Archived: No 19 Third Row

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on 18 December 2015 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘19 Third Row’ on our website at www.cqc.org.uk’

19 Third Row is one of four locations owned and run by Mr J & Mrs D Cole and is situated in the village of Linton, near Ashington. It provides accommodation for up to two people with a learning disability, who require assistance with personal care and support. At the time of the inspection there were two people living at the home.

The provider had fitted window restrictors to the upper floor windows to prevent them opening fully and limiting the chances of a fall occurring from a first floor window. The general manager had also undertaken visual checks on small electrical appliances used in the home, to ensure there were no defects or damage to the items which may make them dangerous to use. A qualified electrician had carried out a check on the fixed electrical systems at the home.

The general manager had also commenced weekly audits of the home to ensure that any issues that required addressing or updating were noted and addressed.

At our focused inspection on 18 December 2015, we found that the provider had followed their action plan and legal requirements had been met.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

The provider had systems in place that identified, assessed and managed risks to the health, safety and welfare of people using the service and others. We saw people's individual records had been reviewed and they included risk assessments which were updated as people's needs changed.

The staff we spoke to were all aware of the complaints, safeguarding and whistle blowing procedures. All of the staff said they would immediately report any concerns they had about poor practice and were confident these would be addressed.

We found the house was clean and people were protected by the systems in place to reduce the risk and spread of infection. We saw staff were provided with appropriate training to equip them with the skills to meet people's needs.

There was no one who was subject to Deprivation of Liberty Safeguard authorisation, but staff were aware of the recent Supreme Court judgement regarding what constituted a deprivation of liberty and had contacted the local authority to discuss the implications which this case had on the people that lived at the home.

Is the service effective?

There were systems in place to ensure people's health and care needs were assessed with them. We found they were involved in this process. We saw that specific care plans were in place for people with particular needs such as, specific medical needs.

Staff training was provided that took account of the needs of the people in the house. For example, we saw training in catheter care and administration of medicines had been provided.

People were supported to be able to eat and drink sufficient amounts to meet their needs and records were kept as necessary. There was a varied selection of food and people were consulted about what they wanted to eat.

Is the service caring?

We saw staff responded kindly and respectfully to requests from people. There was a relaxed atmosphere and we saw there was a good rapport between people and staff. One relative told us they were satisfied with the care and support offered. They said, 'Staff keep in touch with me and I see them most weekends. I have been happy with the care provided.'

People's preferences, interests, and diverse needs were recorded and we saw staff were aware of these during the inspection.

Is the service responsive?

We saw evidence that the care staff identified changes in people's needs and acted to make sure they received the care they needed. For example, there was evidence that staff had acted promptly to inform the GP of concerns about someone's specific health care needs and a referral had been made to a consultant.

People told us they were aware of the complaints procedure and staff could describe how they would assist a person to make a complaint. We saw there were systems in place for dealing with and recording complaints.

Is the service well led?

The service had a quality assurance system in place that included the use of questionnaires for people who used the service and their relatives. This meant people were able to feed back on their experience and the service was able to learn from this.

Staff had regular supervision and staff meetings which meant they were able to feedback to the management of the home their views and suggestions. Appraisals were scheduled to take place. Staff we spoke with confirmed their views were listened and account was taken of them. They said they felt well supported by the management of the home.

We found risk assessments were in place for the house and people's care.

At the time of our visit no complaints had been received and no safeguarding referrals had been made.

We found individual needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw evidence that care plans were being followed. We noted that where there were more complex health issues then advice had been sought from a range of other professionals.

People living at the home were offered a range of food and drinks. We found that there was a range of food and goods in store, which included fresh vegetables. People were also able to visit local cafes and pubs for meals.

Accommodation was provided across two stories and key facilities such as the kitchen area and wet room were easily accessible. We found the accommodation was well maintained and had a homely feel.

We found evidence that proper staff recruitment and selection processes were being followed. Appropriate checks were being undertaken before people started working for the service.

We noted that regular supervision and appraisals meetings were not taking place to ensure staff could discuss any concerns or training needs.

We found records were kept in good order and reviews of care plans and risks took place. There were records of people's personal preferences. Daily records were up to date and included details of activities, meals and any issues of note.

We observed people were asked for their opinion and about what they wanted to do and the provider acted in accordance with their wishes. Staff checked with people they were happy for us to examine their personal files and for us to view their bedrooms.

We established people in the home had comprehensive assessments of their needs, detailed care plans and that risk assessments had been undertaken. These highlighted important aspects of their care needs.

We saw medicines were stored securely in a locked cupboard and signatures were in place to indicate that a medicine had been given. We saw that there were regular audits of the medication and the recording systems.

We saw that there was an up to date training record for all staff. This indicated the range of courses that had been undertaken and the dates training needed to be renewed. Staff told us that they had regular supervision meetings and yearly appraisals with senior staff to discuss their work.

We saw the home had a written complaints procedure that detailed the process to be followed in the event of a complaint. This indicated complaints should be documented, investigated and responded to within a set timescale. We saw there were pictorial questionnaires that people who used the service had completed to show what they thought of the home.