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Archived: Consensa Care Limited - Highbury Gardens

Reports


Inspection carried out on 9 January 2015

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

We carried out an unannounced comprehensive inspection of this service on 9 April 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on 19 January 2015 to follow up on whether action had been taken to deal with the breach.

You can read a summary of our findings from both inspections below.

Comprehensive Inspection of 9 April 2014.

Consensa Care Ltd - Highbury Gardens provides personal care and accommodation for up to six people with a dual diagnosis of mental health and substance abuse needs. People who use the service may neglect their basic needs and place themselves at risk of harm. The service aims to support people with their health needs whilst providing a safe and stable living environment. It is based in a large house with a garden in a residential area. Each person had their own room and the use of shared communal areas. The condition of the home was checked during the inspection and it was clean and well maintained.

At the time of the inspection, the manager of the home, who has been in post since July 2013, was not registered with the Care Quality Commission (CQC). The provider told us the current manager was due to apply to the CQC for registration. The Commission is keeping the situation under review and will take further action if necessary to ensure the service has a registered manager.

During the inspection we spoke with all five of the people who lived at the home. They told us the service had helped them. For example, one person said they enjoyed living in the home. They told us that they were supported to follow their interests. They said, “I have been here a good few years and have done some good art work whilst here. I feel calm.” Another person’s social worker had written to the home stating, “I have been greatly impressed by your long-standing commitment to X’s care and dealing with the challenges they present.”

People and the community mental health teams who supported them were involved by the home in the process of planning support to meet their individual needs and preferences. Each person’s support plan explained how staff supported them to keep healthy and safe and to undertake activities of their choice. People told us they had regular meetings with a support worker which helped them. One person said, “I can raise any issue at all with my key worker.”

Some people told us that they found living in the home ‘boring’ and said they did not get enough assistance to improve their quality of life through involvement in worthwhile activities. People’s records showed that staff had worked with them to encourage them to choose and undertake activities such as going to the gym and the library. However, people had not always continued with their chosen activities. People told us they had ambitions to find work. For example, one person said they wished to be a bricklayer. These long term goals were not reflected in people’s support plans.

During the inspection all the people who used the service went in and out of the home as they wished. They told us they were free to come and go at all times. One person said, “I do what I want to do. The staff cannot stop me.” There were no restrictions on people that came within the scope of the Deprivation of Liberty Safeguards.

People told us they felt safe most of the time but said that on occasions there were incidents when they had been frightened and had lost personal items. They said staff had dealt well with these situations. Reports showed that the provider had taken appropriate action to recompense and safeguard people when such incidents occurred.

People said they were given support with their medicines. Staff had completed records which showed that people were given appropriate support and they received their medicines safely.

People told us the provider asked them about their views of the service. Notes of meetings confirmed some changes had been made in response to their views. A person told us, “the manager has made a few good improvements.”

Staff told us that they thought the way the home was managed had improved since the current manager has been in post. They told us they felt well trained and received good support from their managers. They said they thought there were sufficient staff on duty to meet people’s needs safely.

The provider had made regular visits to the home to speak to people and to ensure staff working to their required standards. This included checks that people’s support plans and risk assessments were accurate and up to date.

The provider had a copy of their complaints procedure on the noticeboard. Notes of keyworker sessions and other meetings showed that people’s complaints were frequently discussed and they were offered support by staff to make complaints. However, given the number of complaints that people had raised which the provider was aware of, and the fact that no formal complaints from people had been logged, it was evident people had not been effectively supported to make use of the provider’s complaints procedure, as required by law.

Additionally, records showed that the Care Quality Commission had not been notified of all the incidents in the home that could affect the health, safety and welfare of people. There was a breach of two health and social care regulations, and the action we have asked the provider to take can be found at the back of this report.

Focused inspection of 19 January 2015

Following our inspection on 9 April 2014 the provider wrote to us to inform us what action they had taken to meet the standards. We undertook this inspection to check that the provider had followed their plans to meet the legal requirements. We found that the provider had followed the plans and that the provider was now compliant with regulations. People who used the service were aware of how to raise a complaint in line with company policy. We also found that the provider had notified the Care Quality Commission of all allegations of abuse and incidents investigated by the police in a timely manner. This meant that the legal requirements were being met.

We found that people were at risk of fire due to unsafe management of smoking in the service. However, the manager had an action plan to address this and we saw that steps had been taken to reduce the risk.

The manager in post at the time of the inspection was not registered with the CQC, however following the inspection the manager has applied for her Disclosure and Barring Service check and was awaiting its return before submitting her application to CQC. We will be monitoring the application process.

Inspection carried out on 09/04/2014

During a routine inspection

Consensa Care Ltd - Highbury Gardens provides personal care and accommodation for up to six people with a dual diagnosis of mental health and substance abuse needs. People who use the service may neglect their basic needs and place themselves at risk of harm. The service aims to support people with their health needs whilst providing a safe and stable living environment. It is based in a large house with a garden in a residential area. Each person had their own room and the use of shared communal areas. The condition of the home was checked during the inspection and it was clean and well maintained.

At the time of the inspection, the manager of the home, who has been in post since July 2013, was not registered with the Care Quality Commission (CQC). The provider told us the current manager was due to apply to the CQC for registration. The Commission is keeping the situation under review and will take further action if necessary to ensure the service has a registered manager.

