Archived: Care Management Group - 72-74 Walsingham Road

The service had a registered manager. A registered manager is a person who has registered with the CQC 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.

There were concerns over how the provider responded to maintenance issues of some areas of the service, compromising safety and infection control measures. We identified this as an area that required further improvement.

People at the service told us that they felt safe. One person said, “I feel very safe, like when I take a shower and they support me not to slip in the shower, but I’m independent.” There were safeguarding policies and procedures in place that were followed and staff were fully aware of their responsibilities in reporting safeguarding incidents. The provider had a whistleblowing policy in place and staff told us they knew how to use it if they needed to.

People’s needs were assessed and their support plans provided staff with guidance about how they wanted their individual needs to be met. Plans we looked at placed the person at the centre of all planning and contained the necessary risk assessments to keep people safe. They were regularly reviewed and amended to ensure they reflected people’s changing support needs.

Essential training was up to date for all staff. Staff had received training specific to people’s support needs, including specific health conditions. People told us they felt the staff were well trained and able to meet their needs. A healthcare professional commented “Staff are well trained, the provider has a clear commitment to training and there is a good level of knowledge about the people”.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and how DoLS is assessed and authorised in other settings such as supported living or people’s own homes. The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had received training on Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Support plans showed that people’s capacity was taken into account and how this affected the support they received.

People had access to GPs and other health care professionals. Prompt referrals were made to health care professionals. One person told us, “I see my doctor when I need to.” We sought feedback from health care professionals. They were positive about the service and staff responsiveness, one health care professional said, “Staff are welcoming and receptive to any feedback.”

People were encouraged to be as independent as possible. People were able to participate in activities of their choice. People were encouraged to take responsibility for their activities of daily living. For example, some people did their own laundry and cooking. One person told us, “I like living here because I do lots of things: cooking, shopping, trips, church, seaside.”

People were supported to remain in regular contact with families and friends. There was open communication between family members and the service. The provider had carried out quality assurance surveys with relatives.

There was an easy read complaints procedure in place. People and their relatives told us they knew how to complain and were confident in doing so.

The provider had systems and processes in place to audit and monitor the quality of the service. Issues identified for development were recorded and an action plan put in place.

Staff were positive about the registered manager and the support they provided. The registered manager responded to staff suggestions and requests. A member of staff said, “[The registered and deputy manager] are very approachable. I’m happy to talk with them or can call them if I need to.”

On the day of the inspection we were informed that the registered manager had left the service and a new manager had been appointed who had not yet registered with the Care Quality Commission for this location. The new manager had only been in post at 72-74 Walsingham Road for two days on the day of our inspection.

Below is a summary of what we found. The summary describes what people using the service, their relatives, visitors and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

Support was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw support plans that were sufficiently detailed to allow staff to deliver safe and positive support. People told us that they were happy with the support that they received. A person who used the service said, 'I am happy that [a named support worker] is there for me.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

There were effective safeguarding procedures in use. Potential risks had been identified and there were procedures in place to reduce the risk of any harm occurring to people who used the service.

Is it effective?

Support plans were current, comprehensive and reflected the needs of the service user and were signed by the service user, where appropriate. This allowed for staff to provide support that was personalised and appropriate to that person.

The people who used the service and the relative we spoke with confirmed there had been plenty of good quality food and drink all through the day. A relative of a person who used the service told us 'I have nothing but praise for the staff. They have helped [my relative] to do new things, including try new food. They have a special diet and they are well looked after in every respect.'

We saw that there were systems in place to support staff. A member of staff said, 'If I have a problem I feel I can approach the new manager and I am looking forward to working with her. The deputy [manager] has listened when I have found things frustrating.'

Is it caring?

Staff spoke with knowledge and warmth for the people they supported. People were supported by committed and respectful staff. Observations of support found that people were empowered to maintain their existing skills and talents and were set new goals.

It is responsive?

People told us that they felt happy and confident approaching staff with any concerns. A relative of a person who used the service said,' I always feel that I am able to communicate with staff and am listened to.'

Is it well-led?

A new manager had just been appointed to start work at 72-74 Walsingham Road. They displayed appropriate insight to the challenge of providing effective leadership to regularly assess and monitor the quality of service that people received.

The people we spoke with told us they were happy with the care they received and with the staff. A person who used the service told us "It's alright here. I'm happy here, I like my room". Staff we spoke with had a good understanding of the support needs of the people who used the service. A care worker told us "It's the most rewarding work I've ever done. I'm happy with the care we provide".

We saw that the service had systems in place to gain and review consent to care and treatment from people who used the service. The overall appearance of the service was clean and we saw that they had appropriate systems and policies in place in regard to cleanliness and infection control.

The provider had taken steps to provide care in an environment that is suitably designed and adequately maintained.

We looked at staffing rotas and during our visit observed levels of staffing. We saw that the service had sufficient numbers of staff to support people. We also saw that care plans, staff records and other records relevant to the management of the home were accurate and fit for purpose.

One person who used the service said 'we are all involved in planning the meals we have, the food is good. They also told us that staff listen to what they want and help us to do it, "I went to change my library book with staff today."

People's needs were assessed and care plans reflected their individual needs. People had communication passports that identified how they like to communicate such as pictures and symbols.

Staff we spoke to told us that they received regular supervision, one person said "The senior staff are approachable and very supportive. We saw that staff received regular training and updates.

We saw the provider carries out monthly audits on care plans, risk assessment, medication, accidents, incidents, compliments and complaints, fire safety and maintenance. They had taken appropriate action to address any concerns and identify areas of good practice.

We saw that there were outstanding significant repairs and maintenance issues. The provider told us that these were all being addressed within the next 3 months and provided a schedule that had been prepared by the maintenance manager..