The inspection took place on 31 March and 1 April 2015 and was an unannounced inspection. The previous inspection on 4 September 2013 found that there no breaches in the legal requirements.
The home is one of a number of locations operated by East View Housing Management Limited, who provide support locally for people with learning disabilities.
The service is registered to provide accommodation and personal care to six people who have learning disabilities, including autism and limited verbal communication. People living at the home were male and female younger people. There were no vacancies at the time of the inspection. The home is a detached chalet bungalow, which stands back a little from a busy road. There is limited off road parking on the unmade drive. Each person has their own bedroom, most have ensuite facilities. There is a communal bathroom, kitchen, a lounge and a lounge/diner area. There is an accessible garden with a paved seating area at the back of the house.
This service had a registered manager in post. A registered manager is a person who is 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 time of inspection we were able to meet with all of the people living in the home and speak with some of them. People told us that they liked living in the home, they were happy and the staff were kind.
Whilst our inspection showed that whilst the service offered people a homely environment and their basic care needs were being supported, there were shortfalls in a number of areas that required Improvement.
Records of incidents of behaviours that challenged did not always provide sufficient information to support risk assessment reviews or promote learning, understanding and evaluation of strategies to reduce the risk of future occurrences.
Some areas of the home required improvement. Growth of mould and mildew in some shower areas had not been addressed. Some of the dining chairs were stained and torn and the dining table tops were damaged and worn.
Some aspects of staff recruitment process had not been completed as needed.
People were offered choices of food they could not have. Some supplies of food and drinks had run low or run out and had not been replenished, this meant there was little choice of food at the home.
The provider had identified areas of training that would help staff provide support to the people they cared for. However, this training had received little priority and in some instances had not been delivered. This affected how staff were able to communicate with some people, their understanding of people’s conditions and how to apply aspects of the Mental Health Act and Deprivation of Liberty Safeguards in their works roles.
Communication by staff did not always ensure that people experienced a good level of care; we saw that some people’s expectations were not well managed and staff were not always aware of people’s priorities or the meaning of some of their mannerisms.
Individual activity planners were not up to date or always presented in the ways identified in people’s care plans. The home was not always responsive to people’s needs because their goals and wishes were not effectively progressed to encourage development of learning and exploring new activities and challenges.
A quality monitoring system was in place but was not effective enough to enable the service to highlight the kind of issues raised within this inspection. Some of the issues that had been highlighted, particularly in relation to the condition of some areas of the home and furnishings, had not been resolved.
There were also the following areas that did work well.
People felt safe in the service and out with staff. The service had safeguarding procedures in place and most staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns.
People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs. People were supported to access routine and specialist health care appointments and staff showed concern when people were unwell and took appropriate action.
We checked the arrangements for the management of medicines. They were stored appropriately and people received the right amount of the right medicine at the right time. Staff had received training to administer medicines and were assessed as being competent to do so.
The manager had an understanding of the mental capacity Act 2005, and Deprivation of Liberty safeguards, they understood in what circumstances a person may need to be referred, and when there was a need for best interest meetings to take place.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Which now correspond to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.