Royal Mencap Society - 25 The Sandfield

We found the following examples of good practice.

People had been supported creatively to ensure that they were still able to do the activities that were important to them throughout the pandemic. We saw risk assessments that clearly identified people’s preferences and the measures staff could take to reduce the risks to people.

People were supported to understand how to keep safe during the pandemic. Easy read information had been shared to improve people’s understanding of the pandemic and what this meant for them. One person said, “I understand why staff are wearing masks; it’s because of the virus.”

The provider had created an update page on their intranet page which had been updated daily throughout the pandemic. They had included ‘good news stories’ to support staff’s morale and well-being.

Royal Mencap Society - 25 The Sandfield is a residential care home providing accommodation and personal care for up to four adults with a learning disability, an autistic spectrum disorder and/or physical disability. There were three people living at the home at the time of our inspection.

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 safe. Risks to people were assessed, monitored and well managed. A person told us, "I love it here”.

Staffing levels met people's personalised care needs. Staff followed good practice guidelines to prevent the spread of infection and gave people their medicines safely and as prescribed. The home was clean and tidy.

People were supported to access health and social care professionals. Dietary needs were assessed, met and guidance provided in care plans. People received enough food to eat and drink. One relative told us, “The food they cook is lovely, fresh and looks yummy”.

People received quality care that contributed to their wellbeing. Caring relationships were formed between staff and people.People were treated with dignity and respect.

Staff recognised people as individuals and worked to ensure people felt fulfilled and had access to a range of activities and social stimulation. Staff actively supported people to remain as independent as possible, and encouraged them to help with household chores and cooking.

People’s care plans contained detailed, personalised information that the staff and the registered manager kept under constant review. The registered manager carried out regular checks on the quality and safety of the service and understood their regulatory responsibilities.

People, their relatives and one volunteer gave positive feedback about the service, it’s staff and the registered manager.

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 support this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

The last rating for this service was Good (published 24 May 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 Royal Mencap Society - 25 The Sandfield on our website at www.cqc.org.uk.

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.

Royal Mencap - 25 The Sandfield is a care home providing accommodation and personal care for up to four adults with a learning disability, an autistic spectrum condition and/or a physical disability. There were four people living at Royal Mencap – 25 The Sandfield during our inspection.

There was a registered manager in post at Royal Mencap – 25 The Sandfield. 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.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues or concerns with the management team. The registered manager had carried out the relevant checks to ensure they employed suitable people at Royal Mencap – 25 The Sandfield.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at the home. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was responsive to people’s needs. Support plans were person centred and contained sufficient detail to provide consistent, high quality care and support. People were supported to engage in a range of activities based on their preferences and interests. There was a complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. There was an experienced registered manager working at the service. Staff, people and their relatives spoke positively about the registered manager. Quality assurance checks and audits were occurring regularly and where issues had been identified, action had been taken to address them. The registered manager and staff were aware of the vision and values of the service and worked hard to provide a service which was person centred for each individual.

We looked at medicines records and protocols, we spoke with staff and we checked the medicines stored at the home. We found that the systems in place supported and protected people to safely take their medicines. A regular audit was in place to ensure that staff were following the local protocols. The registered manager had ensured that all of the changes identified in the action plan had been completed. Staff told us the systems were working well.

We saw staff consulting with people to gain their consent and encourage independence. Staff followed the guidelines in people's communication profile to maximise their ability to make decisions. The support provided was in line with people's support plans. We saw that some progress was being made towards meeting people's goals. The level of activity in the home, particularly in the evening and at weekends was limited and had caused other professionals concern.

The majority of the home was clean and tidy. One room required remedial work and this was being addressed by the registered manager.

Medication administration was generally being done safely but we found a few processes, such as dating prescribed sprays and creams on opening, were not being followed. The registered manager did not have systems in place to monitor medication administration for poor practice.

The procedures in place to recruit new staff appeared robust and were being followed by the registered manager.

The care plans were comprehensive and user friendly. Daily notes had been simplified and staff were completing them consistently.

We saw staff consulting with people to gain their consent and encourage independence. One member of staff told us that their primary function was 'giving [the people living in the home] a good quality of life'.

People living at the home felt safe and staff felt able to report any safeguarding concerns as required. Concerns from a previous inspection about infection control had been resolved.

Staff told us that they felt well supported and had access to high quality training. Concerns were raised by staff about the workload of the manager. Staff records showed that the majority of staff had up-to-date training in all mandatory training topics.

The provider had good quality management systems in place that seemed comprehensive and user friendly. Complaints and incidents were seen as a learning opportunity and were acted on appropriately.

The care plans were comprehensive and user friendly. Daily notes, however, were inconsistent and did not allow behavioural and health changes to be monitored.