Cambridgeshire County Council - 6 St Lukes Close Huntingdon

We found the following examples of good practice.

Family and friends could visit people who lived at the service in line with current guidance.

External health and social care professionals and visitors such as contractors showed their vaccination status and completed a rapid COVID-19 test, prior to entering the service. They also had to wear the correct PPE. There was a separate building based in the services garden to facilitate this when needed.

Staff supported people to use computer tablets and phones to video call and/or communicate with family and friends. This promoted people’s social well-being. There were business contingency plans in place to help with any staff absences due to staff leave, staff being unwell or having to self-isolate due to COVID-19.

The providers compliance team had undertaken a COVID-19 risk assessment of the building. Following this to promote social distancing and good infection control practices, the number of people who could be admitted to the service at one time were reduced. Staff also staggered the times people were admitted into the service. This allowed time for staff to deep clean rooms and reduced the number of people who gathered in one area.

Staff completed a rapid COVID-19 test before each shift and sent the result to the registered manager for their records. Staff were observed to be wearing their PPE correctly including face masks. Staff were bare below the elbow and wore a minimum amount of jewellery with long hair tied up that promoted good infection control.

Cambridgeshire County Council - 6 St Luke’s Close Huntingdon is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Cambridgeshire County Council - 6 St Luke’s Close Huntingdon provides respite care and support for up to six people with physical and learning disabilities. Nursing care is not provided. People use the service for varying lengths of time such as overnight and weekend respite visits throughout the year. There are external and internal communal areas for people and their visitors to use. There were six people using the service when we visited.

At the last inspection on 19 August 2015, the service was rated Good. At this inspection we found the service remained Good.

The service has 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.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

People receiving respite care in the service were assisted by staff in a way that supported their safety and that they were treated respectfully. People had health care and support plans in place to ensure their needs were being met. Risks to people were identified and plans were put into place to enable people to live as safely and independently as possible.

There were sufficient numbers of safely recruited staff available to meet people’s care and support needs. Medication was safely stored and administered to people.

There was a friendly, relaxed atmosphere and staff were kind and attentive in their approach. People were provided with food and drink that met their individual needs and preferences.

Staff were trained to provide effective care which met people’s individual needs. The standard of staff members’ work performance was reviewed by the registered manager through supervisions, spot checks and appraisals.

The registered manager sought feedback about the quality of the service provided from people and/or their relatives, staff and visiting health professionals. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Where improvements had been identified, actions were taken. Learning from incidents were discussed at staff meetings to reduce the risk of recurrence.

Records showed that the CQC was informed of incidents that the provider was legally obliged to notify us of.

Further information is in the detailed findings below

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you would like to see the evidence that supports the summary, please read the full report.

At the time of our inspection on 15 and 16 September 2014, the provider was not carrying out the regulated activity 'Treatment of disease, disorder or injury' at this service. This regulated activity was therefore not assessed on this occasion.

We used a number of different methods to help us understand the experiences of people using the service. Some of the people using the service had complex needs which meant they were not all able to tell us about their experiences. We observed interactions between staff and the people staying at the home and spoke with four people who were staying at the home. We also spoke with five other people's relatives, four professionals who have regular contact with the staff and the people who stay at the home, and five staff members.

Placements to the home were through the local authority, which provided people and their families with specific number of days/ nights. The person and their family then arranged with the staff to use the allocated number during the year. At the time of our inspection there were 40 people who were provided with respite care throughout the year.

Is the service safe?

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People, and their relatives, told us that they, or their family members, felt safe with the staff and trusted them.

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. People's needs were assessed and care was planned and delivered in line with their individual care plans. The staff we spoke with clearly knew the people they were working with well and understood their care needs and preferences. However, we noted that one person's care plan did not record all the necessary information about the care and support they needed. Another person did not have a risk assessment for all the manoeuvres for which they required staff assistance. This meant there was a risk of unsafe or inappropriate care because accurate and appropriate records were not maintained.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Satisfactory recruitment checks had been obtained, and appropriate training given, prior to care workers providing care.

Is the service effective?

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. Visiting professionals provided us with positive feedback in relation to the care and support that people received from the staff at the home. One worker told us that staff always followed any guidance they put in place for people. They said, 'The staff always take on board what I say.'

Is the service caring?

The staff interactions with people that we saw were respectful and caring. People and their relatives told us that they were very happy with the care that they, or their family member, received. One person's relative told us, 'Staff do a brilliant job. They are very caring and supportive.' Another person's relative told us, 'The staff are pretty good. They display a great deal of care and affection. We know [our family member] enjoys coming here ....We've dropped in to see [them] here and [they] always seem happy. The staff do understand [my family member's] needs although these are quite complex.'

Is the service responsive?

We saw that the provider asked people, their relatives, and professionals involved with people's care, to complete annual feedback forms about the quality of the service provided. The majority of the feedback received was positive. Where areas for improvement had been identified, we saw that a senior member of staff had discussed this with the person completing the survey and action had been taken to make improvements to the service provided.

The staff we spoke with clearly knew the people they were working with well and understood their care needs and preferences.

Is the service well led?

A registered manager was in post at the service and had been so for several years. All of the staff we spoke with told us that they felt well supported by the senior team. We saw effective quality assurance systems were in place and concerns raised by people, staff and visitors were acted upon. We saw there were various audits in place to ensure that good standards were maintained. For example regular checks were made by senior staff that people's care plans had been updated.

We found that the provider was compliant with five of the six regulations that we assessed. We have asked the provider to tell us how they will make improvements and meet the requirements of the law. If you wish to see the evidence supporting our summary please read the full report.

During the inspection we saw that staff treated people with respect and in a positive and helpful way. One person told us: "I get on well with all the staff". Another person said: "I feel safe here. The staff listen and understand".

Information about training was available on a computer system. The provider may find it useful to note that computer information on staff training was not up to date and some of the staff on it had left but not been removed from the list. The staff had their certificates from training they had attended. However, according to the manager, a table that should have been completed by staff when they had completed any training had not been updated. A form which is completed by staff following training was used to upload the dates of the courses onto the table. The manager could then ensure all staff had completed mandatory training and when it was due to be updated. We found some certificates were available but there were some mandatory courses that had not been completed by staff.

We spoke with three people living in the home. One person said, "They're (the staff) always very kind." All of those we spoke with said they were well cared for and the staff were very good. There were many complimentary cards received in the home from relatives of those who had been cared for during respite stays.

We spoke with a health professional who stated the staff were very friendly, the home was always clean and the environment was good. They said the staff telephoned for advice when necessary and it was always appropriate.

We found the provider was compliant in four of the five outcomes we inspected. Although people received good care from staff who understood and knew them well, improvements in the administration and recording of medication were needed.