Ann Coleman Centre

The Ann Coleman Centre is a care home providing personal care and support for up to seven people who have learning disabilities, autistic spectrum conditions or additional needs. Five people were living there at the time of the inspection.

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. The building was larger than most domestic properties, which meant it did not meet current best practice guidance, but had been a well-respected part of the local community for many years.

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

People and their relatives told us they were happy with the care received at the Ann Coleman Centre. Staff were kind and caring towards people, and people appeared relaxed and comfortable.

People were protected from the risk of harm or abuse. Staff received training and had a good understanding of safeguarding procedures. Risks to people were assessed to ensure needs were safely met. Risks relating to the environment and equipment were regularly assessