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Inshore Support Limited - 27 Highfield Road Good

Reports


Inspection carried out on 31 August 2018

During a routine inspection

The inspection took place on 31 August 2018 and was unannounced. 27 Highfield Road is a residential care home for three people with a learning disabilities or associated need. At the time of the inspection, three people were living at the service. At our last inspection on 2 February 2016, the service was rated as Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were supported by sufficient numbers of safely recruited staff who were aware of their responsibilities to act and report on any concerns they may have. Risks to people were regularly reviewed and staff kept up to date in changes in people’s care needs. People received their medicines as prescribed. Where incidents and accidents took place, action was taken and lessons were learnt.

Staff received an induction and training that prepared them for their role. Staff felt supported by the registered manager and were provided with opportunity to discuss their learning or any concerns they may have through regular supervision and staff meetings. People were supported to eat and drink enough to maintain a balanced diet. People were supported to access a variety of healthcare services and benefitted from regular healthchecks. Improvements had been made to the environment and were ongoing.

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.

People and staff shared warm, positive relationships. Staff treated people with dignity and respect and supported them to maintain their independence and make choices regarding how they wished to spend their time.

People were involved in the development and review of their care records and were supported by staff who knew them well. Efforts were made to maintain family relationships and support people to access the community and take part in activities they enjoyed. People had no complaints but were aware of the processes to follow should they have any concerns.

Relatives and staff spoke highly of the registered manager and considered the service to be well led. People were supported by a motivated group of staff who enjoyed their work and worked well together as a team. People’s views of the service were sought and a number of audits were in place to review the quality of care provided and drive improvement.

Further information is in the detailed findings below.

Inspection carried out on 2 February 2016

During a routine inspection

The inspection of this service took place on 2 February 2016 and was unannounced. The provider is registered to accommodate and deliver personal care to a maximum of three people who had a learning disability or associated need. On the day of our inspection three people lived there.

At our last inspection in January 2015 we found that the provider was not meeting their legal responsibility to comply with the condition of their registration as they had not had a registered manager in post since 2013. At this inspection, we found that there was 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.

People felt safe in the home and were supported by staff who knew how to recognise abuse and how to report it.

Risks to people were identified, managed and reviewed. There were systems in place to ensure that suitable staff were recruited to work at the home.

People received their medicines when they needed them and staff were trained to do this safely.

There were sufficient staff available to meet the needs of the people living in the home. Staff received regular training and supervision and were knowledgeable about the needs of the people they cared for.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) and the provider was meeting the requirements set out in the MCA and DoLS to ensure people received care in line with their best interests.

People had their health care needs reviewed on a regular basis by their GP and other health care professionals. Staff were aware of people’s individual healthcare needs and referrals were made to health care professionals where necessary. People were supported to make decisions about their daily living and were encouraged to maintain their independence.

People were treated with dignity and respect and had good relationships with staff who treated them with kindness.

People and their families were involved in the planning of their care and reviews took place on a regular basis. People’s views on their care were actively sought and people were confident that if they had to raise a complaint, it would be dealt with to their satisfaction.

People spoke highly of the registered manager and the staff group and staff were highly motivated.

The registered manager had a number of audits in place to check the quality of care provided in order to improve the service offered to people.

Inspection carried out on 26 January 2015

During a routine inspection

Our inspection was unannounced and took place on 26 January 2015.

The provider is registered to accommodate and deliver personal care to a maximum of three people who had a learning disability or associated need. On the day of our inspection three people lived there.

At our last inspection in September 2013 the provider was meeting all of the regulations that we assessed.

We found that provider was not meeting their legal responsibility to comply with the condition of their registration as they had not had a registered manager in post since 2013. 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.

Although we found that medicine recording and administration was managed safely. The storage of medicines and the monitoring of medicine temperatures required improvement to ensure that no unauthorised person could access the medicine and to confirm that it was stored at the correct temperature to ensure that it would be effective.

