We carried out a review of the data available to us about SENSE - 85 Park Road on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about SENSE - 85 Park Road, you can give feedback on this service.
SENSE - 85 Park Road is a residential care home providing accommodation for up to 6 people who require personal care. The service provides support to people living with a learning disability, autistic spectrum disorder or sensory impairment, At the time of our inspection there were 6 people, all living with a sensory impairment living at the service.
People’s experience of the service and what we found:
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support
People were not always supported safely with their individual nutritional needs. Training was ongoing.
An ongoing refurbishment plan was in place, we saw the windows and doors being replaced during the inspection. People’s bedrooms were nicely decorated and personalised.
Medicines were administered safely. We made a recommendation in relation to ensuring PRN protocols were specific. 2 staff checked in the medicines from the pharmacy and medicines administration record included allergy information in them.
Activities were undertaken, however, these were inconsistent and lacked engagement. Records included some information about aids to help people with communication. However, people were not consistently engaged by the staff team.
Right Care
The feedback about people’s care was mainly positive and that their privacy, dignity and independence was respected. We noted some kind and caring interactions however, the engagement between staff and people was limited, dependent on the staff on duty. One person had stained clothing on for a number of hours. Where changes in people’s behaviours were seen, the staff failed to always act on this. We saw people treated with dignity and they were supported and encouraged with their independence. Records were stored securely in line with GDPR requirements.
Risks were assessed and managed and systems were in place to ensure allegations of abuse were dealt with.
Care records had been completed. However, they did not always reflect accurately people’s current and individual needs. Family told us they had been involved in the development of care plans.
Right Culture
We observed differences in the skills of the staff team. We saw evidence of professionals involved in people’s care. Staff were recruited safely, although we made a recommendation in relation to ensuring suitable staff delivered peoples care.
People were mostly supported to have maximum choice and control of their lives and staff somewhat supported them in the least restrictive way possible and in their best interests; the policies and systems in the service somewhat supported this practice. The registered manager gave assurance they would ensure all staff understood how to protect people from unlawful restrictions. Complaints were managed and a range of positive feedback was noted. There was evidence of partnership working and we saw professionals visiting during the inspection.
People were engaged and involved, meetings were taking place. Staff were positive about the management and support they provided. Most relatives were positive, but some feedback was mixed.
Audits and monitoring was being undertaken. However, they failed to identify the shortfalls we noted at this inspection
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good, published 13 September 2017.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation person-centred care, meeting nutrition and hydration needs and good governance.
We made recommendations in relation to sufficient numbers of suitable staff, the management of medicines, ensuring staff understood how to protect people from unlawful restrictions, to ensure all staff regardless of knowledge and skills.
Please see the action we have told the provider to take at the end of this report.
Follow Up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At the last inspection, the service was rated Good. At this inspection we found that the service remained Good.
We found that staff had been recruited safely. The staff we spoke with were aware of how to safeguard vulnerable adults who lived at the home from abuse. There were safe processes and practices in place for the management and administration of medicines.
People who lived at the home were not able to give us their views directly due to cognitive and communication impairments.
Relatives told us they were happy with staffing levels at the home. During the inspection we found that there were a suitable number of staff available to meet people’s needs effectively.
Staff received appropriate training. Relatives felt that staff had the knowledge and skills to meet people’s needs.
People received appropriate support with eating and drinking and their healthcare needs were met at the home.
Staff respected people’s privacy and dignity. We observed staff at the home communicating with people in a kind and caring way. People looked relaxed and comfortable and moved around the home freely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. The service had taken appropriate action where people lacked the capacity to make decisions about their care and needed to be deprived of their liberty to keep them safe.
We saw evidence that people received care that reflected their needs and preferences. Relatives had been consulted about people’s care and were updated by staff regularly. We received positive feedback from relatives about the activities available and found that people were supported regularly to go out into the community.
