We carried out an unannounced inspection at Freehold Cottage Residential Care Home on the 7 and 8 July 2016.Freehold Cottage is registered to provide accommodation, care and support for up to 6 people with a mental illness. The home is a large detached cottage with a garden area to the rear of the property. The service is located near to the towns of Rochdale, Bury and Bacup.
The service was last inspected in September 2013 and was found compliant in all areas inspected.
At the time of this inspection the registered manager had left the service. 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. However; the provider had ensured an acting manager was in post with oversight from the area manager, until a new registered manager was recruited.
During this inspection we received positive feedback from people who used the service. People expressed satisfaction with the service provided and spoke positively about the staff team supporting them, referring to them as, “Family.” People told us they, “Loved” living at Freehold Cottage and felt they had the freedom to independently live their lives and access the community whenever they wished. We saw evidence of people leaving the service without any restrictions placed on them.
We noted the service had processes and procedures in place to maintain a safe environment for people using the service and for staff and visitors. The service had daily ‘housekeeping’ and health and safety checks which covered areas such as fire exits, electrical/ gas appliances and temperature checks.
Fire audits were in date and compliant. Fire safety checks and fire exercises were carried out monthly and staff had received fire training. The service had clear procedures to follow in case of an emergency.
People using the service told us they felt safe living at the home. Staff showed a good understanding around the various signs and indicators of abuse and were clear about what action they would take if they witnessed or suspected any abusive practice. Training in safeguarding and whistle blowing had been completed by all staff; training was reinforced with the services procedural guidance.
At the time of the inspection we found the service had adequate staffing levels. People we spoke with confirmed this by telling us there was always a staff member present and they were supported when needed. Staff referred to the service as their second home and had time to bake cakes and cook fresh meals. Staff also felt they had adequate time to support people effectively and safely. We observed a good level of staff interaction to support what people were telling us. We looked at a month’s staff rotas which showed a sufficient level of staffing was maintained.
The service operated safe and robust recruitment systems and took appropriate steps to verify people’s previous employment and conduct, identity and any criminal record before being successfully appointed. Thorough induction processes were implemented to ensure the correct amount of training and support was given to new staff. Disciplinary procedures were also in place to support the organisation in taking immediate action against staff in the event of any misconduct or failure to follow company policies and procedures.
The service had processes in place for appropriate and safe administration of medicines. Staff were adequately trained in administering medicines. Medicines were stored safely and in line with current National Institute for Health and Care Excellence (NICE) guidance. NICE provides national guidance and advice to improve health and social care.
Care plans were in date and regularly reviewed. They gave clear information about people's needs, wishes, feelings and health conditions. The person had also been involved in the care plan and review process.
Appropriate training was provided. The training records we saw were in date. Staff felt they received an appropriate amount of training to equip them to safely and knowledgably support people living at the service.
We assessed if the service was working within the principles of the Mental Capacity Act and whether any conditions or authorisations to deprive a person of their liberty were being met. These provide legal safeguards for people who may be unable to make their own decisions. At the time of inspection these safeguards were not required due to the high independence of all the people using the service. However the acting manager and staff we spoke with were aware of the steps to take should somebody require having restrictions placed upon them.
Meal times were very relaxed and people could choose what they wished to eat. People freely used the kitchen area to prepare meals, snacks and drinks with the support of staff when required. Weight management and dietary care plans were in situ when required and appropriate referrals had been made to health professionals.
During the inspection we noted positive staff interaction and engagement with people using the service. Staff addressed people in a respectful and caring manner and the service had a calm and warm atmosphere. We observed people enjoying each other’s company, conversing, playing games and accessing the community.
We had positive feedback from people using the service, relatives and staff about the acting manager and the area manager. People told us they were happy to approach either manager with any concerns or questions.
We found the acting manager to be very approachable and assisted us professionally with our inspection by providing us with any requested documentation without delay.