Archived: 59 Hatherley Road Residential Home

59 Hatherley Road is a residential care home providing accommodation and personal care to three people with learning disabilities. The service can support up to three people.

People’s experience of using this service and what we found

The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons. Effective systems were not in place to people’s risks and changes in their needs were assessed, monitored and comprehensively recorded. Protocols for people’s medicines were not always in place to guide staff.

We have made a recommendation about the use of evidence-based screening tools

Systems used to monitor the service had not always been effective in identifying shortfalls in people’s care and medicine records when people’s care needs had changed. People’s care records had not always been updated to reflect their changing needs. This meant staff did not always have the guidance they may need to support people.

We met and spoke to people during our inspection. Not everyone could express their views about the service however we observed staff interactions with people throughout the inspection. Staff explained how they spent their day and known preferences.

We observed staff being caring and respectful towards people and were committed to providing good outcomes for people. Relatives told us they felt the staff were kind and caring and felt their loved ones were safe with the staff supporting them. People's privacy and independence were promoted.

Staff were suitably recruited. Staffing levels were flexible to enable people to access the community with support. People were supported by staff who had been trained and received regular supervision.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had access to a range of activities in the community with the support of staff.

Staff knew people well and were responsive to people’s needs. They adapted their approach to support people’s communication. People received their prescribed medicines safely and were supported to maintain a clean home.

Systems were in place to deal with concerns and complaints and accidents and incidents. Staff and a relative were positive about the management of the service. Staff told us senior staff and the registered manager were very approachable and always available for advice and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 14 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to quality assurances systems used to monitor the service and drive improvement.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Staff focused on the care needs of each individual and adapted their approach and level of support as required. Staff knew people’s individual communication skills, abilities and preferences. We observed that the staff approach was caring and kind. They talked to people with dignity and respect and supported people to make decisions about their life and day to day needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were consulted about the meals they would like to eat. They contributed towards household chores and enjoyed a range of activities in the home and in the local community. People and their relative’s views were encouraged and valued. Staff acted promptly when concerns were raised.

People had detailed care plans which reflected their abilities and support requirements. People’s risks had been assessed and were being monitored.

The systems to manage people’s finances had been reviewed and updated. People benefited from a safe service where staff understood their safeguarding responsibilities and to support people to manage their personal risks. Referrals to health care professionals had been made appropriately when additional support was needed. Peoples’ medicines were managed and administered safely.

The service followed safe recruitment practices. There were sufficient numbers of skilled and trained staff to meet people’s health and welfare needs. Staff felt supported by the registered and deputy manager. Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home.

Further information is in the detailed findings below.

As part of this inspection we spoke with the registered manager, two members of staff and two people who lived in the home. We reviewed the care records relating to the management of the home which included two care records, daily care records, accident and incident records and quality assurance systems. We observed staff interacting with people who lived in the home.

Below is a summary of what we found. The summary describes what people who lived in the home and staff told us, what we observed and the records we looked at.

Is the service safe?

People were safe because staff understood the needs of the people who lived in the home. Care was delivered as planned in people's care records. The home was cleaned and maintained. The registered manager and staff were aware of their role to prevent people who lived in the home from coming to harm. There were effective systems in place to ensure that risks associated with mishandling of people's medication had been reduced. Emergency procedures were in place should they be needed.

Is the service effective?

People received an effective service because staff had a good understanding of people's needs. People looked relaxed and at ease with the staff. We saw staff giving people choice and involving them in the day to day activities around the home. People were involved in planning and preparing meals. We saw that staff were confident and knowledgeable in caring for people. One staff member said 'The training we get here is good'.

Is the service caring?

People received a service which was caring because people's wishes were acknowledged and respected. As people's needs changed, staff knew how to manage and adapt their care effectively. We saw staff giving people information so they could make an informed decision about an activity. Staff were observed communicating with people in a kind and sensitive way.

Is the service responsive?

This service was responsive because people received support and care when they needed it. We saw that a person who visited the home was treated with dignity and respect. People's health was regularly monitored and reviewed by the local GPs. Referrals were quickly made to health services when people's needs changed.

A complaints policy was in place. The registered manager managed complaints and concerns on a day to day basis. People told us they felt they could raise a concern with any of the staff.

Is the service well-led?

The service was well led as there were effective arrangements in place to review and monitor care practices in the home. The management team understood the principles of quality assurance to improve the service and quality of life for people who lived in the home. The registered manager consulted with people, their relatives and staff about the service provided. Actions to improve the home and service provided were carried out as a result of their feedback.

People were cared for by appropriate staff who had all received safeguarding training. They were aware of their own roles and responsibilities with regards to keeping people safe.

We spoke to one person who used the service. They told us 'the staff help me with my personal care, I like it here'. We saw the results of quality surveys for 2012 and they all had positive results. The comments included 'there is a good relationship between staff and people using the service'. 'Quality of care provision is good and people who use the service are always well dressed'. 'There is a good level of engagement in the local community'.

We spoke to all three people who used the service and all expressed how happy they were living at the home. They also had very good relationships with the staff. We observed communication between staff and people was very friendly but respectful.