This inspection took place on 22 September 2015 and was an unannounced inspection. The previous inspection on 14 November 2013 was a follow up inspection and we found the regulation we assessed was being complied with at that visit.
Apple Tree house is registered to provide accommodation for persons who require nursing or personal care for up 12 people with learning disabilities. On the day of the inspection there were 12 people living at the service. The service is located in the market town of Beverley in the East Riding of Yorkshire. It is close to the local shops and offers access to local transport routes.
There was a manager in post who had registered with the Care Quality Commission (CQC) in September 2015. 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.
Medicines were administered safely by trained staff and the arrangements for ordering and storage were appropriate. However we saw there was not an effective stock control system in place and errors were not identified.
The registered manager was able to show they had an understanding of Deprivation of Liberty Safeguards (DoLS). However, some people who used the service had been deprived of their liberty and no applications to authorise this had been made to the local authority.
People who used the service, relatives and staff told us that the home was well managed. We saw that although the registered provider had systems in place for monitoring some parts of the service they were not always effective.
We saw that people had person-centred care plans in place to instruct staff on how best to support them and meet their needs. These were clearly written. However, we saw these were not always consented to or regularly reviewed. We have made a recommendation about this.
We found that people were protected from the risks of harm or abuse because the registered manager had effective systems in place to manage issues of a safeguarding nature. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.
Staff had been employed following the registered providers recruitment and selection policies to ensure that only people considered suitable to work with vulnerable people had been employed.
We saw that people enjoyed premises that were suitable for their purpose. The environment was well maintained, comfortable and in a safe condition.
Staff confirmed that they received induction training when they were employed and told us that they were happy with the training provided for them. The training records evidenced that most staff had completed training that was considered to be essential by the service.
We found that people were cared for and supported by kind and caring staff that also provided clear boundaries for acceptable behaviour. Staff offered advice and guidance to assist people to lead a purposeful and fulfilling life.
People were supported to undertake activities and employment of their choosing and were able to complain if they felt necessary.
You can see what action we told the provider to take at the back of the full version of the report.