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Hardy Drive Requires improvement

Reports


Inspection carried out on 8 October 2019

During a routine inspection

About the service

Hardy Drive provides accommodation and personal care for up to six people who have a learning disability. At the time of our inspection there were six people receiving support.

The service was a domestic style property that was similar to the surrounding properties. There were deliberately no identifying signs, to indicate it was a care home.

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 supported to have maximum choice and control of their lives and, in most instances, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, documentation regarding mental capacity and the Deprivation of Liberty Safeguards (DoLS) was not sufficient.

People felt safe at the service and there were enough staff to meet their support needs. Staff had a good understanding of people’s needs. However, we identified instances where risk had previously not been managed safely. Whilst appropriate actions had been identified by the registered manager, these were yet to be completed.

The provider had quality assurance systems in place. However, these were yet to be fully embedded and they had not identified all issues noted in this report.

Staff told us that they felt supported in their role, however, we identified some gaps in the training they had received.

People were supported to manage their medicines safely.

People lived in a clean environment which was appropriate for their needs.

People were supported to eat and drink enough throughout the day. The service worked well with other professionals to ensure people received the right support.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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.

People and professionals said they felt that staff were always kind and caring. Observations showed that staff were attentive to people’s needs.

People and relatives were encouraged to provide feedback regarding the quality of care provided.

Personalised support plans were in place and these contained detailed information about people’s likes and dislikes.

People were supported to communicate their wishes and make decisions. Staff were knowledgeable about the most effective methods to support people to communicate.

The registered manager was open and honest about where improvements were required. A comprehensive service improvement plan was in place.

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

Rating at Last Inspection

At our last inspection, the service was rated “good” (published on 25th April 2017).

Why we Inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the service to ensure people receive safe, compassionate, high quality care. We will return to visit as per out re-inspection programme. If we receiv

Inspection carried out on 22 March 2017

During a routine inspection

The inspection took place on 22 March 2017 and was unannounced. At the last inspection of this service on 03 November 2015, they were found to not be meeting the standards we inspected. However at this inspection the provider had made all the required improvements. This was in relation to the requirements of the MCA 2005.

Hardy Drive provides accommodation for up to six people who have a learning disability. The service is not registered for nursing care. At the time of our inspection five people were living at Hardy Drive.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However the registered manager was responsible for other homes run by the provider and had an assistant manager at hardy drive. At this inspection we spoke with the assistant manager of the service who is responsible for the home.

People felt safe living at Hardy Drive. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by staff that were skilled and experienced. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.

Staff received regular one to one supervision. People received support they needed to eat and drink sufficient quantities and their health needs were catered for with appropriate referrals made to external health professionals when needed.

People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.

The provider had arrangements to receive feedback from people who used the service, their relatives, and staff members about the services provided. People were supported to raise concerns with staff or management.

There was an open culture in the home and relatives and staff were comfortable to speak with the registered manager and assistant manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

Inspection carried out on 03 November 2015

During a routine inspection

The inspection took place on 03 November 2015 and was unannounced. At our last inspection on 01 August 2013, the service was found to be meeting the required standards in the areas we looked at. Hardy Drive provides accommodation and personal care for up to six adults who live with learning disabilities. At the time of our inspection five people lived at the home.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 time of our inspection the registered manager was on sick leave with cover being provided by two assistant service managers.

The CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others.

At the time of the inspection we found that potential DoLS issues had been properly considered and kept under review but it had been determined that authorities were not required. However, we found that mental capacity assessments had not always been carried out or formalised in a way that satisfied the requirements of the MCA 2005. This is an area for improvement that is being immediately addressed by the assistant managers and provider.

Some people who were present at the home during our inspection were unable to communicate with us. Those that could and some people’s relatives told us that it was safe at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns both internally and externally. Safe and effective recruitment practices were followed and there were sufficient numbers of suitable staff available at all times to meet people’s individual care and support needs.

There were plans and guidance to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. Staff had been trained to help people take their medicines safely and at the right time. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

Relatives and social care professionals were positive about the skills, experience and abilities of staff who worked at the home. Staff received training and refresher updates relevant to their roles. They had regular ‘one to one’ supervision meetings to discuss and review their personal development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were supported to eat a healthy balanced diet that met their individual needs.

Staff obtained people’s consent before providing personal care and support, which they did in a kind and patient way.

Arrangements were in hand to ensure that people were supported by advocacy services where appropriate to help them access independent advice or guidance. People and their relatives were involved in reviews of the care and support provided wherever possible. However, this was not always consistently or accurately reflected in plans of care or the guidance provided to staff. This is an area for improvement being immediately addressed by the management team.

We saw that staff had developed positive and caring relationships with the people they cared for. The confidentiality of information held about people’s medical and personal histories had been securely maintained throughout the home.

We saw that care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences wherever possible. Staff knew the people they looked after very well and were knowledgeable about their background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the community. Relatives told us that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives, staff and professional stakeholders were complimentary about the management team and how the home was run. Appropriate steps were taken to monitor the quality of services provided, reduce potential risks and drive continuous improvement.

Inspection carried out on 1 August 2013

During a routine inspection

The majority of people that we met with during our inspection on 01 August 2013 were not able to tell us about the care and support they received whilst living in the home, due to their complex needs. However, observations made during our visit showed that people were satisfied and happy with the care and the attention they received from care staff.

Care and support was regularly reviewed which ensured that peoples� needs were met. There was evidence of people�s involvement in the planning of their care and support. Medicines were well organised and administration records were in good order. All records we looked at were safely stored and protected people�s privacy and confidentiality.

There were appropriate recruitment procedures in place which ensured that only staff that were suitable to work with vulnerable people were employed.

Inspection carried out on 19 September 2012

During a routine inspection

During our inspection of the home on 19 September 2012, we spoke with the manager, three staff and people who used the service. Due to some people who had little verbal communication, we used different methods to help us understand their experiences of living at Hardy Drive. We observed and talked to staff who were very knowledgeable about the people who lived at Hardy Drive and were able to understand their needs.

Inspection carried out on 24 November 2011

During a routine inspection

The people who we spoke with said that their privacy and dignity was respected at the care home. They also said that they were happy with care and support they received and that they felt safe and that their welfare was protected. The people we spoke with told us that staff were caring and supportive.

Reports under our old system of regulation (including those from before CQC was created)