Updated 21 June 2019This service was inspected but not rated as it was not providing a regulated activity at inspection.
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Updated 21 June 2019The inspection was unannounced and took place on 6 & 7 July 2016. The service provides a residential service with an emphasis on rehabilitation for up to 19 people with a variety of mental health problems and the service was full at the time of inspection. People have their own bedrooms many of which are ensuite, there is a shaft lift and a variety of aids and adaptions are in place to aid people with minimal mobility difficulties. This service was last inspected on 8 January 2014 when we found the provider was meeting all the regulations inspected at that time.
There was a registered manager in post who was available in the service Monday to Friday and included in a telephone on call rota at weekends to advise staff if needed. 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.
People were provided with a safe, clean environment that was maintained to a high standard, with all safety checks and tests routinely completed. There were enough skilled staff to support people and provide continuity, and the provider implemented recruitment procedures quickly when staff left, with an emphasis on recruiting skilled qualified staff. New staff were inducted appropriately into their role and given opportunities to meet regularly with members of the management team individually and in staff meetings, they said that they felt well supported and listened to.
Staff understood how to keep people safe and protect them from harm, they understood how to respond to emergencies that required them to evacuate the building quickly and safely. It was recognised that some restrictive practices were necessary although there was a clear culture of least restrictive practice and positive risk taking embedded across the service. Risks were appropriately assessed to ensure measures implemented kept people safe.
People were encouraged by staff to make everyday decisions for themselves, but staff understood and were working to the principles of the Mental Capacity Act 2005 (MCA) where people could not do so. The MCA provides a framework for acting and making decisions on behalf of people who lack mental capacity to make particular decisions for themselves.
There was a strong rehabilitation focus helping people to regain a meaningful life. Staff worked in partnership with people to promote and encourage their rehabilitation and skills development and included them in every aspect of their support. People were placed at the centre of the service and their involvement and empowerment was clearly embedded. They were able to contribute to their own care records through regular meetings with their key workers (in this service the keyworker was involved in planning with the person how their care needs were met, and agreeing with them the amount of assistance they required) this may also involve participating in discussions about the persons support with professionals and attendance for example at reviews. They were treated with dignity, respect and kindness and their relationships with staff were positive. People understood how to complain and felt confident of approaching staff with any concerns.
Medicines were well managed. People were encouraged to eat healthily and chose from a selection of food provided for them, they had opportunities to self-cater. Their health and wellbeing was monitored closely and specific staff had the responsibility for doing this each month as a preventative measure; any issues arising from these checks were quickly alerted to health professionals.
People were supported to develop relationships and maintain those that were important to them, there was excellent support for them to use new technology to do so and free access to telephone and internet was available to them, many were supported to purchase tablets and smart phones and given support in how to use them. Video link facilities were available so that people could more easily maintain their relationships with the people close to them, staff also used video link with external care co-ordinators who might otherwise be unable to attend care programme meetings locally due to distances so that everyone could contribute to care decisions.
Staff worked closely with their mental health team partners in the local teams and allocated care co-ordinators to ensure that peoples changing needs were identified and solutions found and also to celebrate achievements.
People told us they were happy, they enjoyed the freedoms the service provided and the variety of activities offered in house and in the community, they were supported to access educational and voluntary work opportunities. Professionals held the service in high regard and thought the service was effective in working with people with complex mental health needs and supporting, motivating and preparing them for life in the community.
People were routinely asked to comment about the service and their views were analysed and action taken where improvements could be made. People could join in at the end of management meetings which were open to all. The providers took an active interest in the service and were present several times each week, speaking with staff and the people supported, they attended weekly management meetings and ensured identified shortfalls were addressed.