Archived: Care Management Group

Bales Court is a supported living service where people live in their own home and receive care and support to enable people to live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

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.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

People’s experience of using this service:

¿People were cared for by staff who knew how to keep them safe. Staff were trained and knew how to recognise and report abuse. They understood how to report any concerns and were confident that allegations would be investigated to help ensure people were protected.

¿Staff were recruited safely there were enough numbers to meet people's needs.

¿Staff were supported by a system of induction, training, one-to-one supervision and appraisals

¿ People were supported by a stable and consistent staff team who knew them well and had received training specific to meet their needs.

¿ Staff told us they got to know people well and always sought their consent before delivering care. Staff knew how to apply the Mental Capacity Act 2005 (MCA) law. They understood the law was a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves.

¿ Care plans included clear objectives and goals. Care plans were up to date and accurately reflected individual needs and wishes. The service's risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

¿ Staff understood how to care for people in ways that ensured their dignity and privacy was promoted.

¿ The service offered flexible support to people to meet people's needs and support them as they wanted.

¿ People took part in a range of activities, based on their hobbies and interests.

¿ The service had good community links and had several initiatives with local churches and community venues.

¿ Staff spoke very positively about the registered manager and felt able to raise concerns and

were confident these would be addressed.

¿ The registered manager was open, transparent and very person centred in the way they ran the service.

Rating at last inspection: At the last inspection, in October 2016 the service was rated Good. At this inspection we found the service remained Good.

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection

Follow up: We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.

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

This inspection took place on the 19 October 2016.

On the day of our inspection there was a registered manager in place. 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.

The provider or registered manager had failed to notify CQC of serious incidents and concerns, as a requirement of their registration with CQC.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, they could identify the different types of harm, and knew the procedure for reporting concerns. Risk assessments had been completed in areas where people’s safety could be at risk. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.

People had emergency evacuation plans (PEEPs) in place. This meant that staff were aware of what action they needed to take in the event of an emergency. People received their medicines as prescribed because they were stored, handled and administered safely.

People were supported by staff who received an induction, were well trained and received regular assessments of their work.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, and to report on what we find. The manager was acting in accordance with the requirements of the MCA. They could demonstrate how they supported people to make decisions about their care and where people were unable to make decisions, there were records showing that decisions were being taken in their best interests.

People were encouraged to plan, buy and cook their own food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

People were supported by staff who were kind and caring and treated them with respect and dignity. Staff communicated well with people to make them feel their views mattered and they would be acted on. Staff responded quickly to people who had become distressed. Priority was focused on person centred care and staff were aware of the importance of encouraging people to live their lives as independently as possible.

People were able to contribute to decisions about their care and support needs. People were provided with an independent advocate, if appropriate, to support them with decisions about their care. People were supported to maintain important relationships. Friends and relatives were able to visit whenever people wanted them to.

Support records were person centred and focused on what was important to people. The records were regularly reviewed and people and their relatives were involved. People were encouraged to take part in activities that were important to them. The complaint’s procedure was in a format people could understand, if they wished to make a complaint.

People, relatives and staff gave positive comments regarding the registered manager; they found her approachable and supportive. People who used the service were encouraged to provide their feedback on how the service could be improved. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

We identified one breach of the Health and Social Care Act 2008 (Registration) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

A person told us they were "happy" living in the service. A local authority officer said "staff have done an amazing job, I have really seen the difference in people". We found that people had person centred care plans which took into account their individual support, care and safety needs. Care was provided to meet people's preferences and promote their independence.

People were supported by staff who were appropriately trained and supported in their role and had a good understanding of people's needs and preferences. A staff member told us "I think this is a very lovely home, people are well taken care of".

We found that people's medicines were appropriately managed. The provider had a complaints policy and procedure in place and we found that people were supported by staff to express and identify their feelings and needs.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

One person told us that the staff members were, "Very kind." We looked at written comments that had been made by people who had visited the service. One comment said, "It always feels homely. The staff are very caring." We observed staff members interacting with the people who used the service. People that we observed showed by their behaviour that they were happy and engaged with the staff members.

We spoke with three members of staff. All told us that they had completed training for safeguarding and had recently read the service's safeguarding policy. The staff members were able to demonstrate that they had a good understanding of what constituted abuse and were able to tell us of the procedures that were documented in the service's safeguarding policy.

Appropriate checks were undertaken before staff began work. We saw from files that a person had started work only after a full Criminal Records Bureau (CRB) check had been received and they had demonstrated that they were legally entitled to work in the United Kingdom.

We saw the report of the comprehensive quality audit that had been completed by the Regional Director in November 2012. An action plan had been produced to address the areas for improvement identified in the audit. We saw that most of the actions had been completed.