This inspection took place on 12 October 2015 and was unannounced. This meant the provider did not know we were carrying on the inspection on that day.
35-37 Portland Avenue provides accommodation and personal care for up to four people. The home is a pair of semi-detached bungalows, each with two bedrooms, a lounge and kitchen. They are set in their own gardens in a residential area, near to public transport routes and local shops.
There was a registered manager in place who had been in their present post at the home for over ten years. A registered manager is a person who has registered with the Care Quality Commission (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.
We found people were engaged in their care and the running of the home and staff helped people to express their wishes, likes and dislikes and the activities they wanted to do. People’s care plans were very person centred and written in a way that described their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for people living at the home to understand and also included pictures and symbols.
People who used the service, and family members, were extremely complimentary about the standard of care provided.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. We found the registered provider was following legal requirements in relation to MCA.
Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes and we viewed records that showed us staff were enabled to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended training and development activities to maintain their skills. We also viewed records that showed us there were safe and robust recruitment processes in place.
Throughout the day we saw staff interacting with people in a very caring and professional way. The registered manager and staff that we spoke with showed genuine concern for peoples’ wellbeing and it was evident that all staff knew people at the home very well. This included their personal preferences, likes and dislikes and had used this knowledge to form very strong therapeutic relationships. We saw all of these details were recorded in people’s care plans. We found that staff worked in a variety of ways to ensure people received care and support that suited their individual needs and personality.
People were supported by well trained staff. The provider had its own training department which supported staff to gain the skills and knowledge they needed to meet the needs of people who used the service.
People were protected from the risk of abuse. The care staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They had undertaken training and were able to describe the different ways that people might experience abuse. Staff were able to describe what actions they would take if they witnessed or suspected abuse was taking place.
People received a balanced diet. People at the home had specific diets and preferences and staff were very knowledgeable about these. We saw staff offered a selection of preferred meals and people chose what they wanted to eat. There were snacks and drinks available at all times as well as healthy options for people to choose from which staff encouraged.
We found that the registered manager had checks in place to make sure the building was clean and well-maintained. Improvements to the building and required maintenance was undertaken when required to ensure health and safety for people living and working at the home. There was a designated infection control champion at the home and we found that all relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.
We saw the provider had policies and procedures for dealing with medicines and these were followed by staff. Medicines were securely stored and there were checks and safeguards in place to make sure people received the correct treatment.
People were supported to take part in activities they were interested in and routines they preferred. Staff were constantly looking for more opportunities for people to try.
We found that the registered provider had comprehensive systems in place for monitoring the quality of the service. This included monthly audits of all aspects of the service, such as medication and learning and development for staff, which were used to critically review the home. We also saw the views of the people using the service, their advocates and relatives were regularly sought and used to make changes. The manager produced action plans, which clearly showed when developments were planned or had taken place.
There was a complaints policy at the home which provided people who used the service and their representatives with clear information about how to raise any concerns and how they would be managed. We saw pictures had been used to help people understand the information. The staff we spoke with told us they knew how important it was to act upon people’s concerns and complaints and would report any issues raised to the registered manager or provider.