden where most people chose to eat their evening meal. A large garden umbrella offered protection from the sun. Staff and people spoke about activities they enjoyed and these were being arranged according to their individual preferred interests. People and staff told us short term plans for external activities included day trips and a trip to the theatre. The people we spoke with were very enthusiastic about this. Staff showed a good knowledge of people's individual needs in the way they helped them and how they provided support. One person told us for example that 'staff were nice' and they could 'have fun 'with them. Another person said 'the staff are all right to me' and they 'talk to me'.

Is the service responsive?

The manger had addressed the concerns we raised at the last inspection regarding infection control. This showed they had responded to the concerns raised and taken action to rectify these appropriately.

Staff responded to people's wishes. Activities were based on plans to meet people's assessed needs. This applied to all areas of care. We saw that members of staff checked what people wanted, listened to people and acted on their requests throughout our visit. Staff told us they had enough time to talk with people throughout each shift and check their preferences. There was a keyworker system, each person was allocated a staff member who met up with them on a monthly basis. During this meeting people's care needs were reviewed and action plan developed.

Regular house meetings took place where people were consulted. People and staff told us people had been involved in decisions such as food on the menu and home decorations.

A responsive system was in place to ensure the prompt involvement of medical professionals in people's care when this was required.

Is the service well-led?

Quality assurance systems were in place and these were used to ensure improvements were made to the service. A regular system of monitoring aspects of the service was in place through weekly and monthly checks. The findings informed a continuous improvement plan which was monitored to ensure improvements were made.

The registered manager was not on duty and the operations manager assisted with the inspection process. We looked at systems and procedures. Appropriate recruitment and induction procedures were in place with all necessary pre-employment checks being completed. Arrangements were not fully comprehensive to ensure there were effective systems in place to reduce the risk and spread of infection and to keep the home clean. An effective system to regularly assess and monitor the quality of service that people received was in place. Systems were in place for obtaining feedback, and addressing incidents.

In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of this inspection.