St Mungo's Broadway - 2 Hilldrop Road

Updated 12 February 2021

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.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 28 January 2021 and was announced.

Updated 12 February 2021

We carried out this inspection on 30 May 2018 and 5 June 2018. The first day of the inspection was unannounced. We informed the provider that we would be returning on the second day.

St Mungo's Broadway – 2 Hilldrop Road is a care home which is registered to accommodate a maximum of 29 people with a history of alcohol misuse, homelessness and mental health conditions. On the days of our inspection, the service was providing care for 23 men.

During this inspection we found that the service had been steadily improving and addressing all issues identified by us during our inspections in December 2016 and May 2017. Staff and people using the service commented positively about the changes within the service. Both staff and people were encouraged to share their opinions, by the provider, about the service and contribute to any developments in the service provision.

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 current registered manager had joined the service in December 2017. The registered manager was supported by the members of the providers management team including the regional director and the head of services as well as the newly appointed deputy manager. The management team had the training and experience necessary to manage the regulated activity of accommodation for persons who require nursing or personal care.

At this inspection we found that the service had made improvements to how they managed medicines and people received their medicines in a safe way. Some additional improvements were needed to ensure PRN (as required) medicines administration was recorded correctly at all times and that PRN stock levels reflected the needs of people who used the service.

Risk to health and safety of people had been assessed and people lived in a safe environment. The provider needed to ensure all risk assessments carried out were equally robust and that appropriate records were in place to help to keep people and staff safe at all times.

The service provided people with freshly prepared food and drink which was nutritional and in suitable amounts. Staff were in the process of creating a nutrition information folder to ensure kitchen and care staff had an easy access to this information.

The provision of social activities at the service was reduced due to the recent changes in staff structure. However, the service was in the process of reviewing how activities were provided to ensure there was sufficient amount of interesting and fun things to do for people who used the service.

Staff helped to protect people from avoidable harm from others. Staff were trained in safeguarding adults and they understood their role in ensuring people using the service were safe from any type of abuse. Robust recruitment procedures in place ensured that only suitable staff worked with people. There were enough staff deployed on each shift and people’s needs were met with no delay.

The registered manager had assessed needs and preferences of people who used the service before they moved in. People were able to visit the service during the assessment process to find out if they liked it and if they would like to live there.

Staff were provided with regular mandatory and specialist training to enhance their skills and to be able to provide safe and effective care to people. Staff were also supported and their performance was monitored in regular one to one supervisions and yearly appraisal of their skills.

The service worked within the principles of The Mental Capacity act 2015 (MCA). Best Interest Decisions had been made when people did not have the capacity to decide about their care and treatment. Staff asked for people’s consent before providing any care.

Staff supported people to maintain a healthy lifestyle and had access to appropriate health and social professionals when required.

People were supported by kind and caring staff who respected people’s individual ways of being. Each person had an allocated key-worker who coordinated their care and supported people in making decisions about the support they received from the service.

Staff respected people’s privacy and dignity at all times. People were free to spend their time as they liked and staff did not interfere. However, staff always checked that people were well and safe.

Each person using the service had a person centred care plan which provided staff with information about who people were, what were their care needs and what goals they wanted to achieve through support received from the service. Staff took their time to learn and understand what people’s needs were and what was important to them.

The service promoted equality and diversity amongst people using the service and the staff team. Religious needs had been respected and different cultures were celebrated.

The service had dealt with people’s complaints promptly and according to the provider’s policy.

Staff told us they were supported by the management team. Staff were encouraged to use their skills, knowledge and personal interests to contribute to the improvement in the service delivery.

People were encouraged to express their views about the service they received. Evidence, such as records and our discussions with people who used the service, showed that people were asked about their preferences in how they would like the service to be provided and we saw that people’s opinion mattered.

There were sufficient quality monitoring systems in place to ensure continuous good quality of the service delivery.

We made one recommendation about management of PRN (as prescribed) medicines.