Archived: 63 Lambrook Road

63 Lambrook Road is a residential care home providing personal care to four people with learning disabilities and/or autism.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were supported by staff who were kind and caring and who understood their needs well. People’s views and opinions were sought and listened to. Independence was encouraged and supported.

Some improvement was required in relation to care documentation. Plans weren’t always comprehensive enough to cover people’s full range of care needs. However, the coordinator had already identified that plans needed improving and plans were in place to address this.

The provider had told us prior to the inspection that there had been concerns in relation to medicine administration and a number of errors had occurred over the past few months. People told us they felt safe and it was evident they felt comfortable and settled in the presence of staff. There were sufficient numbers of staff to ensure people received the support they needed.

Staff were positive about working in the service and received good training and support to fulfil their roles. Their performance and development needs were monitored.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People told us about the places and activities they enjoyed taking part in.

The service was well led. Care was person centred in nature and people were encouraged to play an active part in planning their own support. There was an open and transparent culture where people felt able to raise any issues or concerns and could be confident they would be listened to.

Rating at last inspection

The last rating for this service was good (published 6 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 63 Lambrook Road on our website at www.cqc.org.uk.

The inspection was announced. The provider was given 48 hours' notice because we visited at the weekend and, we wanted to make sure people using the service, the registered manager and staff would be available to speak with us. The inspection was carried out by one adult social care inspector.

At our last inspection in December 2015 we found a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not always fully assessed the needs of people using the service and put plans in place to meet their needs. At this inspection we saw the provider had taken the action they had identified in their action plan. As a result improvements had been made and the service was no longer in breach of this regulation.

At the last inspection, the service was rated Requires Improvement.

As a result of this inspection we have rated the service Good.

Why the service is rated good:

There was a registered manager in post at the service. 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. 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 service was designed and delivered around the individual needs of people, provided by caring staff who were well supported by the registered manager and, was continually seeking to improve. It was also very clear that people and staff viewed 63 Lambrook Road as people’s home. We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection.

People were safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The physical environment was personalised and met people’s needs. The service complied with the requirements of the Mental Capacity Act 2005 (MCA).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager provided good leadership and management and was well supported by the provider. The vision and culture of the service was clearly communicated to and understood by staff. A comprehensive and sophisticated quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

This location was inspected by one Adult Social Care Inspector. We spoke with two people who use the service and the registered manager .The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found which describes what we observed, what the staff told us, and the records we looked at.

Is the service safe?

Risks to people who used the service were being managed safely. People's care records showed how possible risks to safety and wellbeing had been identified. The actions that were needed to reduce risks and to keep people safe had been clearly explained.

There were systems in place to ensure that the home was clean and infection control risks were minimised. People who lived at the home felt that it was always kept clean.

Is the service effective?

The two people who we spoke with told us they were happy and satisfied with how they were supported with their needs by the staff at the home. One person said 'you must give the staff 100 marks out of 10'. Another comment we were told was 'the staff are doing their jobs properly'.

Staff were being supervised in their work so that they provided effective care that met people's needs. The staff undertook training and learning opportunities about mental health issues and a range of health and safety topics. They had also been on training to understand how to protect people from the risks of abuse.

Is the service caring?

The manager assisted people in a way that was caring and respectful in approach. One person told us "the staff are tremendous and the home has a happy atmosphere'. Another comment we were told was 'the staff do their jobs properly and it's nice here'.

Is the service responsive?

People told us they spoke with the staff regularly and were able to tell them about any concerns they had. One person told us 'I'd go straight to the manager or the other manager who comes and see us'. Both people told us that the registered manager spent time with them regularly to find out how they were. They told us the manager was 'very nice' and listened and responded to matters they raised with them.

Is the service well-led?

The registered manager demonstrated that they understood the needs of people who used the service. People told us that the manager was approachable. One person said, 'I can speak to them anytime I like'.

People received an individual service; staff knew people well and understood their care needs. Each person had a care plan and any risks to them had been assessed; however care plans had not always been updated when people's needs changed.

The home was clean throughout, homely, and people's rooms were personalised. The accommodation was suitable for people's needs and well maintained. There was suitable and sufficient equipment for people's needs.

Staff received regular training and supervision. The provider carried out regular checks on the quality of the service and operated an effective complaints system.