Background to this inspection
Updated
15 November 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by two inspectors over two days.
Service and service type:
36a Gibraltar Crescent is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager that was in the process of registering with the Care Quality Commission. Once registered, this means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 48 hours’ notice of the inspection site visit. As this is a small service we wanted to make sure someone would be in.
What we did:
Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This enabled us to ensure we were addressing potential areas of concern at our inspection
As part of our inspection we observed the care and support provided to people as many people were unable to communicate with us. Due to this we observed interactions between staff and people. We were able to speak with three people through a British Sign Language Interpreter. We spoke with five staff members including the manager, deputy manager and the provider’s Head of Service for the area. We reviewed a range of documents including two care plans, two staff recruitment files, medication administration records, accident and incidents records, policies and procedures and internal audits that had been completed. Following the inspection, we spoke with two relatives by telephone.
Updated
15 November 2019
About the service:
RNID 36a Gibraltar Crescent is a care home providing care for up to six adults with learning disabilities and hearing impairments. The home is two story house made up of six bedrooms spread across both floors. At the time of our inspection, there were six people living at 36a Gibraltar Crescent. For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s experience of using this service:
Records were not always contemporaneous which resulted in it being difficult to follow up if issues had been addressed. Care plans and other records also contained a lot of out of date information which needed to be archived. Staff were not up to date with training, but the new manager was taking steps to ensure that this was resolved as quickly as possible. A local day centre provided activities for some people living at the service, but there was a lack of meaningful activities for people to take part in when at home. The new manager was in the process of organising new outings and activities for people which suited their interests. The service was not delivering end of life care to any one at the time of our inspection, but discussions around this had not been had with people or their relatives in preparation.
People and their relatives told us they felt safe at the service, and staff were aware of their responsibilities in safeguarding people from abuse. Risks to people were managed appropriately but not always recorded. There were a sufficient number of staff to meet people’s needs, and medicines were recorded correctly and administrated safely. Accidents and incidents were recorded and analysed for trends.
People’s rights were protected in line with the principles of the Mental Capacity Act 2005. The design of the building was utilised to meet people’s needs with additional help from adaptations. Staff felt that the communication within the service was effective and told us they received regular supervision. People were referred to healthcare professionals where required.
People and their relatives told us staff were kind and caring, and we observed friendly interactions between people and staff. People were involved in decisions around their care where possible, and were encouraged to be independent as much as possible. People’s dignity and privacy was respected, and space given to them when needed. The service had not received any complaints, but there was a policy around this in place, and easy read versions for people if required. People’s communication needs were considered, and the majority of staff were British Sign Language trained which aided this further.
The manager has been working at the service for six weeks. People, relatives and staff felt the management team were approachable, and felt the manager had brought a new lease of life to the service. There were plans in place to improve the service for people, as well as audits identifying existing areas of improvement required. People, relatives and staff were engaged in the running of the service.
Rating at last inspection: At the last inspection the service was rated Good (report published on 20 January 2017)
Why we inspected: This was a planned fully comprehensive inspection in line with our inspection scheduling based on the service’s previous rating.
Follow up: We will follow up on the recommendations we have made in relation to ensuring people take part in meaningful activities and improvement of records at our next inspection. We will continue to monitor all information received about the service to ensure the next planned inspection is scheduled accordingly.