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.