Archived: Select Lifestyles Limited - 153 St Marks Road

153 St Mark’s Road is registered to provide accommodation for up to five younger adults who require personal care and support. On the day of the inspection there were four people living at the home. 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.

People and their relatives told us they felt safe. Staff understood their responsibilities in keeping people safe from harm, and knew how to report any concerns. Relatives told us there were enough staff to support people living at the home, and that staff had the right level of skills and experience. Staff received training that was relevant to their role. The provider had effective recruitment processes in place and carried out appropriate checks on staff before they were able to start supporting people. People received their medicines as prescribed and systems to manage medicines were effective.

People were asked for their consent before care was provided. People’s care and support was planned in a way that did not restrict their rights and freedom. People were supported to have enough to eat and drink. People were supported to maintain good health by staff who followed the advice given by healthcare professionals.

People and their relatives told us the staff were kind and caring. Staff understood people’s individual needs and people’s privacy and dignity was respected.

People were supported to take part in activities that interested them. Where people’s needs changed, staff took action to ensure people received care that was appropriate for their needs. People’s relatives felt confident to complain if they were unhappy and there was a system in place for handling complaints.

Relatives and staff expressed confidence in the registered manager and the provider and felt they were listened to when they gave feedback. There was an open culture within the home and people felt able to express their views and opinions. There were systems in place to manage the quality of the service and regular audits were carried out.

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. During the inspection we met the four people who were using the service and spoke with three care staff, the care manager and the operations manager. We also spoke with three relatives of people who used the service and we spoke with one external care professional.

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

Is the service safe?

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements.CQC monitors the operations of the Deprivation of Liberty Safeguards (DOLs) and the Mental Capacity Act. While no applications have needed to be submitted, proper policies were in place. We saw that staff were provided with training in safeguarding vulnerable adults from abuse and that upcoming training in the Deprivation of Liberty Safeguards (DOLs) and the Mental Capacity Act was in place for all staff.

People were cared for in an environment that was safe, clean and hygienic. We saw records which showed that the home environment and the equipment in it was regularly checked. This included regular fire safety checks, this meant people were protected in the event of a fire.

Staff personnel files contained information required by the Health and Social Care Act. This meant the staff employed were suitable and had the skills and experience to support people living in the home.

Is the service effective?

Relatives of people who used the service told us that they were happy with the care and support the service provided. One relative told us about the service: 'Been brilliant, have massive trust in them and done us proud'. Our observations and discussions with staff showed they were knowledgeable about the people they supported and what people's care needs were.

We saw that the service conducted regular staff supervision sessions and that training was planned and delivered to meet the needs of the people living in the home.

Is the service caring?

We saw that people were supported by staff who were kind and caring towards them. Relatives of people we spoke with told us that people were well cared for. One relative told us: 'Staff have empathy, and good with him, has a lot going on that is good for him'.

We saw that staff were patient and encouraged and supported people to take part in activities that they enjoyed. We observed that people were able to do things at their own pace and were not rushed. People were supported and encouraged to be involved in activities of daily living around the home and where appropriate were encouraged to be independent.

Is the service responsive?

People's needs had been assessed before they moved into the home. Each person was allocated a key worker. Records confirmed people's preferences, interests and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their relatives.

Is the service well-led?

We saw that staff, relatives and people using the service were asked for feedback and that any identified needs or wishes were responded to and acted upon. The provider ensured that monthly audits of various aspects of the service's operations were undertaken and we saw records which showed that where any concerns were identified processes were in place to address them.

Staff told us they were clear about their role and responsibilities. One staff member told us:' The staff team click together, work well'. We saw that the service had robust contingency, emergency planning in place to ensure that people using the service always had their needs met.

We saw people were provided with the support that was recorded in their care plans. We saw people's independence was promoted by staff who were available to them if support was needed.

People had regular contact with health professionals. This was recorded in people's records and confirmed by letters and recording by health professionals.

Staff we spoke with had a better understanding of people's behaviour management plans. They were able to respond to behaviours from people that challenged them, without the use of physical restraint. Staff told us they were, 'Not allowed to restrain' people. People's behaviour management plans had been reviewed and were now clearer.

Arrangements in relation to the management of one person's insulin were managed safely following improvements to the person's records. Staff had received training in dietetic care related to management of this person's insulin. This meant the person was at less risk due to better management of their insulin.

We saw that people were cared for by staff who were supported by appropriate training and supervision. This meant they delivered care safely and to an appropriate standard.

People's privacy, dignity and independence were respected. People expressed their views and were involved in making decisions about their daily routines. We saw that people were able to be independent and carried out domestic tasks for themselves.

We observed staff provided people with the support in line with their care plans. One person told us about how information in their care plan reflected their needs.

People had regular contact with health professionals. This was recorded and confirmed by documentation and letters from the health professionals.

Staff we spoke with had been aware of the use of 'controlled walking' as a form of restraint by other staff. This showed staff needed a better understanding of people's behaviour management plans so that they were aware these made no reference to use of physical restraint.

Arrangements in relation to the management of medication showed that these were managed safely but there was an exception in regard to the management of a person's insulin, which may put them at potential risk.

We saw that the provider had a system to assess and monitor the quality of service which involved asking people their views. One person said they 'Liked the staff'. Another person told us that they were 'Ok' and the home 'Did not need an inspection".