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New Boundaries Group - 2 Lloyd Road Good


Inspection carried out on 19 December 2018

During a routine inspection

New Boundaries Group – 2 Lloyd Road is a residential care home for up to three people with a learning difficulty some of whom may also have autism. At the time of our inspection only one person was using the service. 2 Lloyd Road is a spacious bungalow, with a parking area at the front and a private back garden. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of our inspection 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.

The service was safe and the person living there was protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them. Risks to the person using the service were assessed and their safety was monitored and managed, with minimal restrictions on their freedom. Risk assessments were thorough and personalised.

The service ensured there were sufficient numbers of suitable staff to meet the person’s needs and support them to stay safe. Records confirmed that robust recruitment procedures were followed. Medicines were stored, managed and administered safely. Staff were trained, and their competency checked, in respect of administering and managing medicines.

The person using the service was supported to have sufficient amounts to eat and drink and maintain a balanced diet. The person using the service enjoyed their meals and was involved in discussions and decisions regarding the menus and options available.

Staff demonstrated a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff understood the importance of helping the person using the service to make their own choices regarding their care and support. The person using the service was supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

The service ensured the person using the service was treated with kindness, respect and compassion. This person also received emotional support when needed. The person using the service confirmed that they were involved in planning the care and support they received and were able to make choices and decisions and maintain their independence as much as possible. Information was provided to the person using the service in formats they could understand.

The care plan for the person using the service was personalised and described the holistic care and support the person required, together with details of their strengths and aspirations. Information also explained how the person could be supported to maintain and enhance their independence and what could help ensure they consistently had a good quality of life. Any comments and concerns made by the person using the service were listened to and taken seriously. The service also used any comments or complaints to help drive improvement within the service.

The person who used the service, and staff, spoke highly of the management team and told us they felt supported. CQC’s registration requirements were met and complied with and effective quality assurance proce

Inspection carried out on 14 July 2016

During a routine inspection

This inspection took place on 14 July 2016 and was announced.

2 Lloyd Road provides accommodation, care and support for up to three people living with a learning disability and/or mental health needs. At the time of our inspection there were three people living in the home.

The registered manager had been in post since 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People living in the home were safe as individual and environmental risks had been identified and minimised. Risk assessments were regularly reviewed and updated. There was consistently sufficient numbers of staff on duty to meet people’s needs. There were safe recruitment practices in place which ensured that appropriate staff were recruited.

There were safe practices around the storage and administration of medicines. Staff received regular training in the administration of medicines and regular audits ensured that staff were effective in their management of medicines.

People were supported by staff who were knowledgeable and skilled in their work. Staff were supported in their role through regular training and supervision from the manager.

The service was working within the principles of the Mental Capacity Act 2005, but people had not had a mental capacity assessment. People were supported in making their own decisions where they could and staff involved people’s relatives and other relevant professionals where needed.

Care records and risk assessments were person centred and detailed people’s individual needs. These records were reviewed and updated regularly. People were supported to have a healthy intake of food and drink and if there were concerns around people’s healthcare needs then prompt referrals were made to the relevant healthcare professional.

Staff were caring and attentive. People were encouraged to be as independent as possible and staff communicated with people effectively at all times. People were supported to pursue their interests and could access a range of activities of their choice. Visitors were welcome at the home and visits to relative’s were facilitated.

The service was well run and people’s needs were being met. There was open and frequent communication between the management and the staff team and staff felt supported in their role. There were effective systems in place to monitor the quality of the service. Regular audits were carried out by the manager and senior management. These highlighted areas for improvement and the manager took the appropriate remedial action in response to this.

During a check to make sure that the improvements required had been made

When we inspected this service on 11 July 2013, we found that systems for monitoring and assessing the quality of the service were not effective. Monitoring had not taken place regularly and actions needed to improve things had not been followed up. People living in and working at the home had not been regularly asked for their views so their comments could be taken into account in improving it.

After the inspection we received updates showing improvements that had been made in monitoring and checking service quality. The information included details of actions the manager needed to take to improve. We were also provided with a schedule for ensuring that people using and working in the service, people's relatives and other professionals connected with it were asked for their views so that they could be taken into account in improvements.

We spoke with the manager of this service, whilst undertaking another inspection in the group. The manager was able to give us examples of improvements in people's quality of life and of positive comments made by relatives.

We concluded that actions had been taken to ensure people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We also concluded that the provider had taken account of complaints and comments to improve the service.

Inspection carried out on 11 July 2013

During a routine inspection

People living in the home all had some difficulties in communicating verbally. One person did confirm that they were comfortable. Another person was not keen on the presence of strangers and did not want to talk about care but did tell us that they had chosen how they wanted their room decorated. One person could not speak with us. We were not able to use our 'formal' tool for observing how people were being supported because they were active and mobile. For this reason we gathered information about how people were supported by looking and listening to the way staff interacted with them.

Staff made efforts by using pictures, photos and explanation to ensure that people were able to make choices and decisions as far as possible. People living in the home responded well to the permanent staff members on duty. We did raise some concerns with the manager that other staff had not engaged well with people but these were not permanent members of the staff team. We heard people laughing and saw them smiling when interacting with permanent staff and the management team.

We found from records and discussion that staff had acted promptly and assertively to ensure that one person received the treatment necessary for their health and wellbeing. This had improved the person's quality of life and health. We found that staff understood people's needs and we observed that they followed guidance in people's care plans about how they were to be supported. Staff had opportunities to discuss their work, performance and training needs so that they could support people effectively.

Medicines were managed appropriately. A suitable cabinet for medications requiring additional precautions in storage and recording had been ordered so that controlled drugs, if they were prescribed, could be stored in accordance with the law.

We found that there were shortfalls in the provider's systems for assessing and monitoring the quality of the service.

Inspection carried out on 4 April 2012

During a routine inspection

We spoke with people who live at the bungalow as well as the staff, manager and visiting operations manager during our visit to the service.

We were told by people that they were comfortable, happy and felt well supported living there.

People told us that they have lots of opportunities to go out and to invite friends to the service. One person said "We go out quite a lot, sometimes to the pub or garden centre for a meal. Another person told us, "We had a lovely barbecue on Sunday and my friends came."

Reports under our old system of regulation (including those from before CQC was created)