Giles Shirley Hall

Updated 13 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 15 January 2019 and the provider was given 24 hours notice of the inspection. Giles Shirley Hall is a small care home for younger adults who are often out during the day. We gave short advance notice of our visit, as we needed to be sure that someone would be in when we arrived to carry out the inspection. The inspection was carried out by an adult social care inspector.

Prior to our visit we looked at any information we had received about the home and any information sent to us by the provider since its last inspection by CQC in 2016. We also contacted the Local Authority for their feedback on the home.

During the inspection we talked to one person who lived at the home and two relatives. We also spoke with the registered manager and two house managers who worked in the home.

We looked at the communal areas that people shared in the home and visited a sample of their individual bedrooms. We looked at a range of records including two care records, medication records, staff records and records relating to the management of the service.

Updated 13 March 2019

Giles Shirley Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

At the last inspection the service was rated good. At this inspection we found that some improvements to the service were required and as a result the service was rated as requires improvement.

Giles Shirley Hall is registered to provide accommodation for up to 12 people who require accommodation and support with their personal care due to living with learning difficulties. The home is located in Bromborough, Wirral. At the time of our inspection eleven people lived at the home.

In June 2017, CQC published best practice guidance called ‘Registering the Right Support’. This good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability and or autism. During our visit, we found that the service was not consistently developed or designed in line with this best practice guidance.

For example, the size and layout of Giles Shirley Hall did not comply with this guidance. It was situated in a campus style setting with the provider’s day services accommodated in various other buildings outside the home. Day services also operated from within Giles Shirley Hall itself. Giles Shirley Hall, the provider’s day services and associated car park were clearly labelled with exterior signs which identified them as providing services for people with learning disabilities and or autism. This detracted from the values set out in the ‘Registering the Right Support’ guidance which advocates that people’s choice, independence and ability to live as life as ordinary in their own home should be promoted in service delivery. This signage therefore clearly defined people who lived at the home as a separate and distinct community group.

All of the people who lived at the home attended the provider’s day services. From people’s records it was clear that people had a choice in what they attended and enjoyed these activities. The provider’s approach for supporting people who did not wish to attend day services was however unclear. Other aspects of service delivery did not always promote the values specified in the Mental Capacity Act 2005 with regards to gaining people’s consent. Nevertheless we did see evidence of people’s day to day choices being respected and for the most part they were free to choose how they lived their life at the home.

People’s support plans contained clear and easy to understand information about their needs and risks and how to support them effectively. Support plans were person centred and contained information about people’s preferences, daily routines and what was important to them. For those people who were unable to express their needs and wishes verbally, staff had detailed guidance on the behaviours, gestures and body language the person would use to communicate their needs or wishes. From talking to staff it was clear they knew people well. They were able to tell us about people’s changing needs and how the support provided had been adapted to respond to these changes. People’s support plans however had not always been updated to reflect this.

The atmosphere at the home was positive and inclusive. The people we spoke with and their relatives were happy with the support provided. Everyone was confident that people were well looked after, safe and happy at the home.

New staff was recruited safely and there were enough staff on duty each day to meet people’s needs. Staff had received adequate training and support to do their job role and staff spoken with told us they felt supported.

Medication was managed safely and people had access to a range of health and social care professionals in support of their needs.

There were mechanisms in place to monitor the quality and safety of the service but these were not always effective. For example, the provider’s quality assurance system failed to identify that the service did not always reflect best practice guidelines or that aspects of service provision such as adapting the premises to meet people’s needs.

People who lived at the home were given opportunities to express their views and where possible any suggestions for improvement were acted upon. Feedback on the service was positive and from our observations it was clear that people liked the staff and the place in which they lived. Staff morale was good and all of the staff spoken with had a positive, can do attitude. During our visit, we had no concerns about the support people received and the manager and staff team appeared committed to providing a good service.