Archived: Woodlawn Crescent Also known as Royal Mencap Society Woodlawn Crescent

Woodlawn Crescent is a care home that supports up to four people with a learning disability. The home is managed by the Royal Mencap Society and is situated in Whitton in the London Borough of Richmond Upon Thames.

The home had a registered manager, although they were in the process of transferring to a new post within the organisation. An application had also been made for a new registered manager. 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 and associated Regulations about how the service is run.

At the last inspection on 6 July 2015 the home met all the key questions and was rated good in each with an overall good rating.

People and their relatives thought the home was a good place to live and people were happy there. This was particularly regarding the way that staff treated and supported people. When we visited people were supported to choose the activities they wanted to do and when they wished to do them, unless they were external activities with fixed times. Although the home provided community based activities, one relative and a health care professional felt that these had reduced for one person because there were not enough staff. Other relatives were happy with the staffing levels.

We recommend that the provider review the deployment of staff throughout the day and night in line with national guidance on safe staffing levels to ensure people using the service have the support and supervision they need at all times.

People felt safe living at the home and accessing amenities available in the local community. The home was warm and welcoming with a friendly and inclusive atmosphere. Throughout our visit people’s body language and their interaction with staff and each other was positive.

The home was well maintained, furnished, clean and provided a safe environment for people to live and staff to work in.

There were comprehensive records that were kept up to date. The care plans contained clearly recorded, fully completed, and regularly reviewed information. This enabled staff to perform their duties efficiently.

The staff knew the people they worked with and field they worked in well. They had the appropriate skills and training required to meet people’s needs and they were focussed on providing care and support for each person as an individual. This was delivered in an enabling, friendly and professional manner. They were trained and skilled and made themselves accessible to people and their relatives. Staff said they had access to good training and support.

People were protected from nutrition and hydration associated risks by being provided with balanced diets that also met their likes and preferences. They said they liked the choice and variety of food provided. People were encouraged to discuss health needs with staff and they had access to community based health professionals.

The management team at the home, were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible with the organisation’s policies and systems supporting this practice.

Is the service safe?

During this inspection we did not review any information in relation to the questions 'Is the service effective', 'Is the service caring', 'Is the service responsive' and 'Is the service well led'? This was because this was a follow up inspection to check that 1 compliance action made at the last inspection had been met.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

During our last inspection on the 11th April, 2014 we made one compliance action regarding the shower room floor covering. This was a follow up inspection to check that the compliance action had been met. At this inspection we found that the floor covering had been replaced and the compliance action was met.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff treated people with dignity and respect throughout our visit. People said they liked living at the home. We saw there were robust safeguarding procedures in place that staff were trained in, knew how to operate and they understood. Details of areas or circumstances of concern specific to individual people were also recorded in the sample of two support plans we looked at.

The organisation had systems that made sure the manager and staff learnt from events that took place at Woodlawn Crescent. These may have included accidents and incidents, listening to people's concerns, complaints, whistleblowing and investigations. This reduced the risks to people and helped the service to improve.

The home had effective policies and procedures in line with the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff were trained and understood when an application for a mental capacity assessment should be made and how to submit one. None had been submitted in the last year. This meant that people and their rights were safeguarded.

We toured the building, garden and saw that the home was generally safe, clean and hygienic with well maintained equipment that was regularly serviced, apart from the shower room flooring that was a badly stained rust colour and coming away from the wall in one corner. This meant people were generally not put at unnecessary risk.

People's care needs were taken into account by the manager and this was reflected in the rota when making decisions regarding the required staff numbers, qualifications, skills and experience. This ensured that people's needs were met.

No staff were currently subject to disciplinary action and policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

There was an advocacy service available should people require it. This meant that people could access additional support if they needed it.

People's health and care needs were assessed with them by the home and those that wished were involved in contributing to their care plans. Any specialist care and support such as dietary, mobility or equipment needs had been identified in people's support plans. These were person centred. A sample of two support plans showed that people had been involved in producing them. People told us "I do my support plan monthly" and "My keyworker is Helen".

The layout of the service enabled people to move around freely, safely and there was suitable equipment to support them to achieve this.

The visiting policy and visitors' book demonstrated that people were able to see their visitors in private and that visiting times were flexible.

Is the service caring?

We saw that people were supported by kind, competent and attentive staff. The staff were patient and gave encouragement when supporting people. One person said "I like the staff they help me do things'.

People and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

We saw two support plans in which people's preferences, interests, aspirations and diverse needs were recorded and that the care and support provided was in accordance with this information.

Is the service responsive?

People regularly completed a range of activities at home and within the community. During our visit people were engaged in a number of activities with staff, including preparing a meal. We saw charts that showed people attended and carried out a number of activities individually and as a group, that they had chosen. The home had access to transport that enabled people to be involved in activities within their local community and elsewhere.

We saw that if people were upset or unhappy that staff reacted to this in an appropriate and comforting manner that cheered them up.

Is the service well-led?

We saw that the manager and staff listened to people's needs, opinions and acted upon them. The service worked well with other agencies and services to make sure that people received support in a seamless way. This was demonstrated by the relationship the home had with community based health and other services.

Appropriate notifications to the Care Quality Commission were made.

You can see our judgements on the front page of this report.

We were shown a new booklet produced by Mencap called 'Having a health check'. In the booklet it outlined the rights of people with learning disabilities and their entitlements to a health and wellbeing check.

We spoke with the manager who explained that Mencap had recently implemented a new national policy on managing client finances. We asked the manager to explain the policy further and were given a detailed account of this.

We spoke with four staff members including the manager and asked about recruitment and retention of staff. Staff told us about their experience when they joined Mencap. They talked about the application, interview and assessment process. We made enquiries regarding staffing at the service and were informed by the provider that five members of staff and 216 hours of support per week were allocated by the Local Authority.

We looked at two records of people who used the service and two staff files. Records were person centred and described people's specific wishes, using their names and personal reference. People's personal records including medical records were accurate and fit for purpose.