At this inspection visit, we found that the provider was now sending notifications appropriately. Staff had received information and training about their responsibilities in regard to sending notifications, and there was a protocol in place to make sure that notifications were sent if the manager was absent.
We were able to speak with one person briefly who told us they were going out with a member of staff. This person did not wish to say anything further. We saw that staff were interacting with people in a respectful way and were paying attention to people's needs.
We found at this inspection that clear guidelines and procedures had been developed with the assistance of the local speech and language therapy team. We asked three members of staff about their knowledge of the person's needs and what should be done to keep the person safe. Each member of staff was able to describe the way that they assisted the person when eating or drinking and were able to show us where and how they would seek guidance if they were unsure of anything.
We found that two windows on either side of the entrance to the house had been broken and were boarded up. The deputy manager informed us that new made to measure toughened windows had been ordered and as it was a specialised order it took longer for delivery and installation.
We looked at the record of notifications and compared these to the daily care logs of people using the service. We found that two incidents had not been reported to CQC.
We were able to speak with two people who were using the service. One person said they were about to go out with a member of staff and told us what they were going to do. Another person told us about what they were having for lunch and we saw this person being supported by a member of staff to make their meal.
We found that that the home ensured that people's dignity and respect were upheld.
The people who used the service had a personal care plan. We looked at two of these care plans and spoke with the manager and two staff about them. We found some improvement to care plan and risk assessment updates was needed. The service had failed to adhere to guidelines provided by a speech and language therapist intended to keep a person safe from the risk of unnecessary harm when eating and drinking.
People chose their menus at the house meetings. Staff created the menu with choices displayed as words and pictures to help people understand and remember what had been chosen each day. People could have something different if they changed their mind.
The service had detailed guidance for staff about deprivation of liberty safeguards and best interest decision making.
We were able to speak with one person who was using the service. This person told us about an activity they were about to do with a member of staff and went on to show us how they were preparing the things they needed to use. Everyone else using the service was either out taking part in activities or went out with staff soon after our arrival.
This was a follow up inspection to look at the progress towards compliance with outcomes 2, 4 and 5. We found that the provider had taken the necessary action to achieve compliance.
We were able to speak with one person who was using the service. This person told us about their activities and what their plans were for the day. They told us that they cook their own food with help from their support worker and feel involved with deciding how they are cared for.
The service supported people to make choices, for example, it used picture format care plans and other information to help people understand what their care plan said. We were concerned that there was food for everyone using the service being stored in a fridge in one person's bedroom and we saw that there was no toilet paper, soap or hand towels in any of the toilets or bathrooms.
The service used two volunteers and these people were present during our visit. They told us that they felt that they had been given enough guidance about people they helped and felt supported by staff.