Admiral House - London

Admiral House – London is a residential and rehabilitation home for up to 12 men with mental health needs. At the time of the inspection, there were 10 people living there.

People’s experience of using this service:

Two people using the service told us they were happy living at Admiral House and said they felt safe there. They felt able to report any concerns to the staff and managers and were confident they’d be listened to. They confirmed that staff provided support to help them stay well and attend regular health appointments.

Some areas of the home had been refurbished since our last inspection in May 2019 where it had been identified as an area of improvement.

Feedback from involved health and social care professionals was extremely positive about the service provided. They told us the service was well managed and had resulted in positive outcomes for their clients.

We were assured the service met good infection prevention and control guidelines. People were protected from the risk of acquiring infections and the premises were kept clean and hygienic. Personal protective equipment (PPE) was in good supply and staff were following the latest guidance for its use. Both people using the service and staff participated in the testing programme for COVID-19 in line with current published guidance.

Access to the home was restricted for non-essential visitors due to the COVID-19 lockdown restrictions in place at the time of our visit. The service had audited and improved their infection control processes in line with COVID-19 risks. Cleaning schedules had been enhanced and risks from waste disposal mitigated.

More information is in our full report.

Rating at last inspection:

At our last inspection, the service was rated “Requires Improvement”. Our last report was published on 26 June 2019.

Why we inspected:

This was a targeted inspection looking at the infection control and prevention measures the provider had in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

We also reviewed the key question “Is the service Well-Led” during our inspection visit focusing on the management and governance of the service.

Ratings from previous comprehensive inspections for the key questions of Safe, Effective, Caring and Responsive were used in calculating the overall rating at this inspection. Following this inspection, the overall rating has improved to ”Good.”

Follow up:

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Admiral House – London is a residential and rehabilitation home for up to 12 men with mental health needs. At the time of the inspection, there were 10 people living at Admiral House – London.

People’s experience of using this service:

Individual care plans were in place for each person and these were reviewed on a regular basis by key workers. They focussed on ways in which people’s independence could be improved. Although keyworkers completed regular care plan reviews and one to one sessions with people, we found that these could be used more effectively to review people’s goals and amend them according to people’s level of engagement. We have made recommendations regarding this.

Although regular resident meetings were held, we found that some suggestions that people had made were not always followed up in subsequent meetings. We have made recommendations regarding this.

Some areas of the home were in need of refurbishment. This had been identified by the registered manager as an area of improvement.

People using the service told us they were happy living at Admiral House and they felt safe. They lived independent lives and were free to come and go as they pleased. They were able to have family and friends come and visit them.

Staff supported people to eat by preparing their meals for them. They also supported them to make and attend regular health appointments.

People said staff gave them their medicines on time, this was confirmed through the medicine records and audits that we saw during the inspection.

Staff recruitment procedures were robust and there were enough staff employed to meet people’s needs. Staff received regular training and supervision which enabled them to support people with mental health needs.

Risks to people were identified and steps taken to manage the risk. Where an incident had taken place, the relevant risk assessment was reviewed.

When people had made a complaint, the provider had resolved these to their satisfaction. Feedback was sought from people, relatives and professionals through surveys and the feedback received was positive.

The service met the characteristics for a rating of “Requires Improvement” in two of the key questions we inspected. Therefore, our overall rating for the service after this inspection was “Requires Improvement”.

More information is in our full report.

Rating at last inspection:

At our last inspection, the service was rated “Good”. Our last report was published on 16 March 2017.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates a per our re-inspection plan.

There was a registered manager at 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.

Staff had completed medicines administration training within the last two years and were clear about their responsibilities.

Risk assessments and care plans contained clear information for staff. Records were reviewed every month or where the person’s care needs had changed.

Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005. Care records documented that consent had been obtained where necessary and records were signed by people using the service.

Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way.

People using the service were involved in decisions about their care and how their needs were met. People had care plans in place that reflected their assessed needs.

Recruitment procedures ensured that only staff who were suitable worked within the service. There was an induction programme for new staff, which prepared them for their role. Staff were provided with appropriate training to help them carry out their duties. Staff received regular supervision and appraisals of their performance and these were documented. There were enough staff employed to meet people’s needs.

People were supported to maintain a balanced, nutritious diet. People were supported effectively with their health needs and were supported to access a range of healthcare professionals as required.

People using the service and staff felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.

The organisation had adequate systems in place to monitor the quality of the service. This included daily monitoring of medicines and medicines administration charts (MAR) and monthly care plan review meetings. We saw evidence that feedback was obtained by people using the service and the results of this was positive.

We saw that people who used the service could come and go freely and that visitors were welcome. We spoke with both members of staff, three people who used the service, visiting family members and a visiting professional.

We found the premises to be well maintained and clean. People were kept safe from abuse and were encouraged to live active lives. Staff were trained and supported to do their jobs.

Comments people made to us were, 'you are given space to achieve' and 'this is a good place, it suits my relative', 'any problems are solved' and 'they help you get back on your feet'.

The building was well maintained, clean and tidy and we observed the staff supporting the people who use the service in a positive and friendly manner. A person we spoke with said "The staff do what they have to do but you can still have a laugh with them". Another person we spoke with said they consider some of the staff friends.