Archived: RNID Action on Hearing Loss 16 Pendean Court

We found the following examples of good practice.

The service was clean, hygienic and uncluttered in appearance. Effective cleaning routines had been put in place to ensure infection control risks were minimised and people were kept safe. High contact areas were cleaned regularly throughout each shift and cleaning procedures had been reviewed and updated.

All staff had completed online infection prevention and control and Covid-19 training. In addition, the infection control lead carried out competency checks with staff to ensure they understood the online training and were using PPE correctly. The service had maintained good stocks of PPE and managers routinely worked alongside care staff to help ensure best infection control practices were followed.

The registered and deputy managers communicated regularly with people, staff and relatives to make sure everyone understood the precautions being taken, and how to keep people safe. Staff kept in touch with families by regular telephone and video calls. Due to the current national lockdown relatives were not visiting people inside the home. The registered manager was in discussion with people and their families about how best to resume visiting.

There was a designated area, in the lobby of the premises, to enable visiting professionals and staff to sanitise their hands, have their temperature taken and put on PPE. There were PPE stations throughout the service and suitable waste bins were in place for the deposing of used PPE.

Appropriate testing procedures for Covid-19 had been implemented for all staff, and people who used the service, following national guidance regarding the frequency and type of testing.

In consultation with each person’s GP individual risk assessments had been carried out to identify people who were at increased risk of Covid-19. Appropriate measures had been put in place to reduce the risk for people who had been assessed as being more vulnerable. For example, reducing the number of different staff who provided personal care for them.

The service had updated their infection control policy in response to the pandemic. Specific Covid-19 policies had also been developed to provide guidance for staff about how to respond to the pandemic. These policies were kept under continuous review as changes to government guidance was published.

The service had a contingency plan to reduce the risk of cross infection should there be an outbreak of Covid-19 at the service. This included the potential for cohorting people within zones and separating staff teams.

What life is like for people using this service:

¿ People and their relatives consistently told us they felt safe living at the service and staff treated them in a caring and respectful manner. Comments included, "He is happy there", “I wouldn't have him living anywhere else" and "They are absolutely marvellous."

¿ Staff were committed to delivering care in a person-centred way based on people's preferences and wishes. People were observed to have good relationships with the staff team. Staff actively encouraged people to maintain links with the local community, their friends and family.

¿ Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for social interaction and activity with staff. Staff knew how to keep people safe from harm.

¿ People's care was individualised and focused on promoting their independence as well as their physical and mental well-being. People were empowered to take positive risks, to ensure they had as much choice and control of their lives as possible.

¿ The environment was safe and people had access to equipment where needed. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.

¿ People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

¿ People were involved in meal planning and preparation. Staff encouraged people to eat a well-balanced diet and make healthy eating choices.

¿ The registered manager, provider and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us they were approachable and that they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service.

Rating at last inspection: Good (report was published 30 September 2016)

Why we inspected: This inspection was a scheduled comprehensive inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. If any concerning information is received we may inspect sooner.

The full details can be found on our website at www.cqc.org.uk

A registered manager was employed to manage the service locally. 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 received support from staff who knew them well and had the knowledge and skills to meet their needs. Staff had an in depth knowledge of how each person preferred to communicate plus other methods to use if the person became anxious or was having difficulty making themselves understood.

There was a positive culture within the service. The registered manager had clear values about how they wished the service to be provided and these values were shared by the whole staff team. Staff empowered people to make choices about how they spent their day and provided support where necessary. People were listened to when they requested new activities and staff acted upon these requests.

Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected. There were some risk assessments in place to help reduce any risks related to people’s care and support needs. However, although staff administered people’s medicines and looked after their money, there were no risk assessments in place to identify why it would be unsafe for people to do these tasks for themselves. The registered manager told us they would update these as soon as possible.

There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. The recruitment and induction process for new staff was robust. People were involved in recruiting new staff to help ensure the staff team had the skills and interests to meet people’s social and health care needs.

The registered manager and staff had attended training on the Mental Capacity Act 2005 (MCA). Where appropriate, people had mental capacity assessments and Deprivation of Liberty safeguards (DoLS) applications had been made. However, there was no specific guidance for staff about how people’s mental capacity affected how they made decisions and which decisions staff may need to make in people’s best interests. There was no evidence this had impacted the care people received and the registered manager told us they would add this information as soon as possible.

There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post who had overall responsibility for the service. They were supported by other senior staff who had designated management responsibilities. People told us they knew who to speak to and any changes or concerns were dealt with swiftly and efficiently.

Feedback received by the service and outcomes from audits were used to aid learning and drive improvement across the service. The manager, staff and senior managers monitored the quality of the service by regularly by undertaking a range of regular audits and speaking with people to ensure they were happy with the service they received.

The registered manager told us they were open in the way they worked and always apologised if things went wrong. Staff and healthcare professionals confirmed the manager was open and approachable.

We had arranged for an interpreter who could use sign language to communicate with people living at the service and seek their views about their experiences. Unfortunately this person was not able to attend and we were informed at very short notice. This meant we were not able to communicate directly with the people who used the service. We observed that people appeared 'happy' and 'content'. We saw people smile and engage positively when staff approached them and people looked comfortable in their surroundings. We saw that people were calm and relaxed with staff and support was given in a caring and professional way.

Care planning documentation was up to date and reflected the needs of people who used the service

We found staff had a good understanding of the individual needs of people who used the service and had received appropriate training to enable them to understand and meet those needs.

People who lived at the service, and the staff, confirmed they knew how to raise concerns. There were good systems in place to make sure people were listened to and individuals were confident their concerns would be dealt with promptly.

Staff were supported to do their work and told us they had regular training and support meetings to make sure they were kept up to date and well informed. Recruitment was undertaken in a robust and professional manner. We concluded there were sufficient staff on duty to meet the needs of people.

Quality assurance systems were in place, conducted and completed both 'in house' and by the managing company.

People told us their care needs were met and that they were 'okay' with the support and care provided. We saw that people were calm and relaxed with staff and that support was given in a caring and professional way.

During our inspection we also used the Short Observational Framework for Inspection (SOFI). This is a specific way of observing care to help us understand the experience of people who could not speak with us all of the time. We used SOFI to observe how people were feeling and their engagement with staff. We found that overall staff had a good understanding of the individual needs of people who used the service and had received appropriate training to enable them to understand and meet those needs.

People living at the service, and the staff, confirmed they knew how to raise concerns. There were good systems in place to make sure people were listened to and individuals were confident their concerns would be dealt with promptly.

Staff were supported to do their work and told us they had regular training and support meetings to make sure they were kept up to date and well informed.