Background to this inspection
Updated
6 November 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
We undertook an unannounced inspection of this service on 20 and 21 August 2015. We spent some time talking with people in the service and staff; we looked at records as well as operational processes. The inspection was undertaken by one inspector, this was because the service was small and everyone was able to express their views about the service they received. It was considered that additional inspection staff would be intrusive to people’s daily routine.
We reviewed a range of records. This included two care plans and associated risk information and environmental risk information. We looked at recruitment information for four staff, including one who was more recently appointed; their training and supervision records in addition to the training record for the whole staff team. We viewed records of accidents/incidents, complaints information and records of some equipment, servicing information and maintenance records. We also viewed policies and procedures, medicine records and quality monitoring audits undertaken by the registered manager and provider. We spoke with each person, two staff, the registered manager and provider. After the inspection we spoke with a social care professional who had visited the service.
Before the inspection we reviewed the information we held about the service. We considered information which had been shared with us by the local authority and healthcare professionals. We reviewed notifications of incidents and safeguarding documentation that the provider had sent us since our last inspection. A notification is information about important events which the home is required to tell us about by law.
Updated
6 November 2015
We undertook an unannounced inspection of this service on 20 and 21 August 2015. The previous inspection took place on 25 June 2013 and there were no breaches in the legal requirements.
The service is registered to provide accommodation and personal care for up to three people who have learning disabilities, visual impairment and some complex and challenging behavioural needs.
Accommodation is provided in a detached house in a quiet residential area of Folkestone, close to public transport and local amenities and shops. Accommodation is arranged over two floors and each person had their own bedroom. The home benefitted from a large enclosed back garden.
This service had a registered manager in post. A registered manager is a person who is 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.
At the time of inspection the home was full and we were able to speak with each person. People told us that they liked living in the home, they were happy, they liked the staff and the staff were kind. They thought the home provided a relaxed and comfortable living environment.
To help us further understand the experiences of people, we observed their responses to the daily events going on around them, their interaction with each other and with staff.
Our inspection found that whilst the home offered people a homely environment and their health care needs were being supported; there were shortfalls in a number of areas that required improvement.
Some practices for the administration of medicines did not promote proper and safe management. This was because procedures intended to safeguard against mistakes and ensure the correct storage conditions of medicines were not always followed.
Information about safeguarding people from abuse was not up to date, safeguarding refresher training had not been delivered and the registered manager had not reported a matter warranting referral to the local safeguarding team.
Recruitment processes did not fully meet the requirements of the regulations because mandatory photographic identification checks were not completed.
Thermostatic temperature valves were not in place on hot water taps to which people had unsupervised access and the electrical wiring safety certificate had expired.
The provider was not meeting the requirements of the Mental Capacity Act (MCA) 2005 because Deprivation of Liberty Safeguard applications had not been made when they were needed.
The service was not always responsive to people’s needs. This was because people’s goals and wishes were not effectively progressed to encourage development of learning and exploring new activities and challenges.
Although a complaints system was in place, it was not in an accessible format for each person and did not contain the contact details of relevant external authorities.
A quality monitoring system was in place, but was not effective enough to enable the service to highlight the issues raised within this inspection.
Policies and procedures referred to out of date regulations methods used by the service to monitor and assess the service it provided were limited.
There were other elements of the inspection which were positive. People told us that they felt safe in the service and when they were out with staff.
Staff interactions demonstrated they had built rapports with people who responded to this positively. Activities were varied; people took part in activities in the home and the community and told us they enjoyed them.
People and staff told us that there were sufficient staff to meet people’s needs. Our observations showed that staff had time to spend with people and they were patient and kind in their interaction with people.
There was a healthy choice of foods, which people enjoyed. People were consulted about the menus and able to influence changes within them.
People, staff and records confirmed that people were supported to access routine and specialist healthcare appointments to maintain their health and wellbeing.
People felt the service was well-led. The provider adopted an open door policy and worked alongside staff. They took action to address any concerns or issues straightaway to help ensure the service ran smoothly.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.