The Care Quality Commission
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Archived: Care Management Group - 29 Bushey Hall Road

Overall: Good read more about inspection ratings

29 Bushey Hall Road, Bushey, Hertfordshire, WD23 2EE (01923) 630385

Provided and run by:
Care Management Group Limited

Important: The provider of this service changed. See new profile

All Inspections

18 December 2017

During a routine inspection

This inspection took place on 18 December 2017 and 17 January 2018 and was unannounced on the first day.

Care Management Group – 29 Bushey Hall Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Care Management Group – 29 Bushey Hall Road accommodates a maximum of 5 people in one adapted building. On the day of our inspection, there were four people living at the service.

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.” Registering the Right Support CQC policy

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.

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At this inspection we found the service remained Good.

The service has a registered manager. 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. On the first day of our inspection the registered manager was unavailable to participate in the inspection process because they were on annual leave. The deputy manager was however overseeing the service in their absence. We returned on the second day of inspection to meet with the registered manager and gain access to the records we had been unable to access on the first day.

Why the service is rated Good

People were safeguarded from the risk of harm. There were effective safeguarding procedures in place and staff had received safeguarding training.

Risks associated with people’s care and support had been identified and personalised risk

assessments were in place. The assessments gave clear guidance to staff on how individual risks to people could be minimised.

People received their medicines safely. There were effective systems in place for the safe storage and management of medicine and regular audits were completed.

There were sufficient numbers of staff deployed to meet people's needs. Safe recruitment practice were followed.

Staff received regular supervisions and appraisals and felt supported in their roles. An induction was completed by staff when they commenced work at the service followed by an ongoing programme of training. Staff were positive about the training they received.

Decisions made on behalf of people were in line with the principles of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Consent was gained from people before any care or support was provided.

People appeared comfortable and relaxed in the presence of staff. Staff were positive about their work and the support provided. People were treated with dignity and respect.

People received care and support which was personalised. Care plans and risk assessments gave clear guidance to staff and had been regularly reviewed and updated.

There was an effective complaints procedure. Staff were responsive to people and were able to identify when people may be unhappy. Relatives were aware of the complaints procedure and knew who they could raise concerns with.

The service had an open culture and staff were positive about the support they received from the registered manager and colleagues. Team meetings were frequently held and staff members were actively involved.

Quality monitoring systems and processes were used effectively to drive improvements in the service and identify where action needed to be taken. A satisfaction survey had recently been commenced and feedback on the service was encouraged.

Further information is in the detailed findings below

1 and 5 December 2015

During a routine inspection

The service at 29 Bushey Hall road is a large house which is home to five people with learning disabilities and complex needs. These high needs mainly relate to their learning disability.

The inspection was carried out on 1 and 5 December 2015 and was unannounced. At the previous inspection in November 2013 the provider was found to be meeting all the standards we tested.

There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We observed that people received personalised support. People had limited verbal communication due to their complex needs so were not able to tell us about their experience of living at the home. We used the short observation for inspection (SOFI) to help us assess people’s experiences. Staff were aware of people’s needs and abilities and support was tailored around individual’s needs to maximise their potential. Staff spoke about people they supported at the service in a way that was sensitive and caring. We found the registered manager and staff to be open and transparent in their approach to all aspects of the service.

People’s needs were met by adequate staff on duty at all times. People were supported in a timely way and we saw that rotas were flexible.

There were appropriate recruitment processes in place which helped to ensure that people who were employed were appropriate to work with people who lived in the home. The staff were passionate about their work at the home and treated people in a way that respected them as individuals as well as their privacy and dignity. Staff worked at a pace that suited people and did not rush them.

There were processes in place to manage safeguarding incidents. These were appropriately reported and investigated and where appropriate had also been reported to CQC by the provider. There were quality monitoring audits that were in place. We saw that accidents and incident were recorded and reviewed to avoid reoccurrences of incidents.

There was a complaints process and staff told us that people were supported to make a complaint or to raise a concern as necessary. We saw that the complaints process was available in an easy read format supported with pictorials to enable people to understand the process.

