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Giles Shirley Hall Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

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 qua

Inspection areas

Safe

Good

Updated 13 March 2019

The service was safe.

The premises were maintained but there was no safety certificate in place for the passenger lift.

Medicines were stored and administered safely.

Staff were recruited safely. There were sufficient staff on duty to meet people needs.

Staff were knowledgeable about types of abuse and the action to take to protect people from harm.

Effective

Requires improvement

Updated 13 March 2019

The service was not always effective

People were able to make choices in their day to day lives.

The Mental Capacity Act was not always considered when supporting people to make decisions.

People’s nutritional needs and preferences were met. Information on people’s food allergies required more detail.

The premises did not comply with best practice guidelines for learning disability services. Some premises adaptations had not been made as and when required.

Caring

Good

Updated 13 March 2019

The service was caring

People’s feedback on the support provided by the staff team was positive.

Everyone said staff were caring and supportive and knew them well.

People’s bedrooms were homely and personalised with the things that were important to them.

Responsive

Good

Updated 13 March 2019

The service was responsive.

People’s relatives told us that they had a good relationship with staff and they were approachable and responsive.

Support plans were person centred. Staff had detailed guidance on how to support the person in the way they preferred.

People had access to day to day activities to occupy and interest them.

A clear complaints policy was displayed in easy read format for people who lived at the home to refer to.

Well-led

Requires improvement

Updated 13 March 2019

The service was not consistently well led.

Aspects of service delivery required review to ensure they met current best practice guidance for learning disability services.

The provider had not always acted proactively to resolve issues that impacted on people’s experience of the service.

People and relatives told us the support they received was good.

Staff morale was high. The staff team had a can do attitude and the culture of the service was positive.