During the inspection we spoke with all five of the people who lived at the home. They told us the service had helped them. For example, one person said they enjoyed living in the home. They told us that they were supported to follow their interests. They said, “I have been here a good few years and have done some good art work whilst here. I feel calm.” Another person’s social worker had written to the home stating, “I have been greatly impressed by your long-standing commitment to X’s care and dealing with the challenges they present.”

People and the community mental health teams who supported them were involved by the home in the process of planning support to meet their individual needs and preferences. Each person’s support plan explained how staff supported them to keep healthy and safe and to undertake activities of their choice. People told us they had regular meetings with a support worker which helped them. One person said, “I can raise any issue at all with my key worker.”

Some people told us that they found living in the home ‘boring’ and said they did not get enough assistance to improve their quality of life through involvement in worthwhile activities. People’s records showed that staff had worked with them to encourage them to choose and undertake activities such as going to the gym and the library. However, people had not always continued with their chosen activities. People told us they had ambitions to find work. For example, one person said they wished to be a bricklayer. These long term goals were not reflected in people’s support plans.

During the inspection all the people who used the service went in and out of the home as they wished. They told us they were free to come and go at all times. One person said, “I do what I want to do. The staff cannot stop me.” There were no restrictions on people that came within the scope of the Deprivation of Liberty Safeguards.

People told us they felt safe most of the time but said that on occasions there were incidents when they had been frightened and had lost personal items. They said staff had dealt well with these situations. Reports showed that the provider had taken appropriate action to recompense and safeguard people when such incidents occurred.

People said they were given support with their medicines. Staff had completed records which showed that people were given appropriate support and they received their medicines safely.

People told us the provider asked them about their views of the service. Notes of meetings confirmed some changes had been made in response to their views. A person told us, “the manager has made a few good improvements.”

Staff told us that they thought the way the home was managed had improved since the current manager has been in post. They told us they felt well trained and received good support from their managers. They said they thought there were sufficient staff on duty to meet people’s needs safely.

The provider had made regular visits to the home to speak to people and to ensure staff working to their required standards. This included checks that people’s support plans and risk assessments were accurate and up to date.

The provider had a copy of their complaints procedure on the noticeboard. Notes of keyworker sessions and other meetings showed that people’s complaints were frequently discussed and they were offered support by staff to make complaints. However, given the number of complaints that people had raised which the provider was aware of, and the fact that no formal complaints from people had been logged, it was evident people had not been effectively supported to make use of the provider’s complaints procedure, as required by law.

Additionally, records showed that the Care Quality Commission had not been notified of all the incidents in the home that could affect the health, safety and welfare of people. There was a breach of two health and social care regulations, and the action we have asked the provider to take can be found at the back of this report.

Inspection carried out on 4 December 2013

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

At the previous inspection of this service in April 2013 we found that they did not have effective systems in place to monitor the quality of service provided and that staff were not appropriately supported and supervised. During this inspection we found that improvements had been made. Staff received appropriate professional development and people were cared for by staff who were supported to deliver care safely and to an appropriate standard. The service had a manager in place and staff received regular formal supervision. Staff received on-going training, for example about health and safety to help ensure they had the skills and knowledge necessary to carry out their roles.

We found that quality assurance and monitoring processes had been introduced since our last visit which included seeking the views of people who used the service. People told us they were asked for their views on the service. One person said "they talk to me in my keyworker meetings. They ask me what I want to do and things." Another told us "we have residents meetings from time to time." The service had introduced various audits to monitor and improve the care and support provided.

Inspection carried out on 30 April 2013

During a routine inspection

People told us they were able to make decisions over their daily lives. One person said "there is an element of the clients running the show themselves, things like the menu and when to have lunch." People told us they were treated well by staff. We found that care plans and risk assessments were in place, setting out how to meet people's individual needs. There was evidence that care plans were implemented in practice. People told us the service supported them with their needs. One person told us "they help me here, give me inspiration, help me to feel better about my life. They advise me to stop taking drugs, which I welcome."

We found that medications were stored securely, and people told us they received staff support with their mediations. We found some errors with medication administration, which the senior staff took steps to address.

Staff told us they had undertaken various training, including on safeguarding vulnerable adults, health and safety and the Mental Capacity Act 2005. However, staff had not received any recent one to one supervision, and there had not been a manager in place for the past two months. Further, there was very little evidence of any on-going monitoring or quality assurance processes in place. The area manager told us these were all priority issues for them to address.

Inspection carried out on 14 June 2012

During a routine inspection

We spoke with three people who use the service, who all told us that they were satisfied with the care and support provided. They were treated with dignity and respect and their independence was promoted. One person said of the staff, “They are lovely.” and of his keyworker “He is a really nice guy.” Other comments about the service included “I like it here, it is good.” and “I can talk to x or y or any of the other staff.”

Inspection carried out on 28 September 2011

During a routine inspection

Overall, service users gave very positive feedback about the home and the support they receive. Comments included, “I treat the staff with respect, and they are the same to me.” “The staff are brilliant with you.” and, “I do feel that they are quite supportive. They are not on my case all the time. I don’t feel tyranny and oppression here.”