Archived: New Prospects Association Limited - 53 Kilburn Gardens

We last inspected the service in May 2014 where we found that they were meeting all the regulations we inspected.

New Prospects Association Limited - 53 Kilburn Gardens provides accommodation, care and support for up to three people who have learning disabilities. There were three people using the service at the time of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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, relatives and staff were extremely complimentary about the provider and management of the service. One staff member said, “It’s a very good company, our CEO is brilliant – really driven about their [people] needs.” The manager led by example and was “hands on” with all aspects of the service. There was a strong emphasis on continually striving to improve. The manager, staff and people carried out a number of checks to monitor the quality and safety of the service.

Staff were highly motivated and demonstrated a clear commitment to providing dignified and compassionate care and support. They told us that they enjoyed working at the service and morale was excellent.

The service used inclusive ways to enable people to be empowered and voice their opinions in all aspects of the service. Various feedback systems were in place to obtain their views. People and relatives described the responsiveness of staff as “better than brilliant” and stated that staff went, “above and beyond.” Staff found imaginative ways to meet people’s needs and enable them to live as full a life as possible. A creative activities programme was in place to help meet people’s social needs. There was a complaints procedure in place and people knew how to complain.

People told us that they felt safe. There were safeguarding policies and procedures in place. Staff were knowledgeable about what action they would take if abuse was suspected. There were no ongoing safeguarding concerns.

There was a safe system in place for the management of medicines.

The building was safe and generally well maintained. The bathroom was due to be refurbished. People’s bedrooms were personalised to suit their preferences. Various checks and tests were carried out to make sure the premises were safe.

People, relatives and staff told us there were enough staff to meet people’s needs. On the day of the inspection, we saw that people’s needs were met by the number of staff. There was a training programme in place. Staff were trained in safe working practices and to meet the specific needs of people who lived at the service.

People were supported to receive a suitable nutritious diet. People, relatives and health care professionals spoke positively about the caring nature of staff. We observed that people were cared for and supported by staff with kindness and patience.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.

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

Is the service safe?

Care records contained risk assessments and how these risks should be managed. For example, going in the bath, cooking, making hot drinks, using the metro system, going out into the community and going on holiday were all risk assessed. Staff had signed to confirm they understood the risk assessments for each person.

Safeguarding procedures were robust and staff had been trained on how to safeguard the people they supported. The manager was aware of incidents that should be reported and who should be contacted. We spoke with a person who lived at the home who said, "I feel safe here. I did report something, it took guts but I spoke up for myself." This had been reported to the Local Authority Safeguarding Team and fully investigated by the provider. We spoke with a relative who told us they felt the home was safe and people were well cared for.

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

There was a system in place to ensure people's money was safe and any expenditure was appropriately recorded.

The home had policies and procedures in place related to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards to help ensure people were appropriately assessed and to make sure that people were looked after in a way that did not inappropriately restrict their freedom. Relevant staff had been trained to understand when an application should be made, and how to submit one. This meant that people would be safeguarded as and when required.

We found there was a system in place to ensure medications were stored, recorded and administered appropriately.

Is the service effective?

People's health and care needs were assessed and care plans were developed with people and their representatives. The care plans provided staff with information about how each person's care needs should be met. Guidelines were in place to inform staff of the actions to be taken in certain situations and these were monitored by the manager.

The staff we spoke with were able to describe the individual needs of the people they cared for and how these needs were met.

The service worked well with other agencies and prompt referrals were made to health care professionals which helped ensure people's health care needs were met.

Is the service caring?

We spoke with two people who used the service and their comments included, "I'm happy here, I tell the staff what to do and I boss them around" and "Everything is okay." We spoke to a relative who said, "The staff are very good and efficient, they are smashing with X and he is always out and about. The staff bring X to visit me and he is always happy to go back which is a good sign."

We observed the interactions between staff and the people they cared for. We saw staff interacted well with people, and supported them to carry out household tasks and access facilities in the community. One person said, "I help in the kitchen but I'm a bit unsure about the microwave but I'm learning. We saw a member of staff assisting someone to plait their hair. The member of staff was engaged with the person and treated them with respect.

We found that people who lived in the home were well supported to have adequate nutrition and hydration. One person said, "I get everything I want. I sometimes have jacket potato because it's healthier than chips." This person said there was always an alternative meal if they did not want the choice on the menu.

Is the service responsive?

We saw evidence to show that each person who lived at the home had been given a copy of the complaints procedure. A relative told us they knew how to make a complaint but had never needed to. They said they felt confident that if they did complain it would be taken seriously and fully investigated.

We saw prompt referrals were made to health care professionals when required and appropriate training was provided for the staff to help meet individual needs.

Each person had monthly meetings with their key workers, following which and their care records were updated and an action plan was put in place for the next month. This helped ensure any changes in needs or goals were updated.

Is the service well-led?

The provider had systems in place to monitor the quality of the service people received. People were asked their opinion of the service and what they would like in their home. For example, one person had written some guidelines for the staff which said "what I want in my home - no smoking, staff to knock before entering my room and keep the garden nice."

We saw records to show the manager was responsible for monitoring care records, incidents, petty cash, risk assessments, medications, complaints and health and safety. A senior manager audited these each month to ensure standards were being maintained and any improvements were implemented.

We saw minutes of meetings which were held with staff every month. We saw the topics discussed included safeguarding, concerns, complaints and health and safety. There was a list of actions completed, such as, a service user was provided with a new bed for safer moving and handling. The staff told us the manager was very approachable if they wished to raise concerns or suggest new ideas.

Householder meetings were held monthly and the minutes were produced in a pictorial format. Comments included, "Happy at the home, I like the staff and getting out a lot."

People and staff told us that consent was gained before care was delivered and we found that the provider acted in accordance with people's wishes.

We found people's needs were assessed and care and treatment was planned and delivered in line with their individual care plans.

We found there were infection control systems in place and these were adhered to.

We found that there were suitable numbers of skilled, qualified and experienced care staff.

The provider had an effective system to regularly assess and monitor the quality of service that people received.