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Safeharbour (254 Hagley Road) Good

Reports


Inspection carried out on 9 May 2019

During a routine inspection

About the service: Safeharbour (254 Hagley Road) is a residential care home that was providing personal care to six people that live with learning disabilities. At the time of the inspection six people lived at the home.

People’s experience of using this service:

The service had been developed 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 life as any citizen.

The service had required improvement at the last inspection with medicines management. We found the provider had introduced a new electronic system that had improved how medicines were monitored and audited. This meant people received their medicines on time and in a safe way.

Relatives told us they felt the service was safe. We found the service delivered safe care, risks to people’s health and safety were continually assessed to ensure both the home environment and outings in the community were safe. Staff understood how to protect people from risk of harm. There were enough numbers of safely recruited staff. Staff had completed induction training that included safeguarding, medication, health and safety and moving and handling. Staff had access to equipment and clothing that protected people from cross infection.

The service delivered effective care because staff had the skills and knowledge to meet people’s care and health needs. People were supported to access healthcare services to ensure they received ongoing healthcare support. People, as much as practicably possible, had choice and control of their lives and staff were aware of how to support them in the least restrictive way. The service has required improvement where best interest decisions had been taken. This had improved and we found people’s legal rights were protected and decisions, where appropriate, had been made in peoples’ best interests and recorded appropriately. People’s nutritional needs were met.

Staff were kind, caring and had built good relationships with the people receiving care and support. Staff prioritised people’s needs constantly. Staff encouraged people’s independence, where possible and protected their privacy and treated them with dignity.

People were supported by staff who knew their preferences. Any complaints made since the last inspection had been resolved. Relatives knew who to contact if they had any complaints. We found care was tailored to meet people’s varying needs. Activities were varied and person-centred.

The service was well-led. We received positive feedback from staff and the relatives of people living at the home on how the home had improved from the last inspection. Staff were knowledgeable about their roles and spoke passionately about the people they supported. There had been an improvement from the last inspection with the provider’s quality audits systems and notifications had been sent to us as legally required. Audits in place ensured the care provided was innovative and continually improving. Relatives and as much as possible people’s views were sought about the quality of the care being provided. Staff felt supported by the management team. Relatives and staff were happy with the way the service was being managed. The service worked well with partner organisations to ensure people’s needs were met.

Rating at last inspection:

Requires Improvement (published 09 May 2018).

Why we inspected:

This was a planned inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 12 March 2018

During a routine inspection

This inspection took place on 12 March 2018 and was unannounced.

254 Hagley 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.

254 Hagley Road accommodates seven people who may have learning disabilities and /or may live with autism.

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.” The service did not consistently comply with the Registering the Right Support and the registered manager was not aware of the policy.

There was 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 2008 and associated Regulations about how the service is run.

The provider and staff practices of managing people’s medicines, was not safe. We found medicines that were out of date, failure to book in medicines correctly meant it was difficult to check exactly how stock was available and so be able to audit. Some medicines were stored in boxes where the instructions had faded so it made it difficult to read. Staff medication administration competencies had not been checked annually. People’s PRN protocols were not sufficiently detailed, to direct staff when they should be given. Medication audits had failed to identify the shortfalls.

The provider had not taken steps to ensure the systems used to monitor and check the quality and safety of services provided were consistently effective and supported improvements.

Although the provider had notified the Local authority of safeguarding incidents, they had failed to report the events to the Care Quality Commission in the form of notifications.

People felt safe living at the home and staff treated them well. Staff knew how to recognise abuse and were clear about their responsibilities to report safety concerns to the registered manager. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible; they were safe to work with the people who lived there.

People were supported by staff who had received training and the skills necessary to support them. Staff had received training in MAPA, [Management of Actual or Potential Aggression] techniques, but had kept this intervention to the minimum. Incidents were recorded and monitored.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible. Staff respected people's right to consent to and make their own decisions about their care and treatment. Where people did not have capacity to make their own decisions, although the provider systems were in place to support the ethos of people’s decisions being made in their best interests. Not all best interest decisions taken had been recorded.

People were assisted to access health and social care professionals as required to maintain their health and wellbeing.

Staff had built positive relationships with people, showing acts of kindness when providing people with support to meet their particular needs. People were supported with personal care which met their preferences and supported their dignity and privacy. People were encouraged to maintain relationships important to them.

People were provided with meal choices and received assistance to eat their food to support their levels of independence. Staff provided hot and cold drinks

Inspection carried out on 4 April 2017

During a routine inspection

This inspection took place on the 04 April 2017 and was unannounced. 254 Safeharbour is registered to provide accommodation with personal care to seven people with a learning disability, and autistic spectrum disorder. At the time of our inspection seven people were using the service.

There was a manager in post and she was present during 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.

At our last inspection in February 2015 we found that the provider was meeting the regulations of the Health and Social Care Act 2008. However some improvements were needed as the registered manager had not informed us when deprivation of liberty authorisations had been agreed. At this inspection we found the required improvements had been made.

