Archived: Octavia Housing - 108 Highlever Road

108 Highlever Road is a supported living service. It provides care and support to five women who are living with dementia.

People’s experience of using this service

People and their relatives praised the service. Comments from families included “When I leave here I know [my family member] is in safe hands. It’s a remarkable place” and “It’s a happy place.”

Staff displayed positive and compassionate approaches, reassuring people, communicating well and offering choices. People’s life stories and what they liked were well understood by care workers and used to help people reminisce. The service understood what could cause people to become upset and how best to respond to these. Staff responded to people’s wishes and planned activities to meet these and prevent isolation and encouraged people to remain independent.

Risks to people’s safety were assessed and managed. There were enough staff to safely meet people needs and staff were recruited safely. The registered manager worked to ensure a consistent staff team who people knew well. There were appropriate measures to safeguard people from abuse and medicines were safely managed.

The building had been redecorated to a high standard and ensured a dementia friendly environment. Staff received appropriate training and supervision to carry out their roles and managers checked their competency and skills. 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. People were supported to eat and drink in line with their wishes and the service promoted good health and access to healthcare services.

People’s care was planned to meet their needs and was personalised. People had access to a wide range of activities and the service worked to promote social inclusion, with people’s families encouraged to participate in activities and the daily life of the home.

The registered manager promoted an open and positive culture. Managers checked that staff were working to a high standard and engaged with people and their families to ensure satisfaction and to develop the service. Managers encouraged staff to reflect on their successes and learn from these. The service was continuously learning and developing new approaches and worked in partnership with local organisations to improve.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 5 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

108 Highlever Road is an older property divided into five separate rooms, each with en-suite wet room facilities. People have access to a comfortable communal lounge, a kitchen/dining area and a small courtyard garden. The service provides accommodation and personal care for up to five older people, some of whom have dementia. There were four people living at the address at the time of our visit.

During our last comprehensive inspection of this service which took place on 27 and 28 October 2015 we found a breach of the regulations in relation to good governance. This was because the provider had failed to notify us of a serious incident in accordance with their registration requirements.

After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a comprehensive inspection on the 13 June 2017 to check that they had followed their plan and to confirm that they now met legal requirements. At this inspection we found the provider had made improvements in relation to good governance and they were no longer in breach of the regulations.

The service had a registered manager in post. 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 was based at another Octavia Housing service in the local area and divided her time between the two service locations. She was supported in her duties by a full-time deputy manager.

The service received referrals from social workers based in the Royal Borough of Kensington and Chelsea. Social workers completed an initial care and needs assessments. This information was used to inform and develop people’s care plans. Relatives were asked to contribute to the care planning process where this was appropriate. This ensured people’s support needs could be identified and risk assessments completed before people moved into the service on a permanent basis.

People’s risk assessments covered a range of issues including guidance around falls and mobility, nutrition and personal care. Staff supported people to attend health appointments and there were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being.

The provider had safeguarding policies and procedures in place and staff were able to describe the actions they would take to keep people safe. The registered manager and the deputy manager were clear about the action they would take to investigate and follow up any safeguarding concerns.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and DoLS, and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others.

Senior staff understood when a DoLS application should be made and how to submit one. No applications had been made to the relevant agencies as people using the service were not subject to restrictions.

People’s independence was promoted. People were supported to attend day centres during the week. There were opportunities for people to partake in a range of activities that were culturally appropriate and tailored to people’s individual needs and preferences.

Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. This included annual surveys, staff team meetings and auditing the administration of medicines.

Relatives expressed positive views about the service and the staff working there.

People's health and safety was protected when more than one provider was involved in their care and treatment, or when they moved between different services.

There were infection control policies in place and staff ensured that all protocols were followed. There were effective systems in place to reduce the risk and spread of infection.

There were enough qualified, skilled and experienced staff to meet people's needs.

People who use the service and their relatives were asked for their views on the service and they were acted on. For example, people recently chose what they colour they wanted to decorate the living room.