At our previous inspection of the service which took place on 10 February 2014 we found that the provider was not meeting the regulation in relation to safe management of medicines. The provider sent us an action plan to tell us what improvements were going to be made.
This inspection took place on the 9 December 2014. Shila House provides support and accommodation for up to 14 adults with mental health needs.
There were 11 people living at the service when we inspected. The service had a registered manager. 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.
Some areas of the building were hazardous to people, staff and visitors due to inadequate maintenance of the premises.
People told us that they felt safe. Staff knew how to recognise and respond appropriately to incidents or allegations of bullying, harassment, avoidable harm and abuse. Staff were aware of people’s individual risk assessments which included people’s mental health, handling money and falls.
People told us there were enough staff on duty with the right skills. Effective recruitment procedures were in place to ensure that staff employed were suitable and had the necessary skills to work in the service.
Medicines were administered, stored and disposed of correctly and staff had received training in relation to the safe management of medicines.
People told us they were receiving the care they needed and that they knew the staff. People told us and we saw that staff had the skills and knowledge to carry out their roles and responsibilities. Staff were aware of people’s preferences and they had the necessary skills to provide care to people using the service.
Staff were supported and monitored to deliver care and treatment to people to an appropriate standard. Regular supervision sessions, appraisals and training had taken place.
Staff were aware of people’s capacity to make decisions, however most staff had not received recent training in the Mental Capacity Act 2005 (MCA). Staff obtained peoples permission before giving them care and support.
People were supported to maintain good health and have access to healthcare services and receive healthcare support. This included doctors, mental health specialists and occupational therapists. People were supported to receive adequate nutrition.
We saw and people told us staff showed compassion, dignity and respect towards people. People and people significant to them told us people were treated with dignity and respect. People were listened to and were encouraged to make their views known. Regular residents meetings were taking place.
People told us they received personalised care responsive to their needs. Some people participated in the activities available. People had regular one to one sessions. Staff handover meetings provided continuity of care.
People, people significant to them and staff were encouraged to raise concerns about the service. The provider had systems to listen and learn from people’s experiences, concerns and complaints and improvements were made.
People told us that the registered manager and staff were approachable. People and staff were asked for their views about the service.
Accidents and incidents were investigated and lessons learnt were shared with staff. The provider audited the service. Some audits for example the premises audit were not effective whilst others for example medicines management were.
The provider worked with the local authority to implement best practice including staff training and policies.