People received a safe service as clear procedures were in place and staff received training in recognising and reporting abuse. Risks associated with people's daily living had been identified and plans were in place to help to reduce risks. Staff were recruited safely and staffing levels ensured that people were safe. People received their prescribed medicines by staff who had been trained to do this safely.

Staff were trained to meet people's specific needs and they had regular supervision to reflect on and develop their practice. Staff understood the importance of seeking people's consent and were aware of any limitations on people's liberty. People had choices regarding what they ate and drank and were supported to access a range of health care professionals to meet their healthcare needs.

The interactions between people and staff were caring, and respectful. Staff protected people's privacy and dignity and promoted their independence.

Systems were in place to respond to concerns or complaints. Staff were aware of the signs to look out for which may indicate people were unhappy. Relatives, healthcare professionals and staff told us the service was managed well and in people’s best interests. Feedback was regularly sought from relatives to enable the service to make any required improvements. Audits were undertaken regularly to monitor the quality of the service provided.

Inspection carried out on 10 February 2015

During a routine inspection

This unannounced inspection took place on 10 February 2015. At our last inspection in November 2013 the service was meeting the regulations of the Health and Social Care Act 2008.

Safeharbour (254 Hagley Road) is registered to provide accommodation for persons who require nursing or personal care for up to seven people. At the time of our inspection six people were using the service. People who use the service may have a range of needs which include learning disabilities or an autistic spectrum disorder.

The service had a registered manager. 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.

Staff had been provided with training and were knowledgeable about how to protect people from harm. We saw that medicines management within the service was on the whole effective.

There were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People and their relatives told us they felt confident that the service provided to them was safe and protected them from harm.

The staff worked closely with a range of health and social care professionals to ensure people’s health needs were met, for example psychiatrist and nurse specialists.

Staff were responsive in supporting people and interacted with them in a positive manner, using encouraging language whilst maintaining their privacy and dignity. People were encouraged to remain as independent as possible.

A variety of communication methods were adopted in order to maximise people’s level of understanding. Information regarding how to access local advocacy services was displayed in communal areas.

It was evident that the registered manager promoted a culture in the service of putting people’s needs at the centre of decision making and shaped the service accordingly. People and their relatives were consulted about all aspects of the planning of their care and in relation to the activities they were involved in.

People were involved in a range of activities of their choosing, both within the service and in the community. Planned activities were centred on people’s individual abilities and interests. During our visit we saw that people were in good spirits and meaningfully occupied.

Feedback was routinely sought from people, their relatives and stakeholders as part of the provider’s quality assurance system; these were analysed and shared with any plans for improvements outlined.

People, relatives and visiting professionals spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Quality assurance systems and assessments to identify issues that may put people using the service at risk were in place. The registered manager was able to demonstrate analysis of learning and changes to practice from incidents and accidents that had occurred within the service.

The provider supported the rights of people subject to a Deprivation of Liberties Safeguard (DoLS). However, the registered manager had failed to meet the requirement of their registration with the Commission by not informing us of the authorisation of DoLS for people using the service.

Inspection carried out on 5 November 2013

During a routine inspection

People were unable to express their views verbally, so we spent time observing how staff supported them. We spoke with four staff, a relative and the manager. We also spoke with two relatives over the telephone in order to gain their feedback.

Relative�s we spoke with told us they were happy with the support provided. One relative said, �I think the support provided is good I am happy with the service.� Another relative said, �The staff are good and provide support that meet my relative�s needs.�

We observed that staff respected people�s privacy and dignity, and their independence was promoted.

We saw that people�s needs were assessed, and support plans were developed in consultation with people�s representatives. Staff we spoke with were able to tell us about people�s needs. This ensured people received support in a way they preferred.

People received sufficient food and drink that met their needs and preferences.

We found that sufficient staff were available to meet people�s needs.

We found that systems were in place for assessing and monitoring the quality of the service provided.

Inspection carried out on 6 December 2012

During a routine inspection

People were unable to express their views verbally, so we spent time observing how staff supported them. We spoke with two relatives, six staff, and the manager.

People made choices about what they did and what they ate and were supported to develop their independence skills.

We saw that people�s needs were assessed, and support plans were developed in consultation with people�s representatives. Staff spoken with were able to tell us about people�s needs. This ensures they receive support in a way they prefer.

Relatives spoken with told us they were happy with the support provided, and said they are involved in any reviews that are undertaken. One relative told us, �I am very happy, the staff are good and provide good care�. Another relative said, I am please with everything, the staff team are approachable and friendly and support my relative well�.

Staff supported people to meet their health needs to ensure their well being. We observed that staff interacted well with people.

Staff knew how to safeguard the people living there from harm. We observed that people were comfortable in the company of staff.

People had their medicines when they needed to ensure their health needs were met and these were stored safely.

Recruitment processes ensured that staff employed there were suitable to work with the people living there to ensure they were safe.

We found that systems were in place for any concerns to be raised and for improvements to be made.

Inspection carried out on 19 September 2011

During a routine inspection

People receive care from dedicated and enthusiastic staff who strive to increase the independence of people through stimulating activities. The home need to update staff on safeguarding procedures to protect people from harm.

Reports under our old system of regulation (including those from before CQC was created)