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Inspection carried out on 19 July 2017

During a routine inspection

Lister Avenue is registered to provide personal care and accommodation for up to twenty five people who have mental health difficulties. The project consists of five adjacent houses, each accommodating up to five people. At the time of this inspection twenty four people lived at The Lister Project.

At the last inspection in July 2014 the service was rated Good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Lister Avenue on our website at www.cqc.org.uk’

At this unannounced inspection on 19 July and 3 August 2017 we found the service remained Good. The service met all relevant fundamental standards.

The service had a registered manager in post at the time of our 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 and associated Regulations about how the service is run.

People who used the service told us they were happy with how care and support was provided at the home. They spoke positively about the staff who supported them and the manager. Everyone we spoke with told us they felt safe living at Lister Avenue.

We saw there were systems in place to protect people from the risk of harm. Staff we spoke with were very knowledgeable about safeguarding people and were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people and management plans were in place to reduce the risks this ensured people’s safety.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this topic.

Systems were in place to ensure people received their medications in a safe and timely way from staff who were appropriately trained and competent.

There was enough skilled and experienced staff on duty to meet people’s needs. Recruitment systems were robust, so helped the employer make safer recruitment decisions when employing new staff. New staff had received an induction into how the home operated and their job role. This was followed by regular refresher and specialist training to meet the needs of the people using the service.

People were supported to eat and drink sufficient to maintain a balanced diet and adequate hydration.

People’s needs had been assessed before they moved to the home and had been involved in the planning of their care. Care files checked reflected people’s care and support. However, we found the care files were not easy to follow and it was difficult to find information. This was being addressed by the registered manager.

People had access to a varied programme of activities which provided regular in-house stimulation, as well as trips out into the community. People said they enjoyed the activities they took part in.

A complaints policy was available to people using and visiting the service. The people we spoke with told us they had no complaints, but said if they had a concern they would raise it with staff. We saw when concerns had been raised they had been investigated and resolved in a timely manner.

There were systems in place to monitor and improve the quality of the service provided. These had identified areas that needed improvement and action had been taken. However, minor infection control issues we identified at the inspection had not been identified but were actioned immediately. People were listened to and the provider actively sought the views of people who used the service, relatives and external professionals.

Inspection carried out on 30/07/2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.  This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new process being introduced by CQC which looks at the overall quality of the service.

This inspection was unannounced. Lister Avenue was last inspected on 4 February 2014 and they were not in breach of any regulations at that time.

Lister Avenue is commonly known as The Lister Project. It is registered to provide personal care and accommodation for up to 25 people who have mental health issues. The project consists of 5 adjacent houses, each accommodates up to five people. At the time of this inspection 24 people lived at The Lister Project. Here people are helped with rehabilitation so that they could aim to live independently in the community.

There was a registered manager in post at the service. This person has been off sick and alternative arrangements have been made by the provider and CQC has been made aware of this. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The staff team consisted of project leads who were responsible for specific houses, keyworkers who supported individuals and ancillary workers who carried out the domestic and maintenance work at Lister Avenue. One of the project leaders have been appointed as deputy manager in the interim period to be responsible for the day to day running of the service.

People told us they felt safe living at The Lister Project and said they had not witnessed, or experienced staff bullying or harassing anyone. Two people told us that sometimes people squabbled. They said that staff intervened and helped resolve these disagreements. People were safe because staff knew what to do when safeguarding concerns were raised. Staff told us they had received training and had a good understanding of the requirements of The Mental Capacity Act, (2005) and the Deprivation of Liberty Safeguards (DoLS). This meant people were safe and made sure any actions taken by staff were based upon the best interests of the people living at the service.

Staff told us that they assisted people to achieve their highest potential and shared examples of how taking on certain responsibilities had increased people’s confidence. . People told us they were comfortable when discussing their health needs with staff and were confident in the way staff supported their needs. One person said, “Keyworkers know my mental health issues and they know how to help me.” Another person told us that they could be unpredictable at times and their keyworkers knew how to help them “not get into bother.”

