21 March 2017
During a routine inspection
Church House also offers respite/short breaks for young people with a learning disability, physical disabilities and Autism. There were no people staying for planned respite at the time of the inspection.
The service became registered on 08 November 2016 to provide personal care in the community to support people with learning disabilities to live in their own accommodation. The service was not yet providing support to people in the community so this report only covers the regulated activity of accommodation for persons who require nursing or personal care.
At the last inspection on 06 January 2015, the service was rated Good.
This inspection took place on 21 March 2017 and was announced.
There was a registered manager employed at the service. 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 feedback we received from people and their representatives was excellent. Those people that used the service and their representatives expressed great satisfaction and spoke very highly of the registered manager and the staff. Everyone within the organisation was highly motivated and committed to ensuring people that used the service had good quality care.
Medicines were mostly managed safely. One medicine was in stock but there was no record of it. Expiry dates of medicines had not always been checked. This put people at risk of receiving medicines that were out of date. Policies and procedures were in place for the safe administration of medicines and staff had been trained and assessed to administer medicines safely. Staff were observed by the provider and registered manager before being 'signed off' as competent. We made a recommendation about this.
Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support because employment checks and references had been gained before staff started their roles. The registered manager had not always identified where staff had gaps in their employment.
The safety of people was taken seriously by the registered manager and staff who understood their responsibility to protect people's health and well-being. Staff, including the registered manager, had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people's and staff member's safety both internally and externally had been assessed and recorded, with measures put into place to manage any hazards identified.
Staffing levels were kept under review to ensure staff were available to meet people's assessed needs.
Staff had a full understanding of people's care and support needs and had the skills and knowledge to meet them. People received consistent support from the same staff who knew them well. Staff were trained to meet people's needs. Robust induction procedures were in place to ensure staff were able and confident to meet people's needs. The provider encouraged staff to undertake additional qualifications to develop their skills.
People's needs had been assessed to identify the care and support they required. Care and support was planned with people and their representative's and regularly reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed.
People received personalised support from staff. This encouraged and supported people to be active members of their community and involved in having a voice. Staff took people’s views seriously and supported them to write letters to challenge issues that they had an interest in. People were supported to achieve goals to enable them to gain skills and greater independence. Each person had a specific goal plan in place which detailed what the desired outcome was such as managing their own money, self-managing medicines, acknowledging personal space boundaries and travelling independently. People’s achievements were celebrated.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People had capacity to make their own decisions. Staff respected people’s decisions.
People were supported to be as independent as possible to manage their own nutrition and hydration. People shopped for their own food and had support to prepare and cook food if this was needed. Staff had received specialist training to enable them to support a person with percutaneous endoscopic gastrostomy (PEG). This enabled the person to receive suitable nutrition and hydration. Staff ensured people remained as healthy as possible.
People had positive relationships with the staff. People were treated with dignity and respect by staff who also maintained people's privacy. Staff were kind and caring and enabled people to participate in various activities they enjoyed within the home and in the local community, enhancing people's well-being and sense of purpose.
The provider and registered manager were committed to providing a high quality service to people and its continuous development. Feedback from people, their representatives and others was continually sought and used as an opportunity for improve the service people received.