Archived: Care Management Group - 179 Green Lane

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in July 2016 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.

There was a registered manager in post at the time of our inspection. 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 supported safely, with dignity and respect by caring staff who understood their needs, including behaviours which challenged the service. People had ‘positive behaviour support guidance’ in place for staff to follow in helping them manage behaviours which challenged which were personalised. Risks relating to people’s care were carefully managed by staff. Staff knew the best ways to communicate with people and people were supported as far as possible to develop their independent living skills. People received care in purpose built, clean premises which were well maintained and met their needs well.

People took part in activities based on their interests and had structured activity programmes in place. People were supported to maintain relationships with people who were important to them to reduce social isolation.

The provider had robust recruitment procedures in place for new staff. People were supported by the right numbers of staff to keep them safe and to respond to their needs. Staff were well trained and supported in their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People chose their own meals and staff considered people’s cultural needs. Staff supported people to maintain their health and see healthcare professionals as required. People’s medicines were safely managed and administered.

People and relatives were involved in care planning and staff followed people’s care plans to meet their needs. Care plans reflected people’s physical, mental, emotional and social needs, their personal history, preferences, interests and aspirations. The service had begun to engage people and relatives in end of life care planning as part of a programme run by the local hospice.

The service was well led by a registered manager staff who understood their role and responsibilities well.

The provider had good governance systems in place to audit and improve the service with frequent checks of the service in line with CQC standards. Systems were in place for the provider to communicate and gather feedback from people, relatives and staff. The provider investigated and responded to concerns and complaints appropriately.

179, Green Lane is a residential care home which provides accommodation, care and support for up to five females with a range of needs including mental health and learning disabilities. At the time of this inspection there were five people living in this home.

There was a registered manager employed at the service. 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. We met with the registered manager and the service manager.

People and their relatives told us they received safe care and support from staff who they said they were happy with. Staff received training to recognise the signs of, and to help protect people from abuse and they knew what actions to take if any concerns arose.

There were appropriate numbers of staff to support and care for people. They knew all the people well and had a comprehensive knowledge and understanding of their personal needs, likes and dislikes. Staff recruitment processes were robust and this helped to ensure staff working in this home were appropriate and safe to do so.

Risks for people and for staff were assessed and risk management plans were incorporated into care plans that were discussed and agreed with people and their relatives.

We found the home’s procedures for administering medicines to people were satisfactory. All the people needed assistance with their medicines and we found that staff were properly trained to do so.

All staff received training to increase their skills and knowledge of their work with people. Commissioners said they felt staff were well trained and we found people were supported by staff who were regularly supervised.

The registered manager and staff had a good understanding of people’s capacity to make decisions about their care and documented this in people’s care files. We saw appropriate applications were made for people to the local authority for assessments under the Mental Capacity Act 2005 and for Deprivation of their Liberties where it was necessary. We noted that acting in people’s best interests was a priority for staff and the registered manager. People's care needs were recorded and reviewed regularly with staff and other relevant people such as relatives and social workers. Staff had appropriate information in people’s care plans to deliver care the way people preferred.

Our inspection of people’s care files indicated they had regular and appropriate access to all the relevant health care professionals such as GPs and hospitals. Staff told us it was important for people to maintain good health and they said being seen by appropriate health care professionals as necessary was a good way of ensuring people received the support they needed.

All the relatives we spoke with told us staff who supported their family members were caring and friendly. They told us staff respected people’s privacy and dignity and said staff listened to people. This helped people to feel they mattered. Relatives of people told us they were able to contribute to the care planning and decision process about how they wanted their care and support to be provided for people. All the care plans we looked at were personalised and contained information that assisted staff to provide care in a way that respected people’s wishes.

The home had a complaints policy and procedure that relatives of people knew about. They told us they were happy with the service offered to their family members. Relatives and staff said they felt confident they could raise concerns with the registered manager and staff. We reviewed the home’s complaints records and we saw the provider responded to concerns and complaints and learnt from the issues raised.

There were systems in place to monitor the care provided and people's views and opinions were sought regularly. Suggestions for change were listened to and actions taken to improve the service provided.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Was the service safe?

People who use the services were treated with respect and dignity by the staff. They told us they felt safe. One person said, "This is my home, yes of course I feel safe here. I wouldn't want to live anywhere else".

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Three applications had been submitted appropriately. Staff had been trained to understand when an application should be made and the process for submitting an application. This meant that people were safeguarded as required.

Recruitment practice was safe and thorough. The registered manager ensured there were sufficient staff on duty who were appropriately qualified to meet the care needs of the people who used the services. This has helped to ensure that people's needs were met.

Was the service effective?

People who use the services health and care needs were assessed with them, and they were involved in their care and support planning. People told us that they had been involved in their care and support plans and that the plans reflected their needs. We inspected three people's care files. They included essential information about the person, needs and risk assessment information, service delivery plans or support plans, records of health care appointments, a health action plan as well as records of keyworker meetings.

Staff received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Was the service caring?

People who use the services were supported by kind and attentive staff. We saw that support workers showed patience and professionalism and gave appropriate encouragement when supporting the people who use the services. The three people we talked to said the staff treated them well and respected their privacy. One person said "This is my home, I love it here, the staff are lovely, they are very kind to me", and another person told us "I like the staff here, they are kind and the manager is the best'.

People who use the services told us they attended regular house meetings where they were able to discuss relevant issues and make decisions about what they wanted to do. We saw the minutes of these meetings that showed the wishes and preferences of people were obtained and taken into account. This reflected the caring environment that we found on the day of the inspection.

Was the service responsive?

People who use the services met regularly and monthly with their keyworker to review their care and support. This was important as this helped staff understand what people wanted or needed or how they were feeling.

All the people who use the services we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

We saw that the service worked well with other agencies and services to make sure that people were supported in a co-ordinated way. It was clear that the main objective was to support people in relation to maintaining and developing their independence.

The manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to by the manager. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home. This helped to ensure that people received a good quality service.

We spoke with two families of people using the service about their care and welfare. They told us they were very satisfied with the service provided. One relative said ''Things weren't good where she was before. She has made huge improvement. We are very pleased and have not had to worry.'' We saw that people's care needs had been assessed and people had been involved in the process. For example peoples likes and dislikes had been documented. Another relative said ''She (the person using the service) has her moments but doesn't go short of anything.''

Medicines were observed to be handled safely and securely by people with the appropriate knowledge and qualifications. Medicines prescribed were written clearly in the medicine record ensuring the risk of medicine errors was minimised. We saw that all aspects of medicine management had been independently audited to ensure any risks were identified and minimised.

We were able to see that sufficient numbers of staff who knew the needs of the people using the service were available meaning that people could receive consistent care from staff they had formed a rapport with.

Records of all aspects of the service were stored securely and were well maintained.