Archived: The Poplars

The Poplars is registered to provide accommodation for up to six adults with learning disabilities who require personal care. At the time of the inspection there were three people living at the service.

At the previous inspection on 14 and 15 January 2016 we found the provider had not acted in accordance with the principles of the Mental Capacity act 2005 and associated code of practice. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014, which relates to consent.

At this inspection we found that the home had made significant improvements to address the areas of concern. The registered manager and staff understood the Mental Capacity Act (MCA) 2005 and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves.

The service did not have a registered manager. 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. However, the community support leader of the service had submitted an application to become the registered manager.

Staff understood their responsibilities to identify and report all concerns in relation to safeguarding people from abuse. Staff had completed safeguarding training.

The service sought people's views and opinions and acted upon them. Relatives told us they were confident they would be listened to and action would be taken if they raised a concern. Where risks to people had been identified risk assessments were in place and action had been taken to manage the risks. Staff were aware of people's needs and followed guidance to keep them safe.

People received their medicines as prescribed. Records confirmed where people needed support with their medicines, they were supported by staff that had been appropriately trained.

Staff spoke positively about the support they received from the community support leader. Staff had access to effective supervision.

People were supported by staff who had the skills and training to carry out their roles and responsibilities. People benefitted from caring relationships with the staff who had a caring approach to their work. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff and the community support leader shared the visions and values of the service and these were embedded within service delivery. The service had systems to assess the quality of the service provided. Learning from audits were used to improve the service.

People were supported to maintain good health. Various health professionals were involved in assessing, planning and evaluating people's care and treatment. People had sufficient to eat and drink. Where people needed assistance with eating and drinking they were supported appropriately.

The Poplars is registered to provide accommodation for up to six adults with learning disabilities who require personal care. At the time of the inspection there were five people living at the service.

The service did not have a registered manager. 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 service had management arrangements that included a service manager and a community support leader. The service manager had recently applied to be the registered manager and this application was now with the Care Quality Commission.

People were not always supported in line with the principles of The Mental Capacity Act 2005 (MCA). Staff were not always clear about how they would support someone in line with the principles of the MCA and care plans did not always contain Mental Capacity Assessments where necessary.

Records showed that staff had been trained in the MCA. Some staff we spoke with had an understanding of the principles of the MCA. However, some staff told us that they were unsure what the MCA was.

Some staff told us they did not receive regular meetings with their line manager (Supervision). However, documents relating to supervision demonstrated that staff did receive this.

People were safe. Staff understood how to recognise and report concerns. People received their medicines safely as prescribed. Staff assessed risks associated with people's care and took action to manage the risks.

Relatives told us, and we observed people benefitted from caring relationships with the staff who knew how to support them. Staff understood the needs of people and provided care with kindness and compassion. Staff took time to talk with people and provide activities.

We observed there were sufficient staff to meet people’s needs. The service had robust recruitment procedures in place which ensured staff were suitable for their role. Background checks were conducted to ensure staff were of good character.

The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

People received their medicines as prescribed. Staff administering medicines checked each person’s identity. Medicine records were completed accurately.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we took and what action we told the provider to take at the back of the full version of the report.

We considered our inspection findings to answer questions we always ask;

Is the service safe, caring, effective, responsive and well led?

This is a summary of what we found '

Is the service safe?

This service was safe. People we communicated with felt safe. Their needs were well documented and understood by care works supporting them. The garden area was safe and people said they enjoyed it. We asked the provider to note that some areas needed attention such as the grass being cut and broken furniture needing to be cleared. People who required medicines were kept safe from harm due to staff trained in administering medication and we saw a clear and accurate recording system. Medication was also stored safety. We have asked the manager to review national pharmaceutical guidelines to ensure appropriate handling of medication keys.

Is the service caring?

This service was caring because people felt cared for and were involved in the daily running of the house. Interactions we observed were warm, caring and showed patience and understanding of people's needs. People's needs were assessed and clearly documented in support plans for staff to follow. Risk assessment's supported these plans where appropriate. We found that people maintained regular appointments with the dentists, opticians and GP's and that there was access to activities they enjoyed.

Is the service effective?

This service was effective. We saw people eating fresh, healthy and nutritious food and a wide and varied menu. We found that where necessary the service sought support externally in order to support peoples changing needs. For example, one person entering the home with limited capacity and no relatives was supported by an Independent Mental Capacity Advocate (IMCA). Staff we spoke with felt supported and well trained. Training consisted of mandatory training but also 'bespoke' training to ensure that the specific needs of each person in the home were met effectively.

Is the service responsive?

This service was responsive. When people's needs changed the service responded in order to meet those needs and where concerns were raised the service responded with appropriate action, for example, one person's file showed that they wanted a downstairs room. The service made arrangements to ensure this could happen. When further problems arose such as a sloping floor, the service responded immediately to ensure the persons safety.

Is the service well led?

The service was not always well led. It had an in house manager that oversaw the day to day running of the home. There was also a service manager who was also the registered manager who visited occasionally and carried out monthly checks. The governance systems for this service also oversee other services and it would appear that lessons learned are not always applied across services. We have identified issues during the inspection which demonstrate monitoring and audits are not always adequate. Staff we spoke with felt the leadership was clear and that information that effected staff and people living in the home was well communicated. Staff also felt they could raise concerns freely without fear and their feedback was valued.

We found that people’s individual preferences were respected and catered for, and they were offered the opportunity go out into the community. They were encouraged to be as independent as possible and to participate in the life of the home.

We found that people’s care was being properly managed and that everyone had a robust care plan in place that was regularly reviewed and updated. We also found that people who used the service appeared happy with the service and a relative we spoke with said they were particuarly struck by its ‘atmosphere of compassion and practical sense’.

We found that staff were properly trained in safeguarding people from abuse, and were prepared to report any instances of abuse even if this involved close colleagues.

We found that there was an effective system of staff training, supervision and induction in place. However, we found that the provider was not currently conductiing annual appraisals, even though it acknowledged how important these were.

We found that the provider asked for regular feedback from people about the service. It had systems in place to conduct regular audits and assessments of the service, although we did feel there was room for improvement here.

The premises was well maintained and there were systems in place to protect people living in the home. There were effective recruitment and selection processes in place. There was an effective complaints system available.