Staff demonstrated they were clear about their roles and responsibilities and received support from the manager and staff also supported each other. Staff had received training relevant to their roles and had regular supervisions with their line manager. Staff were supported and given opportunities to develop their skills and undertake specialist training relevant to the needs of people who lived at the home.

People were offered a choice of healthy and nutritious meals and snacks and were supported to help themselves to drinks whenever they wanted them. People were encouraged to help staff in the kitchen. People were supported to maintain good health and staff accompanied them to attend appointments at the GP, opticians or other health related appointments.

People were supported at participate in personalised activity programmes, both in the home and in the local area. Activities were developed around the abilities and interests of people who lived at the home to maximise people’s potential.

People had detailed and individualised care and support plans and these were regularly reviewed and updated to make sure they remained current. We saw that there were a range of risk assessments in place which were reviewed whenever there was a change to people’s abilities. People’s support plans ensured staff had all the guidance and information they needed to provide individualised care and support. The same was evident with risk assessments.

There were systems in place to monitor the quality of the service. The provider had obtained feedback from all stakeholders. This was used to enable the manager and staff to identify where improvement were required and to support continual improvements. The manager and staff worked well as a team with common objectives to improve the care experience for people who lived at the home.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS)

We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that most people living at the service were able to make their own decisions and those who were unable had their capacity assessed. The manager and staff understood their roles in relation to DoLS.

13 November 2013

During an inspection looking at part of the service

On our previous inspection visit we found that the provider was not compliant with regulations 9, 10 and 13 of the Health and Social Care Act 2008. During our follow-up inspection, we found the provider was now compliant with those regulations.

We saw that the home had introduced a new style support plan, which contained information on how to support people. We saw that risk assessments had been reviewed. The home had a medication folder which contained information on people's medication and allergies. We saw that there was a system in place to deal with medication that was no longer required. We saw that weekly fire safety checks had been undertaken; however we found that weekly checks on the first aid box had not always been undertaken.

12 September 2013

During a routine inspection

People we spoke with told us that they liked their home and that staff were kind to them. A person we spoke with also told us that the home always had nice food and they were assisted to participate in community activities.

Support plans contained information on people's likes and dislikes, activities and the support they needed. However, we noted that changes to people's support plans following reviews were not always updated in the support plans file. We also noted that risk assessments which were held within the support plans did not show evidence that they had been reviewed.

We looked at two medication audits and found that part of the information recorded was not correct. The home did not have a system in place to ensure that un-used medication was returned to the dispensing pharmacy.

Staff we spoke with all stated that they were happy working at the home and that they were supported by their management team. However, we noted that staff were not always aware of key documents relating to people who used the service.

The home had undertaken some health and safety checks; however, this was not always done in a timely manner to ensure that people were residing in a safe environment.

20 December 2012

During a routine inspection

We saw a small house with five people who had complex needs relating to their learning disability. We were told by relatives that they were pleased with the service. Relatives felt that "There was a lot of group activity" and another spoke of "An energetic can do attitude". One relative said that "They have now got my happy brother back'.

We observed a staff group who were committed to the provision of care for the group of people with complex needs. We saw that the manager was developing the skills and confidence of the staff group. We noted that additional staff will be in post in the next four weeks. The people who lived at the house responded positively to the staff and responded to their involvement. Some concerns were raised about the living environment and the need for this matter to be resolved.

6 March 2012

During a routine inspection

A relative of a person living at 29 Bushey Hall Road told us that the people using the service were encouraged to make choices and that they enjoyed activities that were tailored for their particular needs such as horse riding, going to the pub and getting on the bus.

A care manager from the local authority with whom we spoke said that the service had done a very good job in supporting people with extremely complex needs. We were told of a person who had thrived as a result of moving into 29 Bushey Hall Road and that the service had helped that person beyond the expectations of their family and the care management team.

A relative of a person using the service said that they were confident in the service's ability to keep their relative safe and that the finances of people living there were managed well and securely and that relatives were consulted about and involved in decisions about all major purchases.

A staff member told us that the provider ensured that the staff team had the necessary skills for the job. They said the manager ensured that the staff team were competent to deal with all aspects of the care of people living there.

Staff told us they were highly motivated to work in this field and were confident of the level of support they received from the manager and the organisation to meet the challenges of the role.