The Care Quality Commission
  • Care Home
  • Care home

Archived: Popis Gardens

Overall: Requires improvement read more about inspection ratings

1 & 2 Popis Gardens, King George Road, Ware, Hertfordshire, SG12 7DU (01920) 485030

Provided and run by:
Metropolitan Housing Trust Limited

Important: The provider of this service changed - see old profile

All Inspections

22 February 2017

During a routine inspection

This inspection was carried out on 22 and 23 February 2017 and was unannounced. We carried out this inspection due to concerns we received about the service. At the last inspection on 12 October 2016 the provider was found to be meeting all the standards we inspected. At this inspection we found that they were not meeting all of the regulations. This was in relation to safety, staffing, person centred care and management systems. You can see what action we took at the back of our report.

Popis Gardens provides accommodation and personal care for up to ten adults with learning disabilities. The accommodation is split between two bungalows. There were seven people using the service at the time of this inspection.

The home did not have a registered manager. The manager had been in post since October 2016 and had started the process to register with Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.

Regular reviews of care plans and risk assessments had not been routinely undertaken to help ensure that people’s care remained appropriate to meet their needs. Potential risks to people’s safety and welfare had not been identified and managed appropriately.

Some staff told us that they had not always felt supported in their roles. There had been four managers at Popis Gardens in the past two years and the staff team had found this challenging as each manager had a different approach and a different way of working. Staff had received training in relation to the Mental Capacity Act 2005 (MCA). The service was working within the principles of the MCA however; staff members did not demonstrate a clear understanding of their role in protecting people's rights in accordance with this legislation.

Staff respected people’s dignity as much as possible. However, there had been instances where people's personal care had not been provided by care staff of the same gender which had the effect of significantly compromising people’s dignity.

People did not always receive food choices, care and support in such a way that met their individual choices and preferences. People who used the service and their relatives told us and our observation confirmed that there was a lack of meaningful activities and engagement opportunities at Popis Gardens.

The provider’s governance systems were not used at the home to effectively assess the quality of the service provided. Staff were not confident when raising issues with senior management team as this had not proved effective in bringing about necessary improvements. Continued concerns that had the potential to have a negative impact on the quality of care and support provided had not been identified and managed appropriately by the senior management team.

People told us that they felt safe living at Popis Gardens. The staff team had been trained in how to safeguard people from avoidable harm and were able to tell us about the potential risks and signs of abuse. People received their medicines safely. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so.

Staff received training to support them to care for people safely. People’s weights were regularly monitored and were noted to be stable and there had been no concerns raised by health professionals in relation to people’s dietary intake. People were supported to access health professionals as needed.

People and their relatives spoke positively about the permanent staff team and told us that staff were kind and caring. People's records were stored appropriately to help maintain the dignity and confidentiality of people who used the service. External advocacy services had been secured to support people when making important decisions about their lives. People were supported to maintain relationships with their relatives.

The environment throughout the home was warm and welcoming and people's individual bedrooms were personalised. People’s care plans were sufficiently detailed to be able to guide staff to provide individualised care and support. Complaints were managed in accordance with the provider’s policy and procedures however; actions had not always been taken in a timely manner.

The manager was already aware of the issues that we identified during the course of this inspection and had made a request to the provider’s human resources department for additional support. An interim regional manager had made a commitment to support the manager in addressing areas of concern starting with the staffing concerns.

People who used the service responded openly to the manager and told us they felt supported.

12 October 2016

During a routine inspection

The inspection took place on 12 October 2016 and was unannounced.

Popis Gardens provides supported accommodation and personal care for up to ten adults with learning disabilities. The accommodation is arranged over two bungalows. There were eight people living at Popis Gardens at the time of this inspection.

The service did not have a registered manager at the time of this inspection. However, the new manager had commenced the process to become registered. 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.

When we last inspected the service on 05 October 2015 we identified a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had failed to maintain effective infection control practice in relation to the environment. For example, the kitchens and bathrooms in both bungalows had been in need of refurbishment to help ensure flooring and services were ‘wipe clean’ to support the control of infection.

Following the comprehensive inspection, the provider wrote to us on 27 November 2015 to tell us how they would make the required improvements to meet the legal requirements. At this inspection we found that the provider had made the necessary improvements to help ensure that effective infection control was maintained.

People felt safe living at Popis Gardens. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.

Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.

People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The provider had arrangements in place to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.

There was an open and respectful culture in the home and relatives and staff were comfortable to speak with the staff management team if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

05 October 2015

During a routine inspection

The inspection took place on 05 October 2015 and was unannounced.

The Metropolitan Housing Trust Limited provides accommodation and personal care at Popis Gardens for up to ten people who have a learning disability. Accommodation was arranged in two adjacent bungalows. There were eight people using the service when we inspected.

We last inspected the service on 07 June 2013 and found that the provider was meeting the required standards at that time.

The manager had submitted an application to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with 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.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. The manager reported that applications had been submitted to the local authority in relation to the people who lived at Popis Gardens and these were pending an outcome at the time of this inspection.

People said they felt safe living at the home. Staff members were clear about what constituted abuse and were able to clearly explain how to report concerns. There were enough staff members available to meet people’s needs. The manager understood what recruitment checks were necessary to promote the safety of the people who used the service. Some areas were in need of refurbishment in order to maintain effective infection control. Some improvements were necessary to be able to be confident that people’s medicines were managed safely.

Staff members had received the basic training necessary to support them in their roles. However, much of the training provided was via e-learning and staff did not have the dedicated time to concentrate on this training without distractions. Staff had regular 1:1 time with the manager where they could discuss their performance and development. A person told us that staff always asked them for their consent to care, and family members or independent advocates supported those people who did not have the capacity to make decisions about their care needs. People enjoyed the food they were given and staff supported them with their specific dietary needs. However, the provider did not support people to have effective choices in relation to food. People received support to access health support.

Staff treated people with kindness and respect. People approached staff with confidence and interactions between staff and people who used the service were warm and caring. The staff and management were knowledgeable about people's individual needs which meant that they were able to support people in a way that made them feel safe, valued and cared for. People’s concerns were listened to, taken seriously and acted upon. People’s bedrooms were decorated individually and reflected the person living there. Relatives told us that they could visit people at any time. Staff were aware of the need to promote people’s confidentiality. However, this was not always achieved in a manner that respected people’s choice.

People had care plans to guide staff on how to meet their needs, these were being re-developed to ensure that they accurately reflected how people wanted to receive their care, treatment and support. Many of the staff team had worked with people for a long period of time and it was clear that they understood people’s individual forms of communication. People were encouraged and supported to develop and maintain personal relationships. People were being offered more opportunity to go out into the community and enjoy leisure activities than previously however, this was still limited because there was a lack of people employed to work at the home that could drive the minibus. The provider had arrangements in place to manage complaints or concerns.

Staff had respect for the manager and confidence in their abilities to bring about the necessary improvements to the service. Feedback we received from the local authority team was that there had been some improvements made since the manager had been in post. The manager had instigated some quality monitoring systems since they started to work at Popis Gardens; this was work in progress at the time of this inspection. The provider had recognised a shortfall in the quality monitoring of the service and had commenced a programme of provider visits.