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Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 December 2018

This unannounced inspection took place on 14 November 2018. At the last inspection on 23 August and 08 September 2017 there was a breach of Regulation 17. This was because the provider did not have effective systems in place to manage risks relating to the health, safety and welfare of people using the service. During this inspection, we found the provider had made some improvements, however they had not been completely effective or consistent therefore the service has remained in breach of Regulation 17.

Natalie House is a care home registered to accommodate up to five people who have a learning disability. The home is not purpose built or modified. At the time of our inspection four people were living at the home. People in care homes receive accommodation and nursing or 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.

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 at the time of the inspection. 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.

There was some further improvement required to the systems and processes in place to monitor the safety and quality of the service provided. We found the provider was not meeting the regulations around the overall governance of the service. You can see what action we told the provider to take at the back of the full version of the report.

Relatives were involved, alongside healthcare professionals, to ensure that any decisions made in respect of their care and support needs, were done so within their best interests and in accordance with the Mental Capacity Act 2005. However, this was not always practiced consistently by the service and required some improvement.

People were protected from the risk of abuse and avoidable harm because staff knew what action to take and the provider had safeguarding systems and processes in place to keep people safe. People were supported by sufficient numbers of staff who were kind and respectful and had the knowledge they required to care for people safely.

People were also protected against risks associated with their health and care needs because risk assessments and associated care plans were in place and had been reviewed within the last 12 months. People received support from staff to take their prescribed medicines. Systems and processes were in place to ensure medicines were managed safely. People received their medicines from staff who had undergone training and were permitted to administer medicines.

Where people were assessed to lack the capacity to consent to the support they received, the provider followed key processes to ensure the care being provided was in the least restrictive way possible. Applications had been made to safeguard people against the unlawful deprivation of their liberty, where necessary. People’s privacy, dignity and independence were respected.

People were supported to maintain a healthy diet with choices of different foods available and all their health needs were met with the support from staff and healthcare professionals. Staff knew people very well. There was a complaints process in place although there had been no complaints since the last inspection. People engaged in interests in an environment that was suitable for people living with learning disabilitie

Inspection areas

Safe

Requires improvement

Updated 20 December 2018

The service was not consistently safe:

There was still improvement required to the provider’s recruitment processes to ensure that suitable staff were employed to work with people.

People were supported by sufficient numbers of staff. People were protected from infection and cross contamination because staff members were provided with sufficient personal protective equipment. People were supported by staff to take their medicines safely and as prescribed by the GP.

People were safe with the staff that provided them with support. Staff recognised signs of abuse. Systems were in place to protect people from the risk of harm and staff knew how to report any suspicions of abuse. People were safeguarded from the risk of harm because risk assessments were in place to protect them.

Effective

Requires improvement

Updated 20 December 2018

The service was not consistently effective:

Decisions made in people’s best interests did not consistently apply the best interests process and required improvement.

People received care and support with their consent, where possible and people’s rights were protected because key processes had been followed to ensure that people were not unlawfully restricted.

People received care from staff that had the knowledge they required to do their job. People’s nutritional needs were assessed and they had food that they enjoyed.

People were supported to maintain good health because they had access to other health and social care professionals when necessary.

Caring

Good

Updated 20 December 2018

The service was caring:

People were supported by staff that was caring, kind and respectful.

People’s independence was promoted as much as possible and staff supported people to make some decisions about the care they received.

People were cared for by staff members who protected their privacy and dignity.

Responsive

Good

Updated 20 December 2018

The service was responsive:

People were offered opportunities to engage in activities and outings that interested them.

The provider had a system in place to manage complaints.

Well-led

Requires improvement

Updated 20 December 2018

The service was not consistently well-led:

Although the provider had systems and processes in place to monitor the safety and quality of the service, there was further improvement required to ensure the service operated consistently and effectively.

Relatives spoken with were complimentary about the management team and staff members.