We carried out a review of the data available to us about Royal Mencap Society - 71 Middleton Avenue on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Royal Mencap Society - 71 Middleton Avenue, you can give feedback on this service.
About the service
Royal Mencap Society - 71 Middleton Avenue is a residential care home providing personal care to 6 at the time of the inspection. The service can support up to 6 people.
People’s experience of using this service and what we found
Right Support:
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Medicine records were not always completed in full and the registered manager was reviewing this. The provider ensured people received care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
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.
Right Care:
People received kind and compassionate care. Care records were not always completed correctly, and the registered manager was reviewing this. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
The service had enough appropriately skilled staff to meet people’s care needs and keep them safe. There were not always enough staff to enable people to take part in activities and pursue their interests in their local area. The registered manager was reviewing this. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Right Culture:
Staff placed people’s wishes, needs and rights at the heart of everything they did. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. People and those important to them, including advocates, were involved in planning their care.
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 8 December 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Recommendations
We have made recommendations about reviewing staffing levels and record keeping.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Middleton Avenue provides care for people with physical and learning disabilities or broad spectrum autism. The service is located in a purpose built bungalow in a residential area of Thornaby. The service is registered to provide support to six people and on the day of our inspection there were five people using the service.
The service had a registered manager in place. 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. On the day of our inspection the registered manager was on annual leave and another manager from a neighbouring Mencap service was made available to assist us with our inspection.
We last inspected the service in August 2015 and rated the service as ‘Good.’ and ‘Outstanding’ in responsive. At this inspection we found the service remained ‘Good’ overall and had sustained ‘Outstanding’ in responsive.
The atmosphere of the home was very homely, warm and welcoming. People who used the service were relaxed in their own home environment.
Without exception people were continually empowered on a daily basis to have choice and control over their own lives from being supported by sustained person centred approaches. Person centred care is when the person is central to their support and their preferences are respected.
The home continued to sustain their ability to be extremely person centred and inclusive and this was by offering intense one to one support where needed, adapting situations to suit people while being creative and this was underpinned by a genuine desire to offer a quality personalised service.
People were continually empowered to forward plan and were also supported to achieve personal goals in their lives that contributed to improving their mental health, wellbeing and general health that lead to an enhanced quality of life.
We spent time observing the person centred support that took place in the service. We saw that people were always respected by staff and treated with upmost kindness. We saw staff being respectful, considerate and communicating exceptionally well with people and supporting people who were distressed.
People’s support plans were exceptionally person centred. They included targets that people wanted to achieve and a ‘one page profile’ that referenced people’s personal histories and described their individual support needs. These were regularly reviewed and people were always at the centre of the process.
People were empowered on a regular basis to shape the service they received to meet their needs and their preferences and responsive changes were made when needed.
People were supported to play an active role within their local community by making regular use of local resources including the local park.
Support plans contained person centred risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm to enable them to do the things they wanted to live their lives fully. The support plans we viewed also showed us that people’s health was monitored and referrals were made to other health support professionals where necessary, for example their GP, community nurse or optician.
Staff understood safeguarding issues and procedures were in place to minimise the risk of abuse occurring. Where concerns had been raised we saw they had been referred to the relevant safeguarding department for investigation. Robust recruitment processes were in place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the MCA to make decisions in the person’s best interest. For those people that did not always have capacity, mental capacity assessments and best interest decisions had been completed for them. Records of best interest decisions showed involvement from people’s family and staff.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. The service was truly reflective of what people liked and people were in control of this and chose what they would like to eat.
People had their rights respected and regular access to advocacy services.
People were supported to maintain their independence on a daily basis.
People were supported to be active in their chosen religion both within the home and in the community.
Support staff told us they felt supported to carry out their role and to develop further and that the registered manager led by example, was person centred focussed, supportive and always approachable.
When we looked at the staff training records, they showed us staff were supported and able to maintain and develop their skills through training, and development opportunities were accessible at this service. People were supported by enough staff to meet their needs and were also supported individually with one to one support.
