Background to this inspection
Updated
11 February 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 checked 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 inspection took place on 12 January 2017 and was unannounced. The inspection was carried out by one inspector.
Before the inspection, we reviewed information we held about the service including statutory notifications sent to us by the registered manager about incidents and events that occurred at the service. Statutory notifications are information about important events which the provider is required to send us by law. The provider had completed a Provider Information Return (PIR). This is a form that requires providers to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to inform the planning of the inspection.
During the inspection, we spoke with five people living at the service. We spoke with two healthcare professionals who were visiting people at the service. We also spoke with the registered provider one of whom is the registered manager and the other a manager at the service and three members of care staff.
We looked at eight people’s care plans and their medicine management records. We looked at other records held at the service including staff recruitment, staff supervisions, appraisals and training records. We reviewed further records required for the management of the service including feedback from people, their relatives, policies and procedures, quality assurance audits and health and safety documents.
We observed interactions between staff and people who used the service. In addition, we used the 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.
After the inspection, we received feedback from two healthcare professionals.
Updated
11 February 2017
Aston House Residential Home provides personal care, support and accommodation for up to 15 people with mental health needs. At the time of the inspection, 13 people were using the service.
We last inspected Aston House Residential Home in April 2014. The service met all the regulations we checked at that time.
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.
The registered manager did not carry out audits of medicines to monitor the stocks of medicines. We have made a recommendation about the management of medicines. People were supported to take their medicines safely. Staff were trained in the safe administration of medicines. People we spoke with told us they had no concerns about their medicines.
Quality checks and audits were carried on some aspects of the service out to identify how the service could improve and action was taken to make improvements when necessary.
Staff were trained in how to protect people from abuse. Staff knew how to identify signs of abuse and to report any concerns to ensure they protected people from potential harm. Staff understood the provider’s safeguarding procedures to follow in case of abuse. Staff knew how to whistle blow about poor practice.
Staff assessed risk on people’s safety and well-being. Risk assessments were centred on the needs of each person. Staff had guidance to reduce the identified risks and steps to follow to make sure people were protected from harm.
Accidents and incidents were recorded and monitored to identify how to minimise the risks of a recurrence. There were enough numbers of sufficiently qualified, skilled and experienced staff to meet people's needs safely. Staffing levels were dependent on people’s needs and the staff skills required to provide safe care. The provider followed robust recruitment processes to ensure staff recruited were suitable to support vulnerable adults.
Staff knew each person well and understood how to meet their needs. Staff had established positive relationships with people. Staff carried out assessments to identify people’s health needs and the support they required before and after they started to use the service. Staff regularly reviewed people’s health and had updated their support plans when their needs changed. This ensured that the staff could provide effective care in line with people needs and preferences.
Support plans were developed and showed how staff should deliver people’s care. The registered manager ensured staff followed guidance in place to promote people’s well-being. People received their care as planned and recorded in their support plans. Staff supported people to develop and maintain their independent living skills.
Staff had attended relevant training to provide them with the knowledge and skills to meet people’s needs. The provider ensured staff received further training specific to the needs of the people they supported. Staff felt well-supported by the registered manager in their role. All staff had received regular supervision to enable them to carry out their role effectively. Staff received an annual appraisal of their performance and training needs.
People’s care was provided in line with principles of the Mental Capacity Act 2005 (MCA). Staff were trained in MCA and were knowledgeable about the requirements of the legislation. People’s mental capacity assessments were carried out and meetings held in their ‘best interest’ when appropriate. People gave consent to the care they received and staff respected their wishes if they declined support or changed their mind.
People enjoyed the meals prepared at the service and could choose what they liked to eat. Staff involved people in menu planning and ensured people made informed choices that promoted a healthy lifestyle option. Staff knew about people’s dietary needs and preferences.
People health needs were met and staff made referrals on time to health care professionals when needed. People received the support they needed to attend healthcare appointments for their well-being.
Staff treated people with respect and upheld their right to privacy, dignity and individuality. People received their support in a kind and caring manner. People and their relatives were involved in planning and delivering of people’s care and support.
The registered manager sought people’s views about the service, listened to and acted on their feedback. People, relatives and visitors completed questionnaires regularly and action was taken in response to their views. People understood the provider’s procedure of how to make a complaint and felt confident to approach managers and staff with any concerns they might have.
Staff told us they felt valued and supported by the managers. The registered manager and the staff’s approach promoted a culture of openness and honesty.