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Archived: Cherry Tree Housing Association - 12 Tavistock Avenue Requires improvement

Reports


Inspection carried out on 28 September 2016

During a routine inspection

12 Tavistock Avenue is registered to provide accommodation and personal care for up 3 people who have a learning and or physical disability. At the time of our inspection One person was living at 12 Tavistock Avenue. The provider also manages another home across the road from 12 Tavistock and the staff work at both services.

The last inspection was undertaken on 22 and 28 September 2015. We found that the service was rated 'good' and was meeting the required standards.

We inspected 12 Tavistock Avenue on the 28 September and 5 October 2016 and found that the service had continued to meet the standards.

The home did not have a registered manager in post. The registered manager had left the service six weeks before the inspection commenced. There was a new manager who was in the process of registering with CQC. 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.

At this inspection we found there were sufficient numbers of staff deployed to provide care safely to people living in 12 Tavistock Avenue. The manager had not informed us about incidents that required reporting which is required to help keep people safe from the risk of harm. The person were supported by staff who had undergone a recruitment process to ensure they were suitable to work in a care setting. However there were inconsistencies in the recruitment of staff depending on when they were recruited. We saw that when agency staff were used the manager did not always complete the same level as robust checks as they did for permanent staff.

Risk assessments were completed and reviewed to help staff to manage risks, Although the records were not always updated to reflect the current position. The persons medicines were managed safely and there was a process in place to for the safe ordering, storage and disposal of the persons medicines.

Staff did not feel supported by the manager and felt that they were constantly being criticised about how the service operated and spoken to in a condescending way. Staff had received training but some of the refresher updates had not been provided. We saw there were arrangements in place for staff to have an induction when they commenced their employment to help support them to carry out their roles effectively.

The persons nutritional needs were met and their food and fluid intake and weight were kept under review. The person was able to choose what they ate from the menu. However the menu was under review at the time of our inspection as the new manager felt that more ‘healthier options’ should be introduced.

The persons relatives and staff told us they were supported to maintain their health and well- being and had access to a range of health professionals. We saw that the person had a purple folder which contained a summary of healthcare appointments and records of key events.

Staff spoke to people in a kind, caring and compassionate way. We observed good interaction between staff and people and relatives confirmed this to be the case.

The persons dignity was privacy was maintained. However the person did not always get choices about how they spent their time.

The person received care that was responsive to and met their needs. Staff were aware of the persons individual needs and how to meet these, however due to management changes they were not always able to accommodate the persons needs and wishes. The person was provided with some opportunities to participate in activities mainly in the community.

There was a complaints policy and procedure in place and we saw evidence of one complaint from the other service which we say had been investigated and responded to by the Manager. There were no complaints for the person who lived at 12 Tavistock Avenue.

The person received care that was monitored appropriately by staff. The persons care plans were regularly reviewed. Audits were not effectively reviewed to ensure actions were completed, and notifications were not consistently sent to CQC when required.

Inspection carried out on 28 September 2015

During a routine inspection

The inspection took place on 28 September 2015 and was unannounced.

At our last inspection on 24 January 2014, the service was found to be meeting the required standards. At this inspection we found that they had continued to meet the standards.

There was a manager in post who had registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

12 Tavistock Avenue provides accommodation and personal care for up to three people with learning disabilities. On the day of our inspection, there were three people living at the home.

The CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that people’s freedoms had not been restricted and so DoLS authorities were not required.

There were safeguarding processes in place to keep people safe and people told us that they felt safe living at the home. We saw that staff had received training in how to safeguard people from avoidable harm and knew how to report concerns.

The recruitment process were thorough and the appropriate documents such as references and DBS checks were in place to ensure only suitable staff were recruited to work at the service. There were sufficient numbers of staff employed to work at the service to ensure they were able to meet people’s individual needs.

Checks were in place to ensure the environment and risks to individuals were appropriately identified and managed. People were supported by staff who had been trained to assist people to take their medicines safely.

Staff spoke positively about the support arrangements that were in place. Staff demonstrated they knew people well and supported them in a kind and caring way. People were supported to pursue hobbies and things they enjoyed doing both in the home and community.

People’s privacy and dignity was respected. People received person centred care and were involved in the planning and review of their care. People were asked for consent before support was provided and this was recorded in their care plans.

People were offered healthy and nutritious foods and were involved in planning the menus. People were supported to maintain their health and could see GP’s or other healthcare professionals when required.

Information for people was available in an easy to read format supported by pictorials. People were involved in all aspects of the service. People and their relatives were able to access local advocacy services if they wanted to obtain independent advice.

There was a complaints policy and procedure in place. People knew how to make a complaint if they needed to. There were also systems in place to monitor the quality of care provided, to undertake regular audits and to achieve continual improvement.

Inspection carried out on 24 January 2014

During a routine inspection

People who lived at 12 Tavistock Avenue were treated with dignity and respect. Staff supported people living there to be as independent as possible.

During our inspection on 24 January 2014, we met all three people who used the service. People we spoke with were very happy with the care and support they received and told us that staff were friendly and helpful. One person told us: "I like it here. It’s OK. Staff are OK".

Care plans we looked at provided adequate guidance to staff to help them meet people’s care and support needs safely.

Staff supported people to access a range of social, community and health care services.

Staff responsible for administering people’s medicines had received training to ensure their safe practice.

Staff we spoke with told us that they enjoyed their job and felt well supported and had received the training the needed to meet people’s care and support needs.

People had the opportunity to express their views about how the service was delivered.

Inspection carried out on 13 August 2012

During a routine inspection

During our site visit, on 13 August 2012, we met all three people using the service. Two people gave us positive feedback about the staff and the care they had received. One person commented, “I get on fine with the staff. They are brilliant.” Another said, “I am happy living here. The staff are good.” The remaining person did not give verbal feedback but their facial expression, smile and gestures suggested they were content and happy with the care and service provided.

When asked about choices and activities, a person commented, “I go to bed anytime I want; I like watching films on TV in my room.” The same person also said that whenever they wanted to buy anything from the shops, they tell the staff and ‘the staff take’ them. Another person said that they all ‘go to clubs’ and day centres during the week. One person had attended the cookery class on the day of our visit and showed us the cake that they had baked. People were happy and content living in the home and had been encouraged to lead independent lifestyles.

Reports under our old system of regulation (including those from before CQC was created)