Archived: Care Management Group - 18 Hawthorn Crescent

• Care Management Group – 18 Hawthorn Crescent is situated in Worthing, West Sussex. The provider, Care Management Group, own services across England and Wales. The service is registered to support 4 people with learning disabilities and Autism. At the time of our inspection there were 4 younger adults living in an adapted bungalow within a residential street. The building design was the same as other homes within the residential area. There were deliberately no identifying signs such as cameras or intercoms that would indicate that it was a care home. Staff did not wear uniforms or anything that suggested that they were care staff when coming and going whilst supporting people. This complied with current best practice guidance. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

• The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways: promotion of 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.

• Sufficient staff ensured that people’s needs were met.

• People were supported to remain safe.

• Infection prevention and control were maintained.

• People were supported to maintain their health. They had access to medicines when they needed them and could access external healthcare professionals.

• Staff had the right skills and experience to meet people’s needs.

• People were actively involved in their care. Their wishes and preferences identified and respected.

• Staff were responsive to people’s needs and care was adapted to ensure people were at the centre of any decisions made.

• People told us that staff were kind, caring and compassionate.

• People were treated with respect. Their privacy and dignity was maintained.

• A person-centred culture was created by the provider and shared by all staff.

• People were supported and encouraged to develop their skills and maintain their independence.

• People chose, shopped and helped prepare food.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• Quality assurance processes ensured that the service was effective and people’s needs were met.

• One person told us, "They are very helpful. They do a lot for me. They are good and friendly and I have got a good relationship with staff."

• More information can be found within the full report.

Rating at last inspection:

• At the last inspection the service was rated as Good. (Published on 5 April 2016). At this inspection on 12 February 2019, the overall rating for the service has remained Good.

Why we inspected:

• This was a planned inspection to confirm that the service remained Good.

Follow up:

We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated as Good.

Care Management Group - 18 Hawthorn Crescent is a residential care home that provides support to a maximum of four people who have learning and physical disabilities. The home is situated in a residential area of Worthing, adjacent to another service run by the provider. The two services share a garden and minibus. At the time of this inspection there were four young adults living there.

The service did not have a registered manager in post. Although the registered manager had left, they had not yet deregistered with the Commission. A new manager had started in post at the end of October 2015 and was in the process of registering with us. 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 spoke positively about the service and the staff. They told us that they shared good times and enjoyed the company of staff. The main frustration for people was a shortage of staff which had impacted on their opportunities for leisure and social activities. One person told us, “We’re short staffed all the time, it makes me mad”. A staff member said, “You do need the right staffing level to do things” and added, “Most people are going out but there were days when they were not going out as much”. The manager was actively recruiting to fill vacancies in the staff team. Following our visit she informed us that two new staff members had been appointed.

We had concerns about how staff administered a variable dose laxative to one person and discussed this with the manager. We were informed by staff that an appointment had been made with the GP to review this medicine. Otherwise, medicines were administered safely. Risks to people’s safety had been assessed and were managed in order to maximise their independence.

People felt safe at the home and were able to speak up if they had concerns.

Prior to the appointment of the new manager, the service had been through a difficult period without clear leadership. One staff member told us, “We’ve been trying as a team to cope”. Staff told us that the new manager had already made improvements to the service. Staff had received training to carry out their roles and, since the new manager was appointed, they had received regular supervision. The manager was trying to build up the team and ensure that staff felt supported and were clear on their responsibilities.

Staff knew people well and helped them to make decisions relating to their care and support. We observed that staff took time to discuss options with people and respected their wishes. Staff understood how people’s capacity should be considered and had taken steps to ensure that their rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People were involved in deciding the menu and getting the weekly shop. Each person was supported to eat a healthy and balanced diet that reflected their individual needs. The manager had ensured that people had access to regular healthcare support such as dentist and optician visits.

People were involved in determining the support they received and worked closely with their keyworkers to make plans for future activities and goals they wished to achieve. There were regular residents’ meetings where people were able to share ideas and make suggestions. People were also involved in health and safety checks within the service. There was an open and inclusive atmosphere at the service. The manager and staff team were approachable and people told us they could speak up if they were worried.

The manager and provider had a system to monitor and review the quality of care delivered and the safety of the service. Where improvements had been identified, action plans were in place and these demonstrated that audits had been used effectively to make improvements to the quality and safety of the service.

We read in care records that every person had a personalised care and support plan that was suitable to their needs and reviewed regularly and that people were involved with these. We saw that there were regular community meetings where people's views were listened to and valued. Through observation we saw people being offered choice as to what they wanted to eat and how their room ware decorated. We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefited from a service that constantly monitored its quality of care provided.

Staff told us that they felt they had adequate training and were well supported in order to carry out their role and to meet the needs of the people in the home. We found that safeguarding training had been received by all staff and that their responsibility was well understood.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and one person told us how they had chosen how their room was decorated. Rooms we looked at were personalised.

We saw people being addressed in a respectful manner. We looked at peoples individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded. We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse.and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service