We found that improvement was required to ensure people’s safety. This was regarding the management of hot radiator surfaces to prevent burns and the taking of action to prevent untoward events reoccurring.

We saw that there were systems in place to protect people from the risk of abuse. People told us that they had not experienced anything that hurt them or that they were afraid of.

The provider had a safe system in place to recruit new staff. Staff received an induction which gave them the initial knowledge and support they required to meet people’s needs. Staff numbers and experience ensured that people would be safe and their needs were met in the way that they wanted them to be. Staff had training and one to one supervision to equip them with the knowledge they needed to provide appropriate support to the people who lived there. Staff we spoke with understood their job role and responsibilities.

People told us that the staff were nice and kind and we saw that they were. We observed that interactions between staff and the people who lived there were positive in that staff were kind, polite and helpful to people.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found that the provider was meeting the requirements set out in the MCA and DoLS to ensure that people received care in line with their best interests and were not unlawfully restricted.

People told us that they liked the food and drink that they were offered. Records confirmed that the people who lived there were supported to have a varied diet in sufficient quantities.

We found that a complaints system was available for people to use. This meant that people and their relatives could state their concerns and dissatisfaction and issues would be looked into.

People and their relatives told us that the service was well led. We saw that the provider had monitoring and auditing systems in place to ensure that the service met people’s individual needs and preferences.

Inspection carried out on 13 September 2013

During a routine inspection

We met with the three people who lived at the home, and spoke with the team manager, deputy manager and three care staff. Some people were unable to express their views verbally, so we spent time observing how staff supported them.

People had been supported to consent to their care. One person told us, "Staff talk to me and explain things and when I know I am happy to agree”.

We saw people's needs had been assessed and appropriate plans of care put in place to meet their needs. Care plans included guidance to reduce risks to people’s health and safety.

We saw that people participated in a range of daily activities; menu planning, shopping, cooking, and activities within the local community. This ensured people were supported in a lifestyle of their choosing.

We saw people had their medication when they wanted it and that staff had the guidance and training they needed to do this safely.

People lived in a safe, clean and comfortable environment that had been suitably adapted to meet their needs. One person told us, “This is my room and I have my own lounge, I like it”.

Staff had received specialist training to safely support the people living there. Staff were positive about training opportunities and told us they had the support and guidance they received to do their job.

Inspection carried out on 19 November 2012

During a routine inspection

We saw that staff members interacted well with people who lived at the home ensuring they were treated with respect and dignity. People were involved in managing daily activities of the home, such as menu planning, shopping and meal preparation. This ensured people were supported in promoting their independence and community involvement. Evidence was noted of appropriate opportunities and encouragement to support people in relation to promoting their autonomy, independence, dignity and privacy.Staff were also noted to seek consent from most people before going into private rooms ensuring privacy and dignity.

Evidence of people’s choices and decisions relating to social pastimes was noted congruently throughout the home, during observations, on files and from photographs. People who use the service were given appropriate information and support regarding their care or treatment; this was offered in a variety of ways to encompass specific needs.

The home was clean and well maintained which means that people live in a safe and clean environment. They made some of the following comments:

“I am happy living at the home.” "I like to go out for hot chocolate"

Lots of evidence of verbal re-direction was noted to good effect and staff responded appropriately to non verbal communication. During the course of the inspection, staff were heard to be offering choices, ensuring person centred care, and to be responding appropriately to the affections of people.

Inspection carried out on 10 March 2011

During a routine inspection

At the time of our visit on 10 March 2011 there were three people living in the home. Two people agreed to speak to us. They told us that they liked living there. We saw that staff were interacting well with people who lived at the home, ensuring they were treated with respect. People were involved in managing the daily activities of the home. This ensured that they maintained their independence. The home was clean and well maintained which means that people lived in a safe and clean environment.

They made some of the following comments:

“I am happy living at the home.”

“The staff ask me what I want to do every day and I tell them where I want to go. I like to help around the house. I do the hovering, dusting and help to change my bed.”

“It’s a nice home for me. If I was worried about anything I would tell the staff or the manager.”