Background to this inspection
Updated
18 August 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 inspection took place on 17 and 20 July 2015 and was unannounced.
The inspection was carried out by one inspector. Before the inspection we looked at all the information we had about the service, including notifications of significant events which had taken place since we last inspected. We also received feedback from the local authority’s quality assurance and safeguarding team.
During the inspection we talked with four people using the service, the registered manager, one support worker and an agency worker.
We looked at the care records for two people using the service, the complaints records and other records relating to the management of the service, including audits carried out by the registered manager. We also viewed the staff training and the recruitment records for two support workers and one agency worker.
Following on from the inspection we obtained the views of the service from three healthcare professionals who supported people using the service.
Updated
18 August 2015
Micado -St Mary’s Road provides accommodation for up to five adults who have mental health needs. There were four people living in the service at the time of the inspection and one person was in hospital.
The registered manager informed us that there were plans to change the service from a residential care home to a supported living service. Supported living is where people would have their own tenancy and if they do not require assistance with personal care then the home they live in might not require to be registered with the Care Quality Commission (CQC). The people living in the service only required prompting to take their medicines and did not need assistance or prompting to manage their personal care needs. There was no date for when this would be taking place but people had been consulted about this potential change in the service they were living in.
This inspection visit was unannounced and took place on 17 and 20 July 2015. At the last inspection in 2013 there were no breaches of the Regulations.
The service had 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.
The rota showed that over a period of several weeks at least twice a week waking night staff had been starting their shifts earlier than 8pm and therefore were awake and working over twelve hours each shift. Sometimes they were working fifteen to seventeen hours. Waking night support workers were working alone and without taking a break. By working over twelve hours on some shifts the provider could not be confident that people were being supported safely and that waking night support workers were able to carry out their duties appropriately.
There were systems in place to record some of the medicines being delivered to the service. However, we found some medicines stored by the service where the quantity had not been recorded. Therefore it was not always clear how much of different medicines people had been administered.
There were some systems in place to monitor the safety and quality of the service. However, these had not been fully effective in highlighting the shortfalls identified during this inspection.
People said they felt safe living in the service and spoke positively about the support they received.
Healthcare professionals were also complimentary about the care and support people received from the registered manager and support workers.
There were appropriate procedures for safeguarding adults and the support workers were aware of these.
The provider had acted in accordance with their legal requirements under the Mental Capacity Act
2005 and the Deprivation of Liberties Safeguards. They ensured people were given choices and the opportunities to make decisions. People did not have restrictions in the service and people we spoke with confirmed that they had choices in their everyday lives.
The registered manager and support workers were caring, and treated people with dignity and respect. Care plans were clear and written in a way to address each person’s individual needs.
The support worker we spoke with and records we saw confirmed recruitment procedures were being followed.
New support workers received an induction to working in the service. Ongoing training and support was available for the support workers to ensure they had the necessary skills and information to work in the service.
People could choose what they ate and support workers were available to provide support and assistance with meals.
People felt confident to express any concerns and make a complaint, so that these could be addressed. The provider asked people for their views about the service.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to waking night staff working long hours, medicines not always being recorded when they were stored in the service and shortfalls in carrying out or recording the monitoring of the service.
You can see what action we told the provider to take at the back of the full version of the report.