Archived: 27A New Directions Rugby

At the last inspection in June 2015, the home formed part of a larger service owned by the same provider and it was rated Good overall. This was the first inspection the service had undergone since the provider reduced the size of the service. At this inspection, the service continues to be rated Good.

There was a registered manager in post. 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 were protected from the risks of harm or abuse because staff were trained in safeguarding and understood their responsibilities to raise any concerns with the registered manager. The registered manager made sure there were enough suitably skilled, qualified and experienced staff to support people safely and effectively. Risks to people's health and wellbeing were managed. However, medicines were not always managed safely and checks had not identified where improvements were required.

Staff had the skill, experience and support to enable them to meet people’s needs effectively. The registered manager checked staff’s suitability to deliver care and support during the recruitment process.

Staff worked within the principles of the MCA and supported people to have maximum choice and control of their lives. People were supported to eat and drink enough to maintain a balanced diet that met their needs and preferences.

Staff monitored people’s health and referred them to other healthcare professionals to maintain and improve their health.

People, relatives and staff felt well cared for. People and their relatives were included in planning how they were cared for and supported. Staff understood people’s diverse needs and interests and supported them to enjoy their lives according to their preferences. Staff respected people’s right to privacy and supported people to maintain their independence.

People were encouraged to maintain their links with the local community and opportunities to engage in activities that were meaningful to them.

People knew how to complain and had the opportunity to share their views and opinions about the service they received.

The registered manager and the provider demonstrated they valued care staff and promoted their learning and development. There was an open culture at the service where staff felt well supported, able to raise any concerns and put forward suggestions for improvements. The provider’s quality monitoring system included checking people received the care and support they needed, however it was not always effective.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

The manager of the service undertook a monthly health and safety and environmental audit. We looked at the range of issues audited and they included such things as fire alarms, fire exits, trip hazards, kitchen cleanliness and fridge and freezer temperatures. This demonstrated the service was being proactive to isolate problems before they could become a risk to people.

We looked at medication administration including medication charts. We reviewed records for the receipt, administration and disposal of medicines and conducted a sample audit of medicines to account for them. We found records were complete and people had received the medication they had been prescribed.

We found the provider had systems in place to ensure people's safety and well-being. The service was subject to regular review and actions were taken to minimise risk.

The provider had appropriate security arrangements in place to protect people who lived at the service. We found that the entrance door was secure and visitors could only enter the building with the knowledge of the staff. People told us they felt safe and secure in the home yet they had the freedom to go outside if they wished.

Is the service effective?

We looked at three people's care plans and found they included clear instructions to enable staff to carry out effective care. All aspects of people's personal and health care needs had been assessed and were reviewed on a monthly basis. This meant staff had up-to-date guidance on how to support each individual.

It was clear from what we saw and from speaking with staff that they understood people's care and support needs and they knew them well.

Is the service caring?

Care plans had been regularly reviewed to ensure there was up-to-date information on the person's needs and how these were to be met. Staff we spoke with demonstrated they were aware of the needs of the people they supported and their individual personalities and preferences.

People were very comfortable, well dressed and clean which demonstrated staff took time to assist people with their personal care needs.

The atmosphere throughout the home was relaxed and we saw staff spent time talking to people. They spoke with people respectfully, giving good eye contact and the opportunity to respond.

Is the service responsive?

Care plans recorded what each person could do independently and identified areas where the person required support. When people moved into the home detailed assessments took place which ensured people's independence was maintained.

We saw assessments took place to examine people's ability to manage their own money and to manage their own medicines. We also saw the outcomes of these assessments were kept under constant review to ensure there had been no deterioration in people's abilities.

People had access to activities that were important to them and staff gave encouragement and support to allow people to gain fulfillment.

Is the service well led?

We found the service had an effective quality assurance system in place and any identified actions had led to improvements in the service that people received.

People who used the service, their representatives and staff were asked for their views about their care and treatment. We saw evidence that these had been acted upon. We looked at the way the home gathered information about the service they provided. Records of audits and meetings confirmed that a programme was in place. We found the service was well-led.

On the day of our visit, people who lived at the home engaged in different activities throughout the day. Some people spent the day at a resource centre or at college. One person was writing greeting cards in the dining room. We saw two people making their lunch and hot drinks in the kitchen. One person told us that they enjoyed word searches. They told us, 'That's my hobby. I'm good at it.'

During our visit we observed that the staff were polite and asked people's permission before they helped them. We found that people had agreed to the care and treatment they received.

We found that staff demonstrated they understood people's personal needs and the individual ways they communicated their needs.

We saw that the home was clean and well maintained. Staff we spoke with explained how they minimised the risk of infection.

We spoke with staff and found that they felt supported by their manager and felt able to raise any issues.

We found that the provider dealt with complaints and comments in accordance with their policy.