People told us they were able to come and go as they pleased without restrictions. People said they were treated with kindness and compassion by staff at the project.. Staff told us they had received training in promoting and dealing with issues relating to equality, diversity, gender and ethnicity. They said the training made them aware of people’s anxieties in relation to their diversity, ethnicity and gender. Staff were friendly and caring towards people who lived at the project, and we noted that they maintained confidentiality and discretion when people queried the wellbeing of other people living at The Lister Project. .

People were encouraged and supported by staff to express what was important to them. Staff told us that they asked people about their needs, medical history, options available to them and their preferences when they arrived at the project. This meant staff had a good understanding of people’s needs and expectations.

People told us that the care and support they received was agreed by them.  Keyworkers told us they only supported people after ensuring that people fully understood and agreed with the contents of their support plans Project leaders told us that when allocating rooms they ensured people with mobility problems had ground floor bedrooms so they were able to access the communal parts of the home safely.

People were actively involved in developing The Lister Project. .People told us on average house meetings took place every three months. Within these meetings people discussed what was going right and what could be done to improve their stay. During our inspection we observed an open culture among staff and the people who lived at the project. There was good interaction and respect between them. We also noted staff used a support network to help each other / and share ideas and good practice. The monitoring visits by the provider were detailed and commented on the effectiveness of the service and highlighted any areas for improvements. Any required actions were followed up at the next visit to ensure that action had been taken.

Inspection carried out on 4 February 2014

During a routine inspection

Since our last inspection the staffing structure has been reorganised. This report shows two registered managers. Marie Beech has applied to cancel her registration as manager.

We spoke with seven people living at The Lister Project about their experiences of the support they received. People spoken with were positive about living at the project. Their comments included, �It�s good here. I get the support I need� and �I like all of them [staff]. I can talk to them [staff.]�

During our inspection visit we spoke with the registered manager (Stephanie Street) and the two project leads about the running and management of the project. We spoke with three key workers about their role.

We found that before people received any care and support they were asked for their opinion and agreement to ensure that staff acted in accordance with their wishes.

We found people's care and support needs were assessed and each person had a written outcome plan (support plan) that set out their identified needs and the actions required of staff to meet these.

We found policies were in place to ensure medicines were handled safely.

The provider had a satisfactory recruitment and selection procedure in place to ensure staff were appropriately employed.

The provider had an effective complaints system available.

We spoke with Sheffield Local Authority, contracting and commissioning and they told us they had not identified any concerns at the project.

Inspection carried out on 13 September 2012

During a routine inspection

We spoke with three people about life at the Lister Project. Each person told us that they liked living at the project. One person stated, �it�s a lovely place.�

We spoke with people about how they were respected and involved in life at The Lister Project. From these discussions it was evident that people�s views, experiences and choices were actively sought, listened to and were central to the running of the project. People told us that there were regular meetings for each house as well as, �It�s your home,� a quarterly forum for everyone living at the project. One person told us that new garden furniture and a wooden summer house had been purchased as a result of being mentioned within one of these meetings. Another person was pleased to have received a letter from the providers head office thanking them for a suggestion made within a house meeting.

People also told us that their views about activities and outings were also discussed within these meetings. One person was pleased that their request for a specific outing had been met by the project and stated, �it�s very rare that a suggestion doesn�t happen.�

We spoke with people about the care, treatment and support they received at the project. One person stated, �the staff know me really well, they know the things I need little prompts with and always check on me. It�s nice to know that staff really care.�

We spoke with people about their outcome plans. Each person told us that they reviewed their outcome plan each month together with their keyworker. One person described these sessions as, �really useful and beneficial.� They told us of one of their important goals and of how their keyworker was supporting them to take incremental steps to achieve this. They described their keyworker as being, �really considerate,� and said, �they never, ever rush me or rule any of my goals out.� This demonstrated that people who used the service were fully involved in their outcome plans and that these reflected their individual needs, preferences and goals.

Each person told us that they felt safe living at The Lister Project. One told us, �I fell very, very safe living here.� Another person stated, �If I didn�t feel safe I�d go straight to the staff, I know they�d do what they could to protect me.�

People were positive about staff at the project. One person said, �the staff are such an inspiration, there�s not a bad one amongst them, they�re all great.� Another person stated, �the staff are excellent, they really put themselves out and do what they can for us.