Background to this inspection
Updated
5 December 2017
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This unannounced inspection took place on 21 and 29 September 2017. The inspection team consisted of one inspector and an expert by experience on the first day and one inspector on the 29 September. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
As part of the inspection process we looked at information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any incidences that put people at risk of harm. We refer to these as notifications. We reviewed the notifications that the provider had sent us, to plan the areas we wanted to focus on during our inspection. Before our inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR was returned within the required timescale. We reviewed regular quality reports sent to us by the local authority to see what information they held about the service. These are reports that tell us if the local authority has concerns about the service they purchase on behalf of people. We had received a number of concerns from partner agencies that related to keeping people safe and from risk of avoidable harm. We looked into these concerns as part of our inspection.
We spoke with six people, the registered manager, the provider and six staff members. Because a number of people were unable to tell us about their experiences of care, we spent time observing interactions between staff and the people that lived there. We used a Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We also looked at records in relation to four people’s care and medication records to see how their care and treatment was planned and delivered. Other records looked at included three staff recruitment files to check staff were recruited safely. The provider’s training records were looked at to check staff were suitably trained and supported to deliver care to meet people’s individual needs. We also looked at records relating to the management of the service along with a selection of the provider’s policies and procedures, to ensure people received a good quality service.
Updated
5 December 2017
This inspection took place on 21 and 29 September 2017 and was unannounced on both days. At the last inspection on 16 June 2016, the provider had not complied with the legal requirements of Regulation 20A and had failed to display their rating. At this inspection the provider had met the requirements of that breach.
Lansdowne Road is registered to provider accommodation and support for a maximum of 14 adults with mental health needs. At the time of this inspection visit, there were 11 people living at the home.
It is a legal requirement that the home has a registered manager in post. 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.
Systems in place to monitor and improve the quality of the service were not consistently effective in ensuring people received a good and continually improving quality of service. They had not always been consistently applied to ensure where shortfalls had been identified, they were investigated thoroughly and appropriate action plans put into place to develop and improve the service.
People told us that ‘some’ staff were kind, caring and friendly and treated people with respect, although there were occasions when staff raised their voices to people. People were relaxed and were supported by staff and the management team to maintain relationships that were important to them. There were activities that provided opportunities to optimise people’s social and stimulation requirements. People and their relatives told us they were confident that if they had any concerns or complaints they would be listened to and matters addressed quickly.
Staff were trained to identify signs of abuse and supported by the provider’s processes to keep people safe. Potential risks to people had been identified and appropriate measures had been put in place to reduce the risk of harm. People were supported by sufficient numbers of staff that had been safely recruited. People were supported to receive their medicines as prescribed.
Where people lacked the mental capacity to make informed decisions about their care, relatives, friends and relevant professionals were involved in best interest's decision making. Applications had been submitted to deprive people of their liberty, in their best interests; therefore, the provider had acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
Overall, people spoke positively about the choice of food available. People were supported to eat and drink enough to maintain their health and wellbeing. People were supported to access health care professionals and people’s health care needs were assessed and reviewed.
People felt they received care and support from care staff that had the skills to meet their needs. Staff received supervision and appraisals, providing them with the appropriate support to carry out their roles.