Archived: Care Management Group - Tamarisk House

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways, promotion of choice and control, independence, and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were safeguarded from the risk of abuse.

Individual risks to people were identified and managed and covered falls, choking and anxieties.

There were safe protocols in place to ensure that people received their medicines as prescribed.

Systems were in place to monitor accidents and incidents to take action to prevent things going wrong in the future.

Peoples needs were holistically assessed and person-centred so that staff could support people according to the choice and preferences.

Staff had the training and support they needed to support people.

The service worked with professionals to ensure that their healthcare needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff treated people with kindness and compassion. They understood people well and responded to their needs.

People were involved in making decisions about their care through key worker meetings, residents’ meetings and in the day to day delivery of support.

Care plans included details of people’s hobbies and interests and the service supported people to maintain these as well as to develop new interests.

There was a strong person-centred management team leading the service.

Robust procedures were in place to monitor and audit the quality of care.

A business plan supported the process of driving improvement. This was discussed with staff at staff meetings and supervisions.

The service had consideration of equality characteristics and had actively supported people to enable them to combat discrimination and live the life they chose.

Rating at last inspection: At the last inspection the service was rated good (report published 16 December 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

The service provides a home and support for a maximum of five people with a learning disability. At the time of our inspection, five people were living there. The home is a bungalow in keeping with others in the local community.

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.

Staff promoted people's safety. They knew they had to report any concerns that people might be at risk of harm or abuse, and how to go about this. There were enough staff to meet people's needs and they were recruited in a way that contributed to promoting people's safety.

Risks to people's safety were assessed and staff followed guidance about managing these. Staff knew how to respond in an emergency such as a fire or accident so they could help people to stay safe. The safety of the home and the way that people were supported, including with their medicines, was checked regularly so that any problems could be picked up quickly.

People received support from trained and competent staff. The management team had plans to improve the way that care records focused on individual needs and preferences. However, staff had a good understanding of each person, their needs, wishes and preferences so that they could support people as they wanted.

Staff were aware that any action they took to ensure people's safety and welfare should not restrict them unreasonably. Staff understood the importance of the law about gaining people's consent to receiving care and ensuring they acted in people's best interests. Staff involved family members who knew people well in planning how people's needs could be met.

People received support to eat and drink enough to keep them well and healthy. Staff ensured they sought guidance from professionals and acted on advice from them to promote people's physical and mental wellbeing. They understood the signs that people might show if they were becoming unwell or in pain so that they could respond promptly.

Staff treated people with regard to their dignity, privacy and independence. They took action to intervene if people were upset, anxious or distressed and understood how people might express this. They made efforts to involve people in the day-to-day running of their home and to promote a warm, family atmosphere.

There had been changes in the overall management of the service, but a deputy manager had provided support and guidance to staff. This contributed staff clarity about their roles and responsibility. The new registered manager had been in post for only five weeks at the point of this inspection, but had gained the confidence of staff and family members. They had also identified priorities for further improvement.

People spoken with told us that their keyworkers supported them with their care and helped them to put their 'person centred plan' together. They showed us they knew what was in them. People told us that they were "...happy..." with their keyworkers and that the staff were "...good". The staff member on duty encouraged one person to participate in preparing the evening meal and the person said they enjoyed helping. We also observed that people were offered choices about where they wanted to spend their time, and about drinks.

People's needs had been assessed and records showed that care was planned to meet these needs. There was information about risks to which people may be exposed. A staff member explained these clearly to us and how they were to be minimised. They also gave us information about people's health care, which was consistent with what was in the records we reviewed. This showed that people's safety and welfare was promoted.

People told us that staff helped them with their medicines. There were full records of the medicines that had been given and supplementary guidance for medicines needed only occasionally. Tubs and pump dispensers for creams were not dated when they were opened. This would be good practice in ensuring they remained safe and effective in use. However, we found that these had been recently supplied and we were informed they were replaced each month. This meant people were not at risk.

People told us about the things they were able to do with staff support. This included opportunities for outings and holidays. A staff member on duty felt there were sufficient numbers of staff to meet people's needs safely. We concluded from what we saw and had been told, that there were enough staff employed to meet people's needs effectively and that staff had a clear understanding of their roles.