Medicines were stored, managed and administered safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and how this was monitored.
We found an effective quality assurance survey took place regularly and we looked at the results. The service delivered had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views about the support and service they received at events and via surveys.
The inspection visit took place on the 4th August 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the service in 2013 and found the service was not in breach of any regulations at that time.
71 Middleton Avenue provides care and support for up to six people who live with a learning disability. The home does not provide nursing care. The detached bungalow is situated in Thornaby, close to all amenities and transport links.
There is a registered manager in post. 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.
We spoke with three people who lived at the home who had a range of communication skills, people had some verbal communication whilst other people used signs or gestures which staff interpreted. Two people were out at their day activities during the course of our visit and one person was experiencing anxiety difficulties so we did not seek their views. Comments we received included; “I like it here” and “I like my room.”
We observed people were encouraged to participate in activities that were meaningful to them. For example, one person had gone shopping and to collect some professional photographs they had taken.
We found there were policies in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and staff were fully aware of what these meant and the implications for people living at the service. All paperwork in relation to the six authorisations for people were in place and were well managed to ensure any updates or new renewals were flagged up as requiring action before they expired. People also had best interests decisions in place and these had been undertaken with the person and others close to them such as family and other professionals. This meant peoples’ rights were upheld.
There were some areas of the service that required decorating and the registered manager informed us they had gained funding to do this. Staff told us about how they planned to involve everyone who used the service in making choices around this décor.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff had also received more specific training in managing the needs of people who used the service such as positive behaviour support. There were sufficient staff on duty to meet the needs of the people and the staff team were very supportive of the registered manager and of each other.
Medicines were stored and administered in a safe manner although the service was working with their pharmacy provider to address some concerns they had around the blister packs system the pharmacy provided.
There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify and support their personal and professional development.
We saw people’s care plans were person centred and had been well assessed. We saw people were being given choices and encouraged to take part in all aspects of day to day life at the service, from going to day services to helping plan the décor. One person had recently transitioned into the home and we saw this had been planned and assessed so it was as smooth as possible.
The service was exceptional in enabling people to maintain their independence. The service was using innovative programmes to support people into the community via an awards scheme and staff were also encouraged to develop themselves personally and professionally. The service actively supported people to be involved in the local community as much as possible and were supported to use public transport and accessing regular facilities such as the local G.P, shops and leisure facilities.
We also saw a regular programme of staff meetings where issues where shared and raised and staff told us how they felt supported and supported each other well. The service had an easy read complaints procedure and staff told us how they could recognise if someone was unhappy. This showed the service listened to the views of people and have developed and sustained a positive culture. Staff told us how they felt valued and had been given opportunities to develop themselves within the service such as delivering coaching and training.
Care records were detailed, reviewed regularly and contained enough information to ensure that people were safe and received the care and support they needed in the way they preferred.
There was evidence that people who used the service received coordinated care because there were good channels of communication between staff and other professionals involved in their care and support.
The provider had taken appropriate action to protect people from the risk of abuse and there were policies and systems in place to support people who used the service and staff should any concerns be raised.
The provider had an appropriate recruitment system in place that made sure people were supported by staff who had the appropriate skills and knowledge to meet their needs.
There were quality assurance systems in place that made sure people who used the service were able to express their opinion of the care they received. Additionally, quality assurance checks were carried out regularly by the manager to identify any areas for improvement. We saw evidence that accidents and incidents were learned from and action taken to reduce the risk of recurrence.
We spoke with two members of staff about the care and support people needed. What they told us accurately reflected what was written in the care plans. We also observed the people who lived at the service, and care plans accurately reflected their behaviours and needs.
We were able to speak with two relatives. One person told us that they were happy with the care their family member was receiving. They said that they had noticed a difference in their relative who seemed to have 'flourished since he moved to Middleton Avenue'. Another relative told us that each time they left their family member, they felt reassured that they were leaving them in safe hands.
Interactions between staff and people who used the service were observed as part of the inspection.