Archived: Angel Home Limited

We undertook an unannounced focused inspection on the 11 March 2016 to check that they now met legal requirements. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Angel Home Limited’ on our website at www.cqc.org.uk.

Angel Home Limited provides accommodation, care and support to up to nine people with learning disabilities. At the time of our inspection seven people were using the service.

A registered manager was 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.

Safe medicines management processes were in place and people received their medicines as prescribed. Stock checks were undertaken daily to ensure all medicines were accounted for. Protocols had been updated in regards to “when required” medicines and homely remedies to ensure staff knew what medicines were safe to give people and when they should administer them.

Consent procedures had been reviewed and mental capacity assessments had been completed to identify what aspects of their care people had capacity to consent to. For people who were deprived of their liberty the registered manager had arranged to obtain the legal authorisation to do so through the Deprivation of Liberty Safeguards. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

Care records had been updated to ensure they provided an accurate and complete record of people’s care and support needs. Care records contained detailed information about people’s preferences and the level of support they required. The registered manager reviewed the content of people’s care records to ensure they were accurate and up to date.

The required actions had been completed and the service was now meeting legal requirements.

On the day of our inspection seven people lived at Angel Home and all had complex needs including a learning disability and/or behaviours that challenged. Two people were not able to verbally communicate, and other people were not always able to answer our questions about the care they received. We looked at the care records of four people, spoke with six people and four members of staff.

Below is a summary of what we found.

Is the service safe?

Care plans had details of people's needs and how these were to be met. Risk assessments relating to the care and support being provided were regularly reviewed to ensure people's individual needs were being met safely.

We reviewed maintenance contracts for the building and various pieces of equipment including Legionella water testing, the fire alarm system and equipment, gas safety inspection and portable appliance testing (PAT). We found that these were all valid and within date.

Staff had undertaken training on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) and understood how this could impact on the people they cared for.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. We saw that people were happy, well cared for and treated with respect. Care plans were regularly reviewed with the person using the service.

Staff received a range of training. We evidence that staff received monthly one to one supervision and yearly appraisals.

Is the service caring?

The service was caring. This was confirmed by our observations of staff and people using the service. Staff respected people's privacy, dignity and their right to be involved in decisions and make choices about their care and treatment.

Staff encouraged people to join in with activities relating to the running of the home. This included helping in the kitchen, preparing meals and making decisions about group activities.

Is the service responsive?

People's needs were reassessed on a regular basis and we saw the service responded to any changing needs. People had access to other services and to professionals who worked with the provider and staff for the benefit of people who used the service.

We saw that each person had an activity plan. On the day of our visit which was unannounced, we saw that activities were taking place and people were joining in if they wanted to. People also attended the day centre and one person told us about the work they did.

Is the service well-led?

The home employed a manager who knew their staff and people well. The manager told us about the audits that they conducted and showed us the recorded evidence to support them. Regular audit of medicines by the provider and the supplying pharmacy helped to reduce the associated risks with the storage and handling of medicines.

Cleaning audits including the environment, laundry and the kitchen were also conducted. We saw that the fire alarm and fire door closures were checked weekly. People were kept safe because information about them was regularly checked.

The provider sent us an action plan on 29 October 2013 setting out the actions they would take to achieve compliance with this regulation.

During this visit we checked these actions had been completed.

We found records had been updated to reflect people's circumstances. We looked at the actions the provider had taken to ensure peoples records were up to date and reflected people's individual care. We saw records that had been previously unavailable were now on site and easily accessible to staff.

People we spoke with told us about what they were doing that day and the activities they enjoyed. One person told us 'I want to go to the shops this afternoon' and another person said 'I might go to the shops this afternoon but I like to go to bingo and arts and crafts'.

During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. One person told us they had gone to work that morning and another explained how they like to help in the kitchen.

We looked at how the provider managed people's medicines to ensure people received them in a timely and safe way.

We saw that some records the provider is required to keep had not been updated to reflect changes in people's circumstances. One record concerning a person's wellbeing was not complete and incident reporting forms were not stored on the premises at the time of our inspection.

We spoke to the relatives of one person who used the service, they told us how happy their relative was and said 'he really has a life now' and 'he enjoys his visits at home with us but can't wait to get back'. People who use the service told us they liked living at Angel Home. One person said 'I like it here and I don't want to move' and another person told us 'staff are nice'.

People we met told us how they were able to make choices about how they live their lives. We were told about the type of activities people take part in and how they can choose what meals they would like. Two people who use the service are non-verbal and we were shown how they could make their meal choices through pictorial easy read information.

We spoke to one of the activity professionals that visited the home they told us 'it's nice here, I like to come here its always warm and welcoming and everyone's happy'.

During our inspection we saw that staff always treated people with respect and dignity.