People were encouraged to be as independent as possible. Staff used a variety of methods to communicate effectively with people who were visually and hearing impaired, including objects of reference and’ ‘hand under hand’ techniques. The ‘hand under hand’ approach is where the staff member’s hand performs the activity and the person’s hand rests on top of it.
The service had a registered manager in post. Relatives and staff told us they were happy with how the service was being managed. They found the registered manager and the deputy manager approachable and could raise any concerns.
The registered manager had sought feedback from relatives and staff about the care and support provided. A high level of satisfaction had been expressed about many areas of the service. Where improvements had been suggested, we found evidence that action had been taken.
Audits of many aspects of the service had been completed regularly. We found that the audits completed were effective in ensuring that appropriate levels of quality and safety were maintained at the home.
Further information is in the detailed findings below.
We carried out an inspection of 85 Park Road on 8 April 2015. 24 hours notice of the inspection was given as the service is small and people living at the home are often out of the home.
85 Park Road provides accommodation and personal care for 5 adults with sensory impairment, physical disabilities and learning disabilities. The home is part of the larger organisation of 'SENSE', which is the largest specialist voluntary organisation in the United Kingdom working with people with deaf blindness and associated disabilities. The service does not provide nursing care. At the time of the inspection there were five people accommodated in the home.
85 Park Road is a detached purpose built house located close to local amenities in the town of Accrington. The service has its own transport.
At the previous inspection on 19 December 2013 we found the service was meeting all the regulations we looked at.
There was a registered manager in day to day charge of the home. 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 spoken with made positive comments about the management arrangements. Staff told us, “We have a good management team who keep us up to date and listen to us.” Relatives told us, “The manager is hands on and easy to approach” and “The management team has settled down and improvements are being made.”
We were unable to talk to people about what it was like to live in the home as they had difficulties expressing their views. However, we were able to observe the care and support being given by staff. We did not observe anything to give us cause for concern about people’s well-being and safety. People looked relaxed and happy. We observed caring and friendly interactions between people living in the home and staff. We spoke with relatives who were confident people were treated well. Comments included, “The level of care is excellent” and “I can’t praise them enough; I am very happy with everything.”
Staff told us they were confident to take action if they witnessed or suspected any abusive or neglectful practice and had received training about the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS). The MCA 2005 and DoLS provide legal safeguards for people who may be unable to make decisions about their care. We noted appropriate DoLS applications had been made to ensure people were safe and their best interests were considered.
Staff were aware of people’s capacity to make safe decisions and ability to make choices and decisions about their lives. This was clearly recorded in the support plans. Personal risks had been assessed and discussed, and recorded in the support plan. People were supported to take responsible risks as part of their daily lifestyle with the minimum necessary restrictions.
We found accurate records and appropriate processes were in place for the ordering, receipt, administration and disposal of medicines and people received their medicines on time. There was guidance for staff to follow to support each person when taking their medicines.
A safe and fair recruitment process had been followed and proper checks had been completed before staff began working for the service. We found there were enough staff to meet people's needs in a flexible way. One relative said, “There have been some changes to staff but the core team are very experienced and they support less experienced staff.”
All staff were given the training and support they needed to help them look after people properly.
We observed staff responding to people in a caring and friendly manner and we observed good relationships between people. Relatives said, “Staff are very good; my relative has a special bond with their key worker” and “The staff team are brilliant.” We observed staff had a good knowledge of the people they supported and were able to respond appropriately to keep them safe from harm.
Specialist advice had been sought and people were given the support they needed to eat and drink sufficient amounts to meet their needs. People were helped to develop and maintain skills in the kitchen such as preparing simple meals/drinks where appropriate. We observed people were supported and encouraged with their meals and staff were aware of people’s dietary needs and preferences. We were told menus would be changed to meet people’s needs and preferences.
People were not always able to verbalise their needs. However, staff had been trained in specialised communication methods and records included clear information about how people communicated their needs and feelings. Also each person had a 'communication board' in their bedroom which helped them to understand about daily activities and routines and helped staff to communicate effectively with them. Staff used familiar objects, body language and facial expressions as a means of communicating with people.
Each person had a support plan that was personal to them and included information about their likes and dislikes and routines as well as their care and support needs. People’s changing needs were identified, recorded and regularly reviewed. One relative told us, “I am very much involved and they listen to what I have to say.”
There were opportunities for involvement in activities both inside and outside the home. Activities provided people with appropriate skills whilst promoting enjoyment, improvement and independence. Activities included shopping trips, excursions, and holidays, meals out, horse riding, swimming, music therapy, reflexology, cleaning and baking. Tactile items and communication boards were used to indicate people’s choices and preferences. People were also supported to maintain their relationships with their friends and family. Where possible, people enjoyed regular visits to stay with their relatives.
There was a clear complaints procedure. There had been no complaints made. People were encouraged to discuss any concerns during regular meetings, during day to day discussions with staff and management and also as part of the annual survey. Relatives told us they had no complaints about the service but felt confident they could raise any concerns with the staff or managers. One relative said, “I have no complaints but I find them to be very open and honest if I need to speak to them.”
There were effective systems in place to assess and monitor the quality of the service. They included monthly checks of the medication systems, support plans, staff training, finance, nutrition, safety and the environment. There was evidence improvements had been made when any shortfalls had been noted.
There were opportunities for people, or their relatives, to express their views about the service through regular care reviews and during discussions with staff and management. Regular family days were held to enable people to meet with each other and with management and staff.
During our visit we observed staff responded to people in their care with kindness, patience and understanding. We found people's care and treatment was delivered in a way that was intended to ensure their safety and welfare. People were able to choose from a range of suitable activities, both inside and outside the home, which promoted enjoyment, improvement and independence.
Prior to our inspection we were told the service was relying on agency staff which was impacting on people's care. Staff told us there were now sufficient numbers of skilled and experienced staff to support people properly; this was also clear from looking at staffing rotas.
All the areas of the home, that we looked at, were clean and free from offensive odours. People were provided with a range of appropriate equipment to safely meet their needs and to promote their independence and comfort.
We found records were accurately maintained, were held securely and were kept in a way that allowed them to be located quickly when required.
We found people's needs were assessed and care, treatment and support was planned and delivered in line with their individual plan. People living in the home were not always able to vocalise their needs. However staff had been trained in specialised communication methods and records included clear information about how people communicated their needs and feelings. Staff also worked closely with parents, social workers and advocates which helped to make sure people living in the home were happy and received the care they needed and wanted. People were able to choose from a range of suitable activities which were in line with their preferences and abilities. One key worker said, "Activities are tailored to people's needs".
We found there were sufficient numbers of staff to meet people's needs and their time was available flexibly to meet people's needs. We spoke with two key workers who told us they were happy working at the home. One said, "I love it here; it's a very rewarding job".
Staff told us that the routines of the home were flexible and that people were given choices. We found that people's individual needs, preferences, likes and dislikes were met and that staff focused on promoting independence and positive behaviours. Staff worked closely with people's parents/advocates which helped to make sure people received the care they needed and wanted.
People were able to choose from a range of suitable activities which were in line with their preferences and abilities. Activities were monitored to ensure they were providing people with appropriate 'life' skills whilst promoting improvement and independence. One person was able to tell us that they 'liked' the garden and they were looking forward to having a picnic in the afternoon.
Staff were able to describe what action they would take to protect people from poor practice, abuse or neglect. They told us they were provided with regular 'safeguarding' training.
Staff told us there were sufficient numbers of staff to meet people's needs and all staff were provided with the training and support they needed. One member of staff said, "We are given good quality training". We were told, "It is a very rewarding job".
There were systems in place to obtain peoples' views and opinions. People's views were used to improve the service. The way in which the home was run was monitored each month. Any shortfalls were promptly acted on to ensure people were provided with a safe and efficient service.