Archived: Larch Road

Larch Road cares for people with a learning disability and is registered for 8 people. On the day of our inspection there were 7 people living there. The registered manager had retired in February 2016 and had not yet been replaced. However, the provider had put interim management arrangements in place and the service was being managed by an interim manager with support from a registered manager from the wider organisation, until a new registered manager was appointed. 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 cared for by qualified staff who understood their responsibilities to keep people safe from harm. There were risk assessments in place which were reviewed regularly and helped ensure people were protected from identified risks. There were sufficient numbers of trained staff on duty to meet the needs of people using the service. Staff who administered medicines were suitably trained and their competency checked, to ensure they had the knowledge and skills to manage medicines safely.

Staff received appropriate training for their job role and had frequent supervisions and appraisals with the managers. Training was arranged in response to the particular needs of people using the service and ensured that staff had the knowledge and skills to fulfil their responsibilities to people. Staff gained consent from people before starting care and explained what they were doing in ways that people understood. People were involved in planning their meals, which included shopping and preparing meals or setting tables. People were supported to access community healthcare services to manage their overall health.

People were cared for by caring and compassionate staff who enjoyed their work. Staff spent time getting to know people and their personal characteristics. They developed positive and supportive relationships with people, whilst promoting independence and dignity. People contributed to their care plans and made decisions about their daily activities and meals.

There was an open and inclusive culture within the organisation where staff and people felt supported and heard. The provider and wider organisation were going through a period of transition and there was an element of uncertainty for some staff regarding their future roles. However, staff continued to provide good quality care and support for people using the service.

We last inspected this service on 28 October 2013. At that time we found that the walk in shower in bungalow three had black mould on the ceiling. The shower area did not have external ventilation. The mould presented a potential risk to someone with respiratory problems. At this inspection we found that the mould had gone and the ceiling had been re-decorated. A summary of what we found is set out below.

Is the service safe?

Care staff we spoke with understood the systems in place to protect people who received care from abuse or neglect. Some care staff told us they had witnessed poor care in previous care roles and based on their experience would not hesitate to raise any concerns.

There were two Deprivation of Liberty Safeguards (DoLS) in place. The Deprivation of Liberty Safeguards are a legal framework designed to ensure that the care people receive does not unlawfully deprive someone of their liberty.

The service had policies in place for managing medicines safely. Care staff followed these and they were audited and checked.

Is the service effective?

People's needs were assessed and care plans were reviewed monthly. Care staff reviewed the support provided and identified if any changes to care plans were needed. Risk assessments had been carried out and were reviewed regularly. Care was adjusted if a person's condition meant they required more support.

Care staff had the appropriate training and experience to enable them to carry out their role effectively. Care staff told us they received regular supervision and appraisal. Care staff training was up to date.

Is the service caring?

We spoke with three people who used the service. They said care staff treated them well. One person said, 'Some people need more support than me. I am patient and wait until they can help me. They don't forget and support me as soon as they can'. Another person said, 'Staff are always nice. They have never been unpleasant.'

We observed care staff providing support for people. We saw they had a good rapport with people. Care staff we spoke with told us ensuring people were fulfilled was important to them.

Is the service responsive?

Care staff told us they discussed the care provided every month with the person using the service. We saw the records of those discussions which described what activities were planned for people over the next few weeks. We also saw care staff had organised visits to the dentist, GP, optician and chiropodist.

Is the service well-led?

Care staff told us they felt able to raise issues with their manager. They said they were confident the manager would deal effectively with any issues which arose.

The manager carried out checks and audited processes, for example the management of medicines. When an error occurred they analysed the causes, and put actions into place to reduce the risk of a similar error occurring. If an error occurred staff received additional training and their competency was reviewed.

We spoke with two people about their experiences of living at Larch Road. The first person said: 'I like living here, the staff are very good, and I've got a lovely room. I think the staff work hard and do a good job of looking after me. I would soon tell them if I thought they weren't.' The second person also said they liked living at Larch Road. They said: 'I've got a nice bungalow, and we go out a lot. The staff are very nice, I'm very happy here.'

We saw that both people were very relaxed in the home, and there were no restrictions on their movements or activities.

Two staff we spoke with said they were really happy working at Larch Road. One said: 'The residents are lovely, and it's a lovely place to work.'

We found that people received care and support that protected their rights and met their needs from staff that were properly trained and supported.

We did identify a problem with mould in the shower room, in one bungalow and this together with an accumulation of household rubbish in the garden does require the provider's attention.

People told us they liked using the service. They told us staff were 'ever so good' and they told us about the activities, including holidays, that they were involved in. Our observation showed us that people enjoyed warm relationships with staff and that the atmosphere was relaxed and friendly.