Archived: Helebridge House

Helebridge House provides care and accommodation for up to six people who have a learning disability. At the time of the inspection six people were living at the service.

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.

Window restrictors were not in place for first floor windows which had a wide opening and may pose risk to some people using the service. The registered manager confirmed they had purchased window restrictors after the inspection visit to ensure people were safe.

Care records were not detailed or person centred and did not contain specific information to guide staff who were supporting people. There were brief summaries in areas of support required but no life history profiles about each person in a format which was meaningful for people. This included large print and pictorial information. Staff said they knew people’s needs because they had been supporting them for a long time and information was shared daily between the registered manager and staff.

Records identified risk factors and how to support people’s life choices. For example going out into the community. However there was no clear guidance for staff as to how individual risk factors should be managed.

People told us they were kept informed about their relatives care and support. People said staff spoke with them and asked their views on the care they wanted.

Staff completed a recruitment process to ensure they had the appropriate skills and knowledge to carry out their role. A record of when a Disclosure and Barring Service check (DBS) had been received and when the staff member had commenced employment would show the checks had been completed before the employee had commenced working in the service. Photo identification for staff members were not on file but the registered manager acknowledged they would be put in place.

People living at Helebridge House were supported to lead fulfilled lives which reflected their individual preferences and interests. There were enough staff available to make sure everyone was supported according to their own needs.

Staff members were available to support peoples’ needs and engage in activities. Staffing levels were flexible so they could respond to people who at times required additional support. Staff on duty supported people respectfully. People told us that staff supported them to maintain their independence and we saw evidence of this within the care documentation we viewed. For example supporting people to develop life skills including cooking and supporting people to access links with the local community.

Staff were trained in a range of subjects which were relevant to the needs of the people they supported. There was a small staff team who the registered manager new well and training was discussed on a regular basis. New staff undertook training in induction standards leading to the care certificate award.

There were systems in place to ensure people who used the service were protected from the risk of harm and abuse. Staff we spoke with were knowledgeable of the action to take if they had concerns in this area.

Where people did not have the capacity to make certain decisions, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff understood what restrictive practice meant and how the principles of the legislation should be applied.

The environment was of a homely nature. Rooms were personalised where people had wanted to include their own items.

People knew how to complain and we saw people had the opportunity to discuss how they felt about the service. People told us they were regularly asked if they were happy with the service they received. One person told us “I wouldn’t hesitate to say something if I was not happy”. A relative said, “If I was concerned about anything I feel confident it would get sorted out”.

The system for measuring quality assurance was informal. People and their relatives were regularly consulted about how the home was run. Relatives said, “We are always told about any changes and when we visit we are always made welcome” and “We have regular contact and get to know what’s going on. We are always made to feel welcome and involved”.

We identified breach's of the regulations. You can see what action we have told the provider to take at the back of the full version of the report.

People did not comment or raise concerns about how the home kept their medicines safe. Instead people spoke about Christmas and how they were looking forward to Christmas dinner with all the trimmings. People appeared relaxed in our company chatting about the events happening over the next few days.

Before people received any care or treatment they were asked for their consent and staff acted in accordance with their wishes.

We spent time talking to people who lived at Helebridge House and observing the interactions between them and staff. People's comments included: 'I love it here. The staff are wonderful'; 'I am well looked after'; 'I like going to the day centre' and 'I go for walks, shopping, singing lessons and the life centre.'

We saw the medication records which were appropriately signed by staff when administering a person's medication. However, the same degree of recording was not evident when a person was prescribed a cream. This posed a risk that an overview of people's skin conditions would not be flagged up and acted upon. For example it might not be noticed if a cream was not working effectively.

We observed that staff were well organised, motivated and competent in their roles. Staff provided support in a caring manner making sure that people were comfortable and content.

We looked around the home and found that it was clean and hygienic. We examined the care files belonging to three people who lived in the home and found that they were up to date and reviewed as people's needs/wishes changed.

People told us that they were happy living in the home and talked to us about their personal routines and the activities they enjoyed. We found that people were involved and supported to make decisions about their care and support needs and their needs were well met by the staff team. Comments from people who lived in the home included "We are very, very happy", "I love it here" and "They are very helpful to me".

People saw healthcare professionals on a regular basis or when they needed them. Staff were friendly and respected people's rights to privacy, dignity, and independence. There were enough staff to meet people's needs and additional staff were available when required. However there were occasions when the home was not staffed at night. The staff had received sufficient training to enable them to carry out their roles competently.

There were effective systems for safeguarding people from abuse. Legal safeguards, which protect people unable to make decisions about their own welfare, were understood by the registered manager and used to protect people's rights.