Archived: Idelo Limited - 8 Courtenay Avenue

Idelo Limited-8 Courtenay Avenue provides accommodation and personal care for three adults who have learning disabilities, some of whom live with mental health needs. At the time of the inspection three adults were living in the care home.

People’s experience of using this service:

The care home had been registered before Registering the Right Support and other best practice guidance had been developed. Registering the Right Support guidance focuses on values that include choice, inclusion and the promotion of people’s independence so that people living with learning disabilities and/or autism can live a life as ordinary as any other citizen. However, it was evident that people living in Idelo Limited-8 Courtenay Avenue were provided with the support that they needed to make decisions about their lives, develop their independence and to participate fully within the local community.

People using the service told us that they felt safe and staff were respectful and kind. They spoke of being happy living in the home and leading busy lives. People’s relatives were also positive about the staff and the service provided to people. They told us that staff understood people’s needs including their cultural and religious needs.

People's care and support plans were up to date and personalised. They included details about people’s individual needs and preferences and guidance for staff to follow so people received personalised care and support that met their individual needs and preferences.

Staff knew people well and had a caring approach to their work. They understood the importance of treating people with dignity, protecting people's privacy and respecting their differences and human rights.

People were protected from the risks of harm, abuse and discrimination. Staff knew what their responsibilities were in relation to keeping people safe.

Systems were in place to ensure that people received their prescribed medicines safely. Medicines training was provided to staff and their competence to administer medicines was assessed.

Staff had the skills and knowledge to provide people with the care and support that they needed. They received a range of training and the support that they needed to enable them to carry out their roles and responsibilities.

Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to have choice and control over their day to day lives. Staff gained people's agreement before providing them with assistance with personal care and other activities.

People received the support they needed to stay healthy and to access healthcare services.

Staff encouraged and supported people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them. People told us that they felt a part of their local community. A person told us that they used public transport and accessed a range of community facilities and amenities.

Rating at last inspection: Good. The report was published 25 October 2016. The service was rated good overall but was rated improvement in Safe. This was because some risk assessments had not been reviewed regularly, medicines training for staff was not consistently taking place and references for new staff had not always been followed up to confirm their authenticity. We found during this inspection that management had taken appropriate action to address these issues.

Why we inspected: This was a scheduled planned comprehensive inspection.

Follow up: We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Idelo Limited – 8 Courtenay Avenue is a care home which has been registered to accommodate a maximum of three people with mental health conditions and learning disabilities. On the day of our inspection there were three people using the service.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 safely administered and recorded. However, medicines training and staff competency checks were not consistently completed. Medicines audits were completed by the registered manager but this was not always documented.

Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. Staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.

Detailed current risk assessments were in place for all people using the service. Risk assessments explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person.

The home maintained adequate staffing levels to support people both in the home and the community.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans were person centred and reviewed regularly.

We saw evidence of a staff induction and on-going training programme. Staff had regular supervisions and annual appraisals. Staff were safely recruited with necessary pre-employment checks carried out.

People are supported to eat and drink. People were consulted about weekly menu choices and supported to prepare their own meals. Food was freshly prepared. Details of special diets people required either as a result of a clinical need or a cultural preference were clearly documented and staff were aware of such preferences.

People are supported to maintain good health and have access to healthcare services. Referrals are made quickly when concerns are noted as regards people's health.

A complaints procedure in place which was displayed for people and relatives and complaints were logged and investigated.

The service undertook a range of checks and audits of the quality of the service and took action to

improve the service as a result.

The registered manager and operations manager were accessible to people and staff who spoke positively about them and felt confident about raising concerns.

During the inspection we spoke with relatives of two people who used the service. We spent time observing and we spoke with a person who used the service, two care workers, and the registered manager .

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Those using the service and their relatives told us that they felt their loved ones were safe and staff were friendly.

People's care needs had been assessed and care and treatment was planned and delivered in a way, which promoted people's safety and welfare. Risk assessments had been carried out where necessary. These risk assessments were used by staff to guide the care that was provided. People's health, safety and welfare were protected. We found staff escalated health concerns to the appropriate health professional and ensured that the advice from that health professional was integrated into the person's care plan.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act and is concerned with people's safety and well-being where they are not always able to make decisions for themselves. Arrangements were in place to care for people under DoLS where necessary.

We saw the arrangements for staffing the service were designed around the delivery of safe care. There were systems in place to ensure that medicines were dispensed and administered safely by appropriately trained staff.

Is the service effective?

Staff told us there was good communication amongst staff about the service and people's needs, which enabled them to carry out their roles effectively in providing the care and support people needed. Relatives of those people using the home were very complimentary of staff.

Care plans had been regularly reviewed with involvement from people and those who were important to them and changes required in care and support needs had been addressed by the manager.

Is the service caring?

We observed the care that people were receiving and how staff interacted with them. We saw people using the service were spoken to respectfully and staff used a caring approach.

Staff approached people in a friendly manner and were able to reassure people if they became distressed.

Is the service responsive?

Relatives told us that staff were knowledgeable regarding the specific care needs of people and respected the choices people made. Staff had an understanding of people's cultural and religious needs and where appropriate, arrangements had been made to meet these needs, this included ensuring food was prepared appropriately.

People received individualised care that was responsive to their interests and preferences. A variety of activities were available for people to participate in as they chose. People's care and health was monitored closely. Written notes about people's health and care were completed by staff.

We saw food was provided in a safe way which ensured people were provided with a balanced diet that met their health needs. Relatives of those using the service were given various opportunities to provide feedback on the service. This feedback was used by the provider to improve the service.

Is the service well-led?

The home was led by an experienced manager who understood their role and took steps to ensure care was of a standard people would expect. Monitoring checks of the quality of the service were carried out. Improvements were made when needed. Staff meetings took place regularly so staff views about the service were taken into account.

We found that the provider sought consent from people before care and support, and followed government guidelines when people did not have the capacity to make decisions. We saw that people's needs were comprehensively assessed and that care plans were person-centred and took into account people's needs and wishes. We found evidence that people were supported to take risks, with their safety and welfare in mind.

People who used the service had involvement from a range of health and social care professionals, and we saw that care and support was cooperative and coordinated amongst the different teams. We found that the provider had taken steps to ensure people were safeguarded from the risk of abuse, and had an effective recruitment and selection procedure in place.

We saw that people benefitted from appropriate quality assurance processes.

People's needs were assessed and appropriate care plans developed in line with these needs. People's health needs were responded to, however, these were not always fully included in their care plans.

People told us that they accessed services in the community during the week and visited their family. The home arranged some social activities for people but our findings showed that these were not always tailored to people's individual needs. There was a friendly and relaxed atmosphere in the home and we observed positive interactions between people and staff.

People lived in a homely and well maintained environment. Appropriate health and safety checks were taking place. There were sufficient staff on duty to meet people's needs. There was a complaints system in place and people said they felt able to raise concerns with staff, However, the complaints procedure was not easily accessible for people.