15 December 2015 & 07 January 2016
During a routine inspection
The inspection took place on 15 December 2015 and 07 January 2016. The first visit was unannounced but the registered manager was given a short period of notice before the second visit. This was to help facilitate the inspection and make sure that some people who used the service and staff members were available to talk with us. At our last inspection on 20 November 2013, the service was found to be meeting the required standards in the areas we looked at. Spring House provides domiciliary care and support for people with learning disabilities in their own homes. The service is provided at five different locations in Hatfield, Hemel Hempstead, St. Albans and London Colney.
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. The registered manager was supported by service and assistant service managers responsible for the day-to-day operation of each location where people received care and support.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. At the time of our inspection we found that the provider was working within the principles of the MCA where it was necessary and appropriate to the needs of the people they supported.
People told us that staff helped them stay safe, both where they lived and when out and about in the community. Staff had received training in how to safeguard people from abuse and were knowledgeable about the potential risks and how to report concerns. Robust recruitment practices were followed and there were sufficient numbers of suitable staff available at all times to meet people’s support needs.
Plans and guidance were in place to help staff deal with unforeseen events and emergencies in a safe and effective way. Where necessary and appropriate, people were supported to take their medicines safely and at the right time by trained staff. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.
People who received support, relatives and health care professionals were positive about the skills, experience and abilities of staff employed at the service. Staff received training and refresher updates relevant to their roles and had regular ‘shape your future’ meetings with managers to discuss and review their personal development and performance.
People were encouraged and helped to maintain good health and had access to health and social care professionals when necessary. They were also supported to eat a healthy balanced diet that met their individual needs.
Staff obtained people’s agreement to the support provided and always obtained their consent before helping them with personal care. Throughout our inspection, and at all of the locations where services were provided, we saw that staff supported people in a kind and caring way that promoted their dignity. Staff had developed positive relationships with the people they supported and where clearly very knowledgeable about their needs and personal circumstances.
People who received support, and their relatives wherever possible and appropriate, were involved in the planning and reviews of the care provided. However, this was not always consistently or accurately reflected in plans of care or the guidance provided to staff. This was an area for improvement being immediately addressed by the management team. The confidentiality of information held about people’s medical and personal histories was securely maintained at the service.
People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences and routines. People were supported to pursue social interests and take part in meaningful activities relevant to their needs.
Relatives told us that managers and staff listened to them and responded positively to any concerns they had. People were encouraged to raise any concerns they had and knew how to make a complaint if the need arose.
People, their relatives, staff and professional stakeholders were all complimentary about the management team and how the service was operated at all of the locations where support was provided. The management team monitored the quality of services and potential risks in order to drive continuous improvement.