Archived: South Hill Road

South Hill Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. South Hill Road accommodated four people at the time of the inspection.

The service was last inspected on January 2016 and the rating for this inspection was Good. At this inspection we found the service remained Good.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Records were personalised, up to date and accurately reflected people's care and support needs. They provided staff with detailed information to enable them to provide effective, person centred care that promoted people's independence. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

Medicines were administered and stored safely.

People were supported to access the support of health care professionals when needed. The provider had taken steps to minimise the risk of abuse because staff knew how to identify and report it.

There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated everyone with great respect and dignity. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff received effective training, supervision and a yearly appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to achieve their goals and aspirations.

People received a varied and nutritional diet and were provided with choice.

The interactions between people and staff showed that staff knew the people really well. Staff spoken with had a good knowledge of people's needs and spoke with genuine affection about the people they supported. The atmosphere at the home was homely and relaxed. It was clear that people felt relaxed and comfortable in the company of staff.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. The provider continuously sought to make improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service.

Further information is in the detailed findings below.

We last inspected South Hill Road on 5 August 2014. At that inspection we found the service was meeting all the legal requirements in force at the time.

South Hill Road provides accommodation and personal care for up to four adults with learning disabilities. Nursing care is not provided.

A registered manager was in place. ‘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 told us they felt safe and were well cared for. Staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistle blowing procedure which was in place to report concerns and poor practice.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, where decisions were made on behalf of people who were unable to make decisions themselves. Staff had completed other relevant training for their role and they were well supported by the management team. Training included care and safety related topics.

People’s health needs were identified and staff worked with other professionals to ensure these were addressed. Arrangements for managing people’s medicines were safe. Appropriate processes were in place for the administration of medicines. Medicines records were accurate.

Menus were designed with suggestions from people who used the service. Staff were aware of people’s likes and dislikes and special diets that were required. People were supported to be part of the local community. They were provided with opportunities to follow their interests and hobbies.

Staff knew the people they were supporting well. Care was provided with kindness and people’s privacy and dignity were respected. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

A complaints procedure was available and people we spoke with said they knew how to complain.

Staff said the registered manager was supportive and approachable. There were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.

We found that people were now protected against the risk of unsafe or unsuitable premises and the provider had taken steps to provide care in an environment that was adequately maintained.

We found that suitable staff appraisal and supervision arrangements were now in place. Overdue appraisals and supervision sessions had been conducted and records were now accurate and up to date.

' 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?

People using the service told us they felt safe with staff who provided their care and support. Relatives we spoke with told us they were confident that their family members were safe at the home. One person told us, 'I feel safe here; the staff are nice to me.' One relative told us, 'She is happy and content; safe and well looked after ' she would tell me if she wasn't.' Another relative said, 'I have no concerns at all. He is safe and well and I have confidence in the staff.'

People were cared for in an environment that was clean and hygienic. Equipment at the home had been well maintained and serviced regularly, therefore not putting people at unnecessary risk. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. The building was clean, secure and other appropriate measures were in place to ensure the security of the premises. One relative told us, "I have no worries about his care now and I find the staff are definitely well trained. Another relative commented, "The staff are very good; they treat people with respect. They are polite, well-mannered and handle people very well."

However, we found that the service had not always taken steps to provide care in an environment that was adequately maintained. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to making improvements and repairs to ensure that people who used the service, staff and visitors, were protected against the risks of unsafe or unsuitable premises.

Is the service effective?

People told us that they were happy with the care that was delivered and their needs were met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. We looked at how staff were supported to deliver care and treatment safely and to an appropriate standard. Staff had received training to meet the needs of the people living at the home. A relative told us, 'Staff seem well trained and have a genuine interest in with a good sense of humour.' Another relative commented, 'I think the staff are enthusiastic; they interact and get to know people. They encourage people to do things: promoting their independence.'

However, we found that staff were not always fully supported and suitable appraisal and supervision arrangements were not fully in place. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staff supervision and appraisal arrangements.

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. All people and relatives spoken with talked highly of the level of care provided by staff. One relative commented, "It's a friendly and caring service; they get on well with the people they look after.' Another relative told us, 'The staff are good; they treat people with respect, they are polite and well-mannered.'

Is the service responsive?

People's needs had been assessed before they moved into the home. Care records for people at the service were reviewed every six months to make sure that the information was accurate and up to date. Where people's needs had changed, their care plans were updated more frequently. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

People and their relatives were consulted about the service people received and the environment in which they lived. Meetings for people and their relatives were regularly held. This demonstrated that the provider took account of the views of people using the service and their relatives.

People had access to activities that were important to them and were supported to maintain relationships with their friends and relatives.

The provider had a written complaints policy and procedure, which detailed the process that should be followed in the event of a complaint. People and their relatives knew how to make a complaint if they were unhappy. We saw that no complaints had been received by the service within the last five years.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People and their relatives were able to complete a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times. The provider undertook regular audits and risk assessments to monitor the quality of the services and there were effective systems to identify, assess and manage risks to the health, safety and welfare of people using the service and others. One relative told us, 'It's a good and well-managed service.'

People who used the service and their relatives had commented upon the care that had been provided. They said that staff were 'friendly and accessible', working in an atmosphere that is 'very good', 'always cosy and friendly'. They had commented that care provided is 'excellent' and 'long may it continue'.

During this inspection we checked on the safety and suitability of the accommodation and environment. Family members had said the building is 'first class' and 'smart, clean and tidy'.

One family member had also said 'the service and accommodation will take some beating'.

People spoken to had access to their care plan and we were told that any changes in their care had been discussed with them and their family members.

People who used the service and their relatives had commented upon the care that had been provided and said that staff 'do a fantastic job and deserve a medal'.

One family had also said 'thank you so much for the care, love and attention given to my daughter during her recent illness.'

A further comment had been recorded from other professional staff that thanked staff 'for all the help and support' and acknowledged the 'hard work and brilliant job' that had been done.

People spoken to had access to their care plan and we were told that any changes in their care had been discussed with them.