Archived: Care Management Group - 59 Bury Road

Care Management Group – 59 Bury Road is a residential care home providing accommodation and personal care to six people living with a learning disability or autistic spectrum disorder at the time of the inspection. The service can support up to six people in a large residential property.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People continued to receive safe care at 59 Bury Road. Staff understood how to provide safe care and guidance was in place for staff to follow to reduce risks to people. The service acted to safeguard people from abuse and people, staff and families were made aware of how to report any concerns. Staff were safely recruited and there were enough staff to meet people’s needs. Medication management was safe, and staff used protective equipment to protect people from the spread of infections. Incidents were used to improve care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The registered manager acted to address the assessment and review of people’s mental capacity where required during the inspection.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s needs were assessed, and these were met by staff who completed the appropriate training and received support to provide effective care. Staff used a positive behavioural approach to support people to manage behaviours that may challenge others or cause them harm. People’s healthcare and dietary needs were assessed and met. The service offered a homely environment and people’s rooms were personalised.

People were supported by kind, caring and compassionate staff. Staff understood how to support people when they were distressed or anxious and provided a thoughtful and consistent approach to supporting people at these times.

People’s communication needs were known, recorded and met. Care plans were clearly laid out and described how people preferred to receive care and this was followed in practice. People were supported to participate in activities that met their interests. A complaints procedure was in place and available to people in an accessible format. People had been supported to consider their end of life needs.

The service had experienced several staff and leadership changes over recent months. Staff told us the new registered manager had improved the culture of the service and people benefited from a more inclusive and person-centred approach. There was a system in place to monitor and improve the quality and safety of the service. We have made a recommendation for the provider to improve the implementation of the Mental Capacity Act (2005) which provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Management Group – 59 Bury Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 told us they felt safe and secure and relatives had no concerns about safety at the home. Staff understood local safeguarding procedures. They knew what action to take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. Medicines were managed safely.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. Staffing numbers were maintained at a level to meet people’s needs safely.

Staff received regular training and there were opportunities for them to study for additional qualifications. Staff were supported by the management through supervision and appraisal. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS are used when it is necessary to restrict the liberty of those without capacity to consent for their own safety. Two people living at the home who were currently subject to DoLS. We found the registered manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. People were generally able to make day to day decisions for themselves. The registered manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.

People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were communicated to staff in a variety of ways – verbally, through physical gestures or body language. Staff took time to engage with people, providing reassurance and support. People were involved in decisions about their care as much as they were able andtheir privacy and dignity was respected and promoted. Staff understood how to care for people in a sensitive way.

Care plans provided information about people in a person-centred way. People were involved as much as possible in planning their care. People’s personal histories had been recorded and their preferences, likes and dislikes were documented so that staff knew how people wished to be supported. The registered manager and staff were flexible and responsive to people's individual preferences and ensured people were supported to live the life they wanted. People were encouraged to maintain their independence and to participate in activities that interested them. There was a variety of activities and outings on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.

The service was well led. The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and could make comments and suggestions about any changes. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.

A system of audits were in place to measure and monitor the quality of the service provided and this helped to ensure care was delivered consistently. Suggestions on improvements to the service were welcomed and people’s feedback encouraged.

One person using the service told us they were 'very happy' living at the home. The relatives we spoke with told us they were 'more than happy with the care' and that their overall impression was that 'the care was very good and the staff knew what they were doing'.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

There was an effective complaints system available.

Comments from people included. 'I can go to the shops and out for meals. I go to bed when I want to. They are helping me find a new club to go to.'

For each person living in the home there was a detailed plan of care that included people's individual needs and wishes and also detailed people's physical and emotional healthcare needs.

In order to meet individual needs, the home's staff worked with a variety of healthcare professionals including learning disability teams. We were shown that advocates and specialist consultants were used where appropriate.

People were protected from risk of abuse or harm by there being safeguarding polices and procedures in place and by staff knowing how and when to use them.

We saw that there was a caring and experienced staff team and that staff were well supported and trained to undertake their roles.

People were positive about the manager and staff team and said that they were kind and supportive

There were quality audits undertaken to ensure that the home was kept under review. Records showed us that families and professionals involved in people's care were consulted. Outcomes from the last audits were positive.