Archived: Mr Rajeshwar Mohan & Mrs Manju Mohan - 20 Waterloo Road

Is the service safe?

We observed that people were treated with dignity and respect by the care staff. We saw that people were given choices in the care they received.

All people spoken with told us that they were very happy with the care that the staff provided. One person that lived there said, 'The staff are kind. They take us out and keep us safe. I like my home. It's good here.' One relative told us, 'I know my relative is safe and happy there. The staff are like family to them.'

All of the staff spoken with were able to give a good and accurate account of their understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Act (DOL). The registered manager told us and records confirmed that applications to restrict anyone's liberty in the home had not been made at the time of our inspection. Consideration had been given to the recent court judgement under Deprivation of Liberty Act (DOLS) and the manager had reviewed people's need for a DOLS assessment so in line with the recent good practice guidelines. Records showed that all staff had received Mental Capacity Act and DOL training. This meant that people were supported by staff who understood their responsibilities and protected their human rights because they understood their responsibilities under the act.

The provider had policies and procedures in place to protect people from harm. Staff that we spoke with confirmed that they had received training on how to protect people from harm and showed a good understanding of what safeguarding people meant. This meant that the safety of people who lived there and of others was always promoted and protected.

We saw that people had an assessment of their needs and associated risks. A plan of care was completed which enabled staff to offer care and support to people in a safe way. Staff told us and records sampled showed that they had received training and support to enable them to deliver care safely.

We saw that systems were in place to make sure that learning took place from accidents, incidents, complaints and investigations. This reduced the risks to people and helped the service to continually improve.

People who lived there were independent with personal care needs, however, we saw that safe hygiene practices in personal care was promoted and encouraged by the staff. We saw that the home was visibly clean and that staff used protective aprons and safe hand washing techniques when required such as for food preparation or cleaning. Audits and checks on cleaning schedules and food hygiene practices were in place. We saw that infection control policies and procedures were in place and the home had an infection control lead. Training for some staff required updating as they had been off sick. This meant that people were protected from the risk of infection because appropriate guidance had been followed and the majority of staff had received regular and appropriate training updates.

People were seen regularly by their GP for well person and other checks. We saw records that showed and people told us that they received their medicines as prescribed by their doctor to ensure their health needs were met.

Is the service effective?

Relatives, advocates and health care professionals spoken with, confirmed that they could visit throughout the day. We saw that facilities were available so people could meet in private if they wanted to.

People spoken with told us and records sampled showed that they had been involved in an assessment of their needs and were able to tell staff what support they needed. This meant that people were able to influence the care they received. One person we spoke with said, 'I choose what I want to eat each day and where I want to go. Staff help me here and are kind to me."

We saw that relatives and advocates were involved with people's care. An advocate told us, 'They always ensure that people's health care needs are well met, they involve other health professionals and inform my client as well as me how they are. I am always fully involved where appropriate.'

All staff spoken with were able to give us good detail about the support they provided to people. People's health and care needs were assessed and care plans told staff what people's care needs were so they were supported in a consistent manner. Referrals had been made to external professionals so people got the support they needed to maintain their health and wellbeing and we saw that staff followed their advice.

We saw that people's cultural, dietary and linguistic needs were met by staff with the appropriate skills. One person said, 'They help me to eat the right food because of my religion. They make sure I can get to the temple when I want to go. I meet my family there as well.'

Is the service caring?

We saw that staff treated people with dignity and respect. We saw that they were patient and caring; they took their time and did not rush people. Staff were seen to be attentive and interacted well with the people they supported. We saw that people responded positively to staff.

People's preferences, interests, aspirations and diverse needs had been recorded in their care records.

People, their relatives and other professionals involved with the service had completed an annual satisfaction survey. We saw that people and their relatives had made positive comments in the surveys we looked at.

Is the service responsive?

We saw that people were supported to take part in a range of activities at home and in the local community. We saw that staff responded to spontaneous requests from people to do activities, or to spend their time in a way that they preferred. People had also been supported to go on holiday. One person said, 'We are going on holiday and staying in a caravan in Wales.'

We saw that when needed staff had requested the involvement of other health professionals in people's care.

Is the service well lead?

The home had a manager who was registered with us, CQC. They were experienced and knowledgeable about the needs of the people that lived in the home.

We found that systems were in place to regularly assess the quality of the service that people received.

Records showed that regular spot checks on staff skills and work practices were carried out by the manager. We saw that detailed feedback was provided to staff following these checks. Supervision and training records showed that supervision and staff training was regular and up to date. This ensured that people received care from staff that were suitably skilled to deliver care and feedback was continuously given on their performance.

All staff spoken with were clear about their role and responsibilities. They had a good understanding of the ethos of the home and the systems in place to monitor quality assurance. This ensured that people received good quality of care.

One person said, 'I like living here. The staff help me and we go out a lot.' One relative spoken with said, 'My relative has lived there for a long time. They are very happy and do lots of things they enjoy. The staff are great.'

People told us and we saw that they were involved in decisions about their care and were asked for their consent before care was given. One person said, 'They always listen to us and give us choices.'

We saw that people had personalised care plans which were regularly reviewed and updated. Advice and information from health care professionals involved in their care and treatment was documented. This meant that staff had all the information they needed to support people with their health and wellbeing in the way that they preferred.

People were involved in various interesting activities of their choice and were supported to maintain important relationships. One person said, 'I go to the temple and the library. I visit my family every week.'

People received their medicines as prescribed by their doctor to ensure their health needs were met.

Staff training was up to date and staff were supported in their roles.

There were audit systems in place for monitoring and improving the quality of the service.

On the day of our inspection three people were living at the home. People had various levels of verbal communication skills due to their learning disability. We observed their experiences to support our inspection.

We spoke with two members of staff and the manager about the service provided. We looked at the care records for all of the people who live here.

People were involved in decisions about their care and how the home was run. We saw that staff knocked on doors to respect people's privacy and spoke to people in a respectful manner.

Records gave staff enough information to support people with their needs in the way they prefer.

People were involved in activities of their choice in the community. One person said, 'I help to get the shopping each week. We all choose what we want and we make a list. I like my home.' Another person said, 'I go to the temple on Saturdays. The staff help me.'

The furnishings, decor and presentation of the home had been updated to provide a homely environment.

Systems were in place to ensure that people were safeguarded from harm. Staff received training and support to be able to safely care for people in the way that they chose.

Systems in place to assess and monitor the quality of the service provided were not robust.