Archived: Blackwood Road

Blackwood Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Blackwood Road accommodates up to seven people in one adapted building. At the time of inspection the service was providing support and care for seven people with a learning disability, as well as people with a physical disability.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the last inspection, the service was rated good. At this inspection we found the service remained ‘Good’ and the responsiveness of the service had improved to outstanding.

People and relatives were without exception extremely positive about the care and support provided. The service was adaptable and responsive to people’s individual needs and choices, empowering people to live as full lives as possible. Information was provided in a range of accessible formats to assist people in understanding the care available to them. Relatives we spoke with, our observations and records we viewed clearly demonstrated that people received highly personalised care. People had choice and control over how their needs were met. Staff listened to people and worked with them to achieve their goals from preparing cakes, planning a holiday to researching and locating a family member’s grave.

The provider had systems in place to ensure people were protected from abuse and harm. Staff had completed safeguarding training and were aware of the provider’s whistleblowing process. Safeguarding concerns were fully investigated with appropriate action taken. Risk assessments were specific to the person and identified the risk and the actions needed to be taken to keep the person safe. Medicines were managed safely. Sufficient well trained staff were available to ensure people’s needs were met promptly. The provider ensured checks were in place to maintain the safety of the home. Systems were in place to ensure people would remain safe in the event of an emergency.

The home was well maintained and decorated to a high standard. People and relatives were consulted in the choice of décor. People were supported to personalise their own rooms. The service supported people to gain access to healthcare professionals. People were promoted to eat a healthy balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Relatives told us staff were kind and caring. People were treated with respect and dignity. Staff had extensive knowledge about people, their preferences, interests and people important to them. People were involved in all aspects of decision making about their care and treatment. People were encouraged to be as independent as possible.

External healthcare professionals told us the service provided exceptional end of life care, stating staff went that ‘extra mile.’ A relative told us, “They were all amazing. The care [relative] received was outstanding.”

Care plans were person centred and provided staff with clear information on how to support people in line with their preferences. Staff worked well together. Staff told us they were supported by the management team. The provider had an effective quality assurance processes to monitor the quality and safety of the service provided and to ensure that people received appropriate care and support.

The provider had a clear ethos of providing high quality care for people. The registered manager and the manager were passionate about people receiving the best care possible. Feedback from people, relatives and staff was continually sought and acted upon.

Further information is in the detailed findings below.

We previously inspected the service on 4 November 2013 and found the service was meeting the requirements of the regulations we inspected.

Blackwood Road provides personal care and support for up to seven adults with a learning disability, as well as people with a physical disability. At the time of our inspection there were seven people living in the home.

At the time of our inspection there was 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.

Staff had a good understanding of safeguarding and were confident in their role in safeguarding people. Any safeguarding concerns were investigated with outcomes fed back and practices changed if necessary in order to prevent reoccurrences. Logs and records were kept for all accidents and incidents including details of investigations, outcomes and action taken. Lessons were learnt from accidents and incidents and appropriate feedback given.

Risk assessments were in place for people where risks had been identified. There were also generic risk assessments regarding the premises and environment.

Medicines were managed effectively with safe storage and appropriate administration, reflective of the individual needs of people. All records were up to date and fully completed, with medicine audits being carried out regularly.

Staff were recruited in a safe and consistent manner with all appropriate checks carried out. Staffing levels were planned in line with the needs of each individual person. From staffing rotas we saw that staffing levels were consistent and appropriate staffing cover was readily available and used from relief and agency staff when required.

Staff had up to date training and competency assessments were carried out in relation to specific areas including management of medicine.

Staff received regular supervisions which included questionnaires on different topics. Annual appraisals were out of date for some staff members. The registered manager had a clear plan in place to bring those outstanding appraisals up to date.

The provider had created booklets that were given to all staff which covered what the Mental Capacity Act (MCA) is and the five principles all staff must follow when using the act. The back of the booklet had prompts and details in relation to the 'Speak Up' whistle blowing policy and what to do if staff had concerns.

The registered manager and staff we spoke to had a good understanding of the MCA, Deprivation of Liberty Safeguards (DoLS) and best interest assessments and these were evident within care files and DoLS authorisations were in place for every person within the home.

We observed people and staff during mealtimes. People were enjoying their meals, some independently and others with support from staff. There were choices available for people and support provided by staff was gentle and at an appropriate pace to each individual.

Communication passports were in place for each person that contained clear details of how to communicate with each person effectively. During the inspection we observed that staff followed the communication passports for individuals and responded appropriately.

Care plans were personalised, detailed and contained people’s personal preferences, likes and dislikes. Care plans were up to date and reflective of each person’s individual needs.

A range of regular audits were carried out by the registered manager and members of staff that related to the service the home provided as well as the premises and environment.

There was a range of activities available for people in the service. Activities ranged from sensory games, listening to music and everyday tasks to lunch outings, concerts and day trips. Staff had a good understanding of activities each individual enjoyed doing. Discussions took place during ‘Tenant Meetings’ in relation to activities of interest.

People’s rooms were personalised and individually decorated to reflect the personalities and personal preferences of each person.

We were able to observe the experiences of the all the people who used the service. All the interactions we observed between the staff and the people who used the service were open, respectful and courteous.

We saw that staff provided what was required by the people who used the service in a way that demonstrated their knowledge of each individual's needs. We spoke with the four staff on duty and the manager. Most of the people at Blackwood Road had learning disabilities which limited their communication and they could not tell us their views.

We were able to observe the experiences of people who used the service. For instance, we spent time with people as they had their breakfast and observed how staff supported and encouraged them. We saw staff enabled people to make their own choices and decisions. We saw staff understood each person's different needs, for example when they could not manage independently and so required additional support.

Staff supported people to make choices about how they spent their day and the activities they were offered. On the day of our visit the people who used the service were planning a day out and we saw how staff supported them in the choice of where they would go for lunch.

We observed people being spoken to and supported in a sensitive, respectful and professional manner. Staff made sure people who used the service were included in day to day decision-making wherever possible.

Each person had their own bedroom which was personalised. We saw the provider had made suitable adaptations to meet people's physical needs. We observed that staff respected people's privacy and knocked before they entered their rooms. We saw that the people who used the service related well with the staff. We saw that the staff communicated well and appropriately with people in a way that was easily understood.

The manager had carried out a survey of the relatives of people who used the service. In the survey everyone said that the care at the home was very good and one person commented, 'We appreciate the care and attention to our relative'. Another relative commented, 'The staff are patient, always polite and caring. My relative goes out to lots of places'.

We found that before people received any care or treatment they were asked for their consent and the provider had acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found that people who used the service had their care and welfare needs met.

We found that people who used the service were protected and safe. We found that there was an effective infection control system in place and that the home had a clean and suitable environment.

We found that people's views were important and listened to by the staff. We found that there was an effective complaints system in place.

During our visit, all interactions we observed between the staff and the people living at the home were open, respectful and courteous.

We saw that staff provided whatever was wanted in a way that demonstrated a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to the people to do things as independently as possible.

We saw that staff included people living at the home in the day to day running of the home and that, whenever possible, it was the people living at the home that made decisions on what happened through the day and when. We saw that people's needs were met in a calm and unhurried way.

Care plans were written in a clear and easy to understand way and people's personal preferences were clearly recorded. There were sufficient staff on duty to support people for their care needs. We looked at how the service recruited staff by checking four staff files. These showed that the appropriate checks and procedures were being followed.