East View Housing Management Limited - 25 Alexandra Road

We found the following examples of good practice.

The home was clean and tidy. People had designated days when they and staff cleaned their rooms. Staff regularly cleaned high touch areas around the home such as door handles and light switches. Staff opened windows at regular intervals to ensure good ventilation. The living room furniture had been arranged to ensure there was a distance between people if they sat on the sofa and chairs.

Staff had supported people to understand the changes to government guidance and what it meant for them at different times throughout the pandemic. When people were not able to go out regularly, staff ensured people had things to do at home. Staff told us that activities arranged at the home had brought people closer as companions. People had completed pieces of artwork together and had held video console competitions.

Staff had worked hard to ensure that promoting people's independence and reaching their goals was not affected by the pandemic. One person's goal was to improve their experience of leaving of the home. Staff had worked with the person to increase their confidence in going out in between various lockdowns and the person was now happy to go out regularly.

There was a regular staff team at the home. Where staff were needed to be shared with two of the provider’s other homes, staff did a lateral flow test before working at the home. The home had one regular agency member that they had used if they needed to. This staff member was subject to the home’s testing regime. Where staff had been risk assessed as more vulnerable to COVID-19 or having vulnerable family members, adjustments had been made to their working arrangements where needed.

People at the home naturally socially distanced from each other but staff reminded people if they needed to do so. When the home had an outbreak of COVID-19, staff had encouraged people to remain in their bedrooms. As people used a communal bathroom, staff developed a system with people to ensure the bathroom could be deep cleaned between each use. Due to the small domestic property type, zoning and cohorting was not possible. However, people were aware of the need to socially distance and if they needed to isolate.

People were supported to go out when they chose to. Where people were happy to, staff encouraged them to wear face masks in busy places. Where people were unable to wear face masks, people were encouraged by staff to keep their distance from others when out.

Staff were wearing personal protective equipment (PPE) in line with government guidance. Staff had received training in how to safely put on and take off PPE. People living at the home were used to staff wearing PPE.

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 our last inspection we found some improvement was needed in relation to the monitoring and completion of maintenance within the home. At this inspection improvements had been made in this area, all maintenance had been recorded and addressed promptly. New audits had been introduced to monitor the effectiveness of the systems that had been introduced to address this area. Despite these improvements we identified minor areas of record keeping that needed to improve to document more clearly the running of the home. Whilst staff received training in fire safety, there was no system to test that staff knew how to respond in the event of a fire.

There were good recruitment procedures and enough staff to meet people’s individual needs and wishes. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Risks to individuals were well managed and people were able to stay safe without having their freedoms restricted. People’s independence was well promoted. Incidents and accidents were well managed. People’s medicines were managed safely.

People’s needs were effectively met because staff had the training and skills they needed to do so. Staff were supported well with induction, training, supervision and appraisal. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

People had enough to eat and drink and had been involved in menu planning and where they chose the preparation of their food. Everyone was supported to maintain good physical and mental health. Appropriate referrals were made to health care professionals when needed.

People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of people and had developed positive relationships with people. People told us they were happy with the support they received and with their day to day activities. They told us they knew who to talk to if they had any concerns or worries. There was a friendly and relaxed atmosphere in the home.

There was good leadership in the home and the registered manager had an open door policy which staff valued. The organisation had effective systems to monitor and review the quality of the care provided.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary describes what people using the service and staff told us, our observations during the inspection and the records we looked at.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that care plans were sufficiently detailed to allow staff to deliver safe and effective care that reflected the support required in people's needs assessments. Care records were reviewed when needed, we saw that they were complete and reflected people's current circumstances. One person told us, 'I enjoy doing all the things I do, the staff are good. I am very happy here'.

Other records showed that systems were in place to make sure that staff learnt from events such as accidents and incidents, complaints and concerns. Records kept by the service ensured that risks were identified and reviewed. This helped reduce risks to people and enabled the service to improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care settings. This is when restrictions may have to be made to help keep people safe. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Staff files contained all of the information needed by the Health and Social Care Act as well as details of the training they had received. This meant the provider could demonstrate that the staff employed to work at the service were suitable and had the skills and experience needed to support the people who lived there.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. People understood that they had given their consent to receive the care and support provided and knew that they could change their minds about the decisions that they had made. One person who used the service told us, 'The staff are great, I get any help I need'.

Is the service caring?

People were treated with respect and staff were courteous. Staff encouraged and engaged with people. They explained to people what they were doing and offered them a wide variety of activities. People told us that the staff were supportive. We saw that staff knew how to communicate effectively with people and we saw how this managed people's expectations and helped them plan for activities and events.

Is the service responsive?

People had regular review meetings with keyworkers to make sure that changes in their needs were identified and action taken. Records confirmed that people's preferences, interests and diverse needs had been recorded and that care and support had been provided that met their wishes. People had access to activities that were important to them. For example, some people had work placements, or went to college and day centres. People were supported to attend religious services and social events such as clubs and music events.

Is the service well-led?

The name of a previous registered manager appears in this report, who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because it had not been removed as the registered manager of this location at the time of our inspection.

Staff had a good understanding of their roles in the service and felt supported by the acting manager. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service were given opportunities to express their views. We found the acting manager had good knowledge and oversight of the running of the home.

We were able to meet all of the people who lived in the house. We also met two staff who worked across this and two other houses operated by the provider in the same street. People were able to tell us about their experiences and told us they liked the people they lived with and where they lived. Staff were seen interacting well with the people in the house and showed a good understanding of their individual characters and support needs.

People told us about the things they did during the week which they enjoyed. They all had a busy activity programme and also enjoyed an active social life.

We saw that appropriate systems were in place for the safe management of medicines, and for the receipt of and response to complaints.

We found that people lived in a safe, well maintained and homely environment.

We had some concern that a robust recruitment and induction process for new staff was not clearly evidenced and that records were not always kept updated.