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Inspection carried out on 31 October 2018

During a routine inspection

Callum House is a residential care service that offers housing and personal support for up to eight people with learning disabilities . Callum House is a detached house on two floors, with bedrooms on the ground, first and second floors. The two ground floor bedrooms have en-suites and the remaining six bedrooms have access to two communal bathrooms and a shower room. At the time of our inspection the shower was not in use. The service has a large lounge and a kitchen / diner that allowed for everyone to sit and eat meals comfortably. At the time of our inspection six people were using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Systems were in place to safeguard people from abuse and staff knew the procedure and guidance to follow if something went wrong.

Risks relating to people’s care were identified and staff knew how to manage these risks to help keep people safe but still encourage people’s independence. Staff spoke to people about the risks they faced to help people understand how to keep safe.

Not all maintenance issues identified by staff had been addressed in a timely way by the provider. However, important safety issues were addressed during our inspection so we were assured people were safe. We will continue to monitor the maintenance of the service to make sure the regulations are being met.

People’s medicines were managed safely by staff. The storage of people’s medicine was improved during our inspection so it was easier for staff to see which medicine belonged to which person. The service had started to undertake regular temperature checks to make sure people's medicine was stored correctly.

We have made a recommendation about the management of medicine storage.

There was enough staff to make sure people were safe. More staff were being recruited at the time of our inspection to allow for more flexibility of the duty rota. Staff received adequate training, induction and supervision to support them to do their jobs. The recruitment process ensured staff were suitable to work with people.

People’s needs and preferences were assessed by the service before they began receiving care and reviewed regularly.

People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs. Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Specialist dietary needs such as those associated with the risk of choking were provided for.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with everyone according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Care records focused on people as individuals and gave clear information to staff. People were appropriately supported by staff to make decisions about their care and support needs. Staff encouraged people to follow their own activities and interests. Relatives told us they felt comfortable raising any concerns they had with staff and knew how to make a complaint if needed.

The service had a range of audits in place to assess, monitor and drive improvement.

Further information is in the detailed findings below.

Inspection carried out on 23 June 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced comprehensive inspection of this service on 14 April 2016. A breach of legal requirement was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to health and safety issues at the service.

We undertook this focused inspection on 23 June 2016 to check that they had followed their plan and to confirm that they now met the legal requirements inspected. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Callum House on our website at www.cqc.org.uk.

Callum House is a residential care service that offers housing and personal support for up to eight people who have a range of needs including learning disabilities. At the time of our inspection six people were using the service.

The service had 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.

At our previous inspection we found we found some risks to people had not been adequately assessed or addressed. Several first floor radiators and a towel rail were excessively hot and we were concerned that a person may suffer burns if they fell against the surface. In addition two hot water outlets did not have thermostatic controls in place and temperatures were excessively high so people may have been at risk from scalds. During this inspection we saw radiator covers had been fitted in two first floor bedrooms with others on order. Thermostatic controls had been fitted where possible and one outlet had been decommissioned until effective controls could be sourced. Where necessary people’s risk to burns and scalds was assessed with guidance for staff to reduce and effectively manage this risk.

Inspection carried out on 14 April 2016

During a routine inspection

Our inspection took place on 14 April 2016 and was unannounced.

Callum House is a residential care service that offers housing and personal support for up to eight people who have a range of needs including learning disabilities. At the time of our inspection six people were using the service. At our last inspection in October 2014 the service was meeting the regulations inspected.

The service had 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.

Staff knew how to recognise signs of potential abuse and followed the right reporting procedures. Staff positively supported people when they became upset or anxious and clear guidance was written for staff in people’s care records. Staff helped make sure people were safe at Callum House and in the community by looking at the risks they may face and by taking steps to reduce those risks. However, we found some risks to people had not been adequately assessed or addressed. Several first floor radiators and one towel rail were excessively hot and we were concerned that a person may suffer burns if they fell against the surface. In addition two hot water outlets did not have thermostatic controls in place and temperatures were excessively high which may have put people may have been at risk from scalds.

People were cared for by staff who received appropriate training and support to do their job well. Staff felt supported by managers. There were enough staff to support people to live a full, active and independent life as possible at Callum House and in the community.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely, and people received their medicines as prescribed. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

Care records focused on people as individuals and gave clear information to staff. People were appropriately supported by staff to make decisions about their care and support needs. Staff encouraged people to follow their own activities and interests. Relatives told us they felt comfortable raising any concerns they had with staff and knew how to make a complaint if needed.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

We have recommended that the provider consults the guidance around managing the risks from hot water and surfaces in health and social care published by the Health and Safety Executive.

Inspection carried out on 25 September 2014

During an inspection to make sure that the improvements required had been made

At our last inspection we found that the home was not compliant with fire safety regulations and had not maintained the premises so people were safe. We asked the home to tell us what they would do to make things right. They sent us an action plan to tell us what improvements they would make. We carried out an inspection to review these improvements. We did not review any information in relation to the questions, is the service effective, caring, responsive and well led?

During this inspection we met with two of the people using the service and the registered manager.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found the provider had taken steps to make sure people were living in a safe environment by ensuring that the legal requirements for fire safety at the home were met. We saw fire safety equipment was maintained and tested. We noted essential maintenance had been carried out to reduce the risk of trips and falls and that work was continuing to improve the environment for people and to prevent any future hazards.

Inspection carried out on 13 May 2014

During a routine inspection

On the day of our inspection there were six people living at Callum House on a permanent basis. We spoke with four of the people who used the service, two care workers and the registered manager. During the inspection we worked to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

Is the service safe?

The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

People we spoke with told us they liked living at Callum House and would go to the staff if they had any problems. One person said “If I get upset I talk to staff.” Another person told us “the staff are nice.”

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

We saw people’s medicines were handled appropriately and kept safely.

Systems were in place to make sure managers and staff learn from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service continually improve.

Recruitment practice was safe and thorough. The provider could demonstrate that that the staff employed to work at the service were suitable and had the skills and experience needed to support the people living there.

We saw there were building works at Callum House and we were concerned there may not be compliance with some fire safety regulations. We have referred our findings to the London Fire Authority. We also saw some areas of the building had not been well maintained. We have asked the provider to tell us how they will make improvements in this area.

Is the service effective?

People all had an individual care plan which set out their care needs. It was clear from our observations and from speaking with staff that they had a good understanding of people’s care and support needs and that they knew them well.

People had access to a range of health care professionals some of whom visited the home. People told us about staff escorting them to healthcare appointments and we saw hospital passports were in place for everyone. This meant that people were sure that their individual care needs and wishes were known and planned for.

Is the service caring?

We saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives.

When speaking with staff it was clear that they genuinely cared for the people they supported.

Staff were aware of people’s preferences, interests, aspirations and diverse needs. Our observation of the care provider, discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

We saw people were able to participate in a range of activities both in the home and local community. We observed people going and returning from various activities during our inspection. We saw what one person had made during their arts and craft session. People told us what they liked to do . One person said “ I like to go to Tesco’s but I don’t want to go out today”. We were told how staff encouraged people to help clean their rooms, do their own laundry and how they assisted people to prepare and cook their own meals.

We saw people had regular residents meetings which gave them an opportunity to discuss issues about the service.

Is the service well led?

The home had a system to assure the quality of service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.

Information from the analysis of surveys had been used to identify any areas for improvement.

We saw changes and improvements had been made following incidents and accidents at the service to minimise the risk of them happening again.

Inspection carried out on 10 April 2013

During a routine inspection

On the day of our inspection there were seven people living at Callum House on a permanent basis.

We used a number of different methods to help us understand the experiences of people using the service because some of the people who lived at this care home had complex needs, which meant they were not always able to communicate with us. The people who did speak with us all said that they were happy living at the home. We received positive responses from people about the staff who cared for them. One person told us "the staff are good to me, I like living here".

We were able to observe that people's experience of the service was a positive one. During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. We also gathered evidence of people's experiences of the service by speaking to the registered manager and other staff who worked in the home and reviewing various records the provider is required to keep.

We saw that polices and procedures had been put in place to ensure the safety and well being of people using the service and we saw evidence of a quality assurance system regularly monitored by the provider.

Inspection carried out on 9 May 2012

During a routine inspection

People who use the service told us that there were regular service users meetings where they talked about the home. They also told us there was a questionnaire that they completed once a year.

People told us they went out regularly to day services, college, on shopping trips, day trips and had been on holidays.

One person told us “I go to college on Mondays, I go swimming and to the gym sometimes” another person told us “I go to the coffee shop and have cooking lessons at the day centre”.

We observed some people getting ready to go swimming. They told us it was something they enjoyed and it helped them to lose weight.

All of the people we spoke to told us that staff treated them well and listed to what they had to say.

They told us that the home was always clean and comfortable.

We observed positive interactions between staff and people using the service throughout the course of our visit, we saw staff speaking and listening to people in a courteous and respectful manner.

Inspection carried out on 7 December 2010

During a routine inspection

We met and spoke to six people who use the service. We met in the lounge and talked about living at Callum House. All of the people we spoke to said positive things about the home.

People told us that they had a chance to talk about important things happening at the home at service users meetings.

They enjoyed the food provided and they can if they wish involve themselves in planning what to eat, shopping for supplies and the preparation of meals.

The home was always clean and tidy.

They liked the home, their bedrooms, the furniture and how the place was decorated. One person showed us their bedroom, they told us that they really liked the room and liked to play music.

One person told us that later in the day they were going to put up and decorate the Christmas tree. They had plans to visit family on Christmas Eve and where looking forward to the Christmas party.

Other people told us they would spend Christmas at home with their family but were looking forward to a meal out at the Toby Carvery with the other people who use the service and some staff on Boxing Day.

We spoke to a member of staff, they told us that they had attended lots of training, they enjoyed coming to work and they were very well supported by the management team.

We spoke to the registered manager, they told us;

All of the people who use the service have care plans, person centred plans and health action plans. All of these have been kept under regular review by key workers, service users and care managers.

Staff attended training on infection control in February and August 2010.

The registered manager is the Infection Prevention and Control lead for the home.

Bathrooms have been replaced, hand washing signs put up and electric hand dryers have been installed in the home.

Four new staff had been recruited since the last inspection.

All staff have attended mandatory training and common induction training including safeguarding, fire safety, first aid, moving and handling, health and safety, infection control, medication, food hygiene and managing violence and aggression.

Staff will attend a four day course to obtain a Learning Disability Qualification in January 2011.

Staff are attending regular team meetings and receive regular formal supervision.

The registered providers continue to carry out regular monitoring visits in order to make sure that people are safe and their views are sought and acted upon.

The home has not received any complaints since the last inspection.

There have been no safeguarding issues this year.

Reports under our old system of regulation (including those from before CQC was created)