All inspections: 5 Duke Street - Care Quality Commission

This inspection was carried out on 15 May 2015 and was announced. Nabida Care Limited. Had been inspected previously in April 2014 and found to be non-compliant due to lack of quality monitoring and lack of feedback from service users (Regulation 10). An action plan had been submitted 6 June 2014 where provider stated they would be compliant by 5 September 2014. We found that there had been improvements made however, the improvements had not been embedded.

The service provided accommodation in 13 self-contained flats for people between the age of 18 and 65 who have high levels of need or risks are supported to gain skills which will enable them to eventually move onto a permanent place of residency. People who use the service had previously required in-patient mental health support.

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.

People were encouraged to make their own decisions about their lifestyle choices that would protect them from avoidable harm, they were assessed for their risk to others and risks to themselves; people’s human rights were respected. People were encouraged to maintain a recovery programme and staff worked with other agencies to monitor for substance use.

People were encouraged to become independent. People were helped to budget and manage their finances and staff facilitated people to find meaningful activities and people received care that was individual to their needs.

There was sufficient staffing to provide for people’s needs and staff received regular supervisions and appraisals. The staff team worked well together and respected the manager.

Staff were supportive and developed therapeutic relationships with people who used the service.

When people were discharged from the service they were able to access the support of staff for an agreed period.

Quality monitoring systems were in place however these were in their infancy. There was not an effective system to gain people’s feedback about the service.

During our inspection of 5 Duke Street we set out to answer our five questions.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff and we found that staff had responded swiftly when there were any concerns of people becoming unwell. The provider had appropriate recruitment systems to make sure all staff had the required checks before starting work at the service. There were sufficient numbers of suitably experienced and trained staff working at the home at all times. There were no staff vacancies at the time of our inspection.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their recovery plans. We saw that individualised care plans had been put in place to ensure people's health and wellbeing. We found that people had been supported by the staff to become more independent. For example, in the day to day skills that they would need when they moved from the service.

Is the service caring?

People were supported by knowledgeable and approachable staff. We heard staff speak to people in an encouraging and sensitive way. We read that staff had assisted people successfully with a number of different needs in order increase people's independence.

Is the service responsive?

People's needs had been assessed before they moved into the property and we saw records which confirmed that regular meetings had been held with people and their key workers in order to respond to people's changing requirements. When changes had been required to keep people safe we saw that these had been actioned promptly. Records confirmed that what people felt was important to them such as maintaining relationships with their friends and families had been included in their support plans.

Is the service well-led?

Staffs had a good understanding of the ethos of the service, and were knowledgeable of the needs of the people who used the service. We found that there was a good system in place to regularly monitor the quality, safety and d'cor of the environment. However we were not able to find any evidence of quality assurance processes in the form of clinical audits which would show that the quality of the service had been assessed and monitored. We found that systems were not always in place to find out what people, their representatives and staff's views or experience was of the service, so that any improvements could be made.

We completed a review of documents in order to follow up on actions that the provider had completed since our last inspection. We found that improvements had been made in the risk assessments of people that were currently living at the property.

We saw that when people were transferring to the property that regular reviews of risk had been completed in the time set down by the provider.

We found that improvements had been made with regards to refresher training for all staff as we saw that dates had now been set so that staffs knowledge would be refreshed within an agreed timescale.

We found improvements in the way the provider managed medicines. We saw that staff training had taken place and that there was a good system in place for the recording, monitoring and disposal of medicines.

We saw that one person who used the service had not had their risk assessments reviewed within the timescale set down by the provider. This concerned us as the need to review risk assessments had been identified at the last inspection.

We spoke with four people who used the service and they all said that the staff at Nabida Care Management had supported them to do things for themselves and that they 'couldn't fault them'. We also spoke with a relative of a person who used the service and they told us that they were really happy with the service and that staff had helped their relative to 'settle down and gain confidence', and 'that this would set them up for the rest of their life'.

We spoke with knowledgeable staff that were committed to providing opportunities to encourage peoples independence. We saw that the self contained flats were well maintained and in good decorative order.

We had some concerns that not all of the staff had the opportunity to receive supervision on a regular basis, and that there was no documentation which showed when training was to be refreshed.

We had some concerns that not all of the people who used the service had had their risk assessments reviewed in a timely way.

We noted that the storage and recording of some medicines required improvements.

Archived: 5 Duke Street

All Inspections

15 May 2015

During a routine inspection

29 April 2014

During a routine inspection

During a check to make sure that the improvements required had been made

19 July 2013

During an inspection looking at part of the service

2 May 2013

During a routine inspection