Background to this inspection
Updated
14 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection visit took place on 27 November 2018 and was announced. We gave short notice because the service is small and we wanted to ensure staff and the registered manager would be available to speak with us on the day of our inspection visit. One inspector and an expert by experience undertook the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert by experience on this inspection had experience of learning disabilities services.
Prior to our inspection visit, we reviewed the information we held about the service. We reviewed statutory notifications sent to us from the provider. A statutory notification is information about important events which the provider is required to send us by law. The local authority had no concerns about this service when we asked them as part of our inspection planning.
We spoke with two people who gave us feedback about their experiences of living in the home. Two people were unable to verbally tell us about their experiences of living in the home, so we spent time with them and we observed how their care and support were delivered in the communal areas. This helped us judge whether people’s needs were appropriately met and to identify if people experienced good standards of care.
During the inspection visit we spoke with one person’s relative, six care staff, and the registered manager.
We reviewed two people’s care plans, daily records and three people’s medicine administration records. We looked at two staff recruitment files for pre-employment checks. We also looked at the management records of the checks the registered manager and provider made to assure themselves people received a safe, effective quality service.
Updated
14 December 2018
We inspected this service on 27 November 2018. The inspection was announced and carried out by one inspector and an expert by experience.
The service is a ‘care home’ operated by P.A.K.S Trust. The service consists of two separate houses; 18 and 42 Clarence Street. A third house, 17 Clarence Street, was previously part of this service. However, this property had not been used since June 2018. The provider was in the process of removing 17 Clarence Street from their registration with us. The service is one of six services provided by P.A.K.S Trust and provides accommodation with personal care for up to four adults. People cared for at the home are living with learning disabilities, including autism. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection visit, there were four people living at the home.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in post. 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.
At the last inspection in April 2016 all five key areas were rated as Good. At this inspection we found the quality of care had been maintained and people continued to receive a service that was safe, caring, effective and responsive to their needs. The rating continues to be Good.
There were enough staff on shift with the appropriate level of skills, experience and support to meet people’s needs and provide effective care. Staff knew what action to take in the event of an emergency and had been trained in first aid.
Staff understood their responsibilities to protect people from the risks of abuse. Staff had been trained in what constituted abuse and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.
Risks of harm or injury to people had been assessed and management plans were in place. The home was clean and tidy and staff understood how to prevent the risks of cross infection. At the time of our inspection visit, there had been a large flood from a water pipe in the kitchen of one house. Immediate action was being taken, by the provider, to address this and there was minimal disruption to the service.
People were encouraged and supported to maintain good health. Staff frequently liaised with other healthcare professionals. People received their prescribed medicines in a safe way.
Staff worked within the principles of the Mental Capacity Act 2005. The registered manager understood their responsibilities under the Act. Three people had authorised deprivation of liberty safeguards (DoLS) in place when their care and support included restrictions in the person's best interests.
Staff supported people in a caring and compassionate way. People had varied levels of verbal communication and some used gestures and non-verbal communication which staff understood well. The registered manager told us about their plans to improve the use of pictorial communication to support people in making choices.
People had individual plans of care which provided staff with the information they needed. Care plans were pictorial and accessible to people, however, they did not always reflect people’s involvement in planning their care and support. The registered manager told us care plans were to be updated to a new style which would be more inclusive and accessible so people could be more involved in reviewing their care.
People made individual choices about how they wanted to spend their time. There were opportunities for people to attend a day centre operated by the provider. People were supported with various activities both inside and outside the home.
People had no complaints about the service. They felt staff would address any concern if they needed to raise something.
The registered manager checked the quality of the service to make sure people's needs were met safely and effectively. Feedback about the service was encouraged on a day to day basis from people and staff. Staff felt supported in their role. The provider and registered manager understood their regulatory responsibilities.
Further information is in the detailed findings below.