Archived: Housemartins

We previously inspected this service on 20 July 2016. At this inspection we identified a breach of regulationsin relation to the safety of the environment. This inspection was to follow up if the required improvements had been made.

This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Housemartins on our website at www.cqc.org.uk

When we visited, the registered manager had left. A new manager was appointed who had previously worked at the service. They were in the process of registering with the Care Quality Commission, which was completed on 28 February 2017. 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 this visit we found people were safer because improvements had been made to address environmental risks at the home. People were protected from scalds because the hot water supply was now thermostatically controlled. This was to ensure hot water temperatures in areas of the home people accessed independently were within the health and safety executive recommended range. Fire safety had been improved as new emergency lighting and fire alarm sounders had been fitted and an external fire exit was being fitted, which provided a second means of escape from the building in the event of a fire. Faulty window restrictors had been fitted in two upstairs bedrooms, which reduced risks of people falling from the upper floor.

People were protected from potential abuse and avoidable harm. Staff had received safeguarding adults training and the provider had safeguarding and whistle blowing policies. This meant staff were clear about how to report concerns. The manager had notified the Care Quality Commission and the local authority safeguarding team about suspected abuse concerns and sent details of action taken in response.

Staff demonstrated a good awareness of each person's safety and how to minimise risks for people. Detailed individualised risk assessments showed risks for each person and identified ‘triggers’ so staff could avoid them wherever possible. Detailed behaviour support plans and relevant training meant staff felt much more confident in managing any behaviour that challenged the service. Accidents and incidents were reported and included measures to continually review and improve practice and reduce the risks of recurrence.

People were supported by skilled staff that provided care at a time and pace convenient for each person. People received their medicines on time and in a safe way. The home was clean throughout. Checks of cleanliness and infection control were carried out with actions taken in response to findings.

Housemartins is registered to provide accommodation with personal care for up to five people with learning disabilities. Four people currently live at the home, some people had autism and others had physical health needs.

The home had a new registered manager who registered in March 2016. 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 this inspection we identified several environmental risks for people who lived at Housemartins. These included scald risks due to excessively hot water, broken window restrictors in some upstairs bedrooms, and fire risks, identified by a contractor who visited the home on 13 July 2016 to undertake a fire risk assessment. We asked the registered manager to seek further advice to help them risk assess and prioritise what urgent actions were needed to improve people’s safety and reduce environmental risks for them. They sent us a report within a few days of the inspection, which set out actions underway to address the concerns. They have kept us regularly updated since then on the progress of remedial works being undertaken at the home.

Staff treated people with sensitivity, dignity and respect. People’s physical and psychological needs were met by staff who were knowledgeable and confident to care for them. People were supported to keep in touch with family and friends and spend time with them.

People had access to healthcare services for ongoing healthcare support. Staff recognised when a person's health deteriorated and sought medical advice promptly when they were feeling unwell. They worked closely with local healthcare professionals such as the GP, community nurse and learning disability team, who confirmed staff sought advice appropriately about people's health needs and followed their advice. People received their prescribed medicines on time and in a safe way. They were supported to improve their health through good nutrition. Staff encouraged people to eat a well-balanced diet, make healthy eating choices and be active.

Staff demonstrated a good understanding of what might constitute abuse and knew how to report any concerns they might have. For example, staff knew how to report any concerns within the organisation and externally to organisations such as the local authority, police and to the Care Quality Commission.

Staff were knowledgeable about people's care needs and received regular relevant training and updating. The provider had a written complaints policy and procedure, although no complaints were received. Information about how to raise concerns or complaints was provided in a suitable format for people. People and relatives said they could speak to the registered manager and other staff if they had any problems.

The culture at the service was open, and promoted person centred values. Staff worked proactively with other professionals for the benefit of the people they supported. The provider had a range of quality monitoring arrangements in place. These included audits of care records and medicines management and regular health and safety checks. They made continuous improvements in response to their findings.

We found that people's views and experiences were taken into account in the way the service was delivered. One person's relative commented in a survey, 'All staff happily listen to any thoughts and suggestions and act on them accordingly.' We saw people were enabled to be involved in decisions about their daily life, whatever their communication or other needs were.

People told us that they got on with all the staff, including the registered manager. There was a stable staff team who, through supervision and training, were able to deliver care safely and to an appropriate standard. Staff we spoke with knew individuals well, and we saw people were offered support in a friendly, caring way.

People's care needs were assessed and care plans showed that they were to be supported in individualised ways to meet their needs and preferences. Their health and medication needs were met as well as their social needs. Individuals' privacy, dignity and independence were respected, with people having various opportunities to be part of their local community.

There were five people living in the home at the time of our inspection including two people who had just returned from spending Christmas with their families. People were seen to be able to move freely about the home and outside and were comfortable in each others company as well as with the staff who supported them.

People were routinely asked for their consent about their care treatment and support by staff and professionals visiting the home.

We saw a comprehensive range of information in the documents and forms about people in the home and saw how people and their families had been involved in planning to meet people's needs.

The home had a clean and tidy appearance and there was a simple cleaning routine in place to manage every day cleanliness, hygiene and infection control.

The risks to people were minimised and their safety protected whilst their independence was encouraged.

We found there were sufficient staff available to meet people's needs and that the staff were knowledgeable and well supported by the provider.

We saw evidence that routine quality assurance processes and regular audits and service monitoring was undertaken.