Archived: United Response - 73 Elmers Green

The registered manager had left their position and was no longer working for the service. There was a new home manager who was in the process of registering with the Care Quality Commission. 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 our last inspection on 31 October 2016, we asked the provider to take action to make improvements in relation to the safe management of medicines, risk management, audits and quality monitoring, this action has been completed.

Relatives we spoke with told us their family members were safe in the home. Records relating to safeguarding investigations were in place and demonstrated the actions taken as a response to any allegations.

Medicines were stored, administered and handled safely. Staff had completed medicines training and competency checks that demonstrated they had the knowledge and skills to administer medicines safely.

Risks had been assessed and measures were in place to ensure people were cared for safely.

Appropriate staffing levels were in place that ensured people received suitable and timely care. Staff told us and records confirmed relevant training had been completed. Safe recruitment procedures had been followed to ensure only staff suitable for their role were employed to work with this vulnerable client group.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Capacity assessments had been completed and relevant deprivation of liberty applications had been submitted to the assessing authority.

Choices of meals were seen. People were supported to be involved in decisions relating to the meals on offer.

Relatives told us they were happy with the care people received. We saw staff interacting well with people and it was clear people were treated with dignity and respect. Measures to ensure people were supported with their individual communication needs was recorded in their care files.

Care files were detailed and comprehensive and provided information about how to support people’s individual needs. Systems were in place to support people’s end of life needs, if it was required.

There was a variety of activities available for people to take part in. We observed activities taking place during our inspection.

Systems to deal with complaints were in place. Policies and procedures were available to guide staff about how to deal with complaints.

We received positive feedback about the improvements that had been made since the new home manager started at the service. Team meetings were regular and minutes confirmed the topics discussed as part of the meetings.

Regular audits and quality monitoring were taking place. This ensured the home was safe for people to live in.

United Response – 73 Elmers Green is a care home, providing accommodation and personal care for up to four people who have a learning disability and who may have complex needs. The property is a bungalow situated on a quiet residential estate in Skelmersdale. People who live in the home have their own bedrooms and there are suitable shared facilities including a spacious sitting room, dining kitchen and gardens for people to use.

There was a registered manager employed in the home. 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 who used the service were not able to tell us their views about their care. We saw that people were comfortable with the staff who were supporting them. They approached the staff in a confident manner and showed no signs of anxiety around any of the staff on duty during the inspection.

The staff on duty knew people well and knew how people expressed their wishes about their support. We saw that people made choices about their lives in the home and the decisions they made were respected.

The staff were knowledgeable about how to protect people from abuse.

Each person had a detailed care plan that gave guidance for staff about how to provide their support. The care records included information about how to keep people safe from identified risks. However, we saw that one staff member had not followed guidance about how to protect people from the risk of choking. People were not always safe because risks to their safety were not always managed. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Medicines were not always handled safely in the home. Although care staff had received training in how to support people with their medicines, the procedures used when administering medicines did not protect people from the risk of harm. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were enough staff to support people and to allow them to take part in activities they enjoyed in the home and in the local community.

Staff treated people in a kind, caring and respectful way. They gave people time to carry out tasks for themselves and supported their independence. The staff knew people well. They knew how people communicated their wishes and gave people choices in a way they could understand.

Staff had received training to give them the skills and knowledge to provide people’s support. However, we saw the training provided had not always ensured people received effective care.

People knew the staff and registered manager of the home. Care staff felt well supported by the registered manager.

The registered manager understood her responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People’s rights were protected because the principles of the MCA had been followed.

The registered manager carried out checks on the service provided. However, these had not ensured that staff followed guidance about how to protect people or that the procedures for handling medicines were safe. The systems used to assess the service been effective in ensuring the safety of the service. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

We looked at records and found care and support was planned and delivered in a way that ensured people's safety and welfare. Care plans reflected people's needs, preferences and diversity. They were sufficiently detailed to make sure peoples' care and support would be provided according to their needs and safety. Lifestyle profile supported staff day and night to provide a personalised approach to individual needs.

People's care and support was planned and delivered in a way that protected them from unlawful discrimination. People were involved in the local community and leisure time was arranged around what people wanted to do. Staff had written guidance how to support and protect people in difficult situations. There was enough staff who were trained to support people as and when they required it.

We observed people were comfortable around staff and showed no sign of fearful or concerning behaviour around them.

People lived in a well maintained environment that met with their needs and kept them safe.

We saw written confirmation people were supported to give their views. People could access an advocate and other health and social care professionals to act in their best interests and promote their quality of life experience.

The people living at Elmers Green had limited verbal communication but could communicate in a number of other ways. They were given information in a format that they could understand and were supported by their families and people who knew how to communicate with them when decisions needed to be made about their care and welfare. They were represented in their best interests when it was appropriate to do so.

The people who lived at Elmers Green were cared for by staff who were appropriated recruited, well trained and experienced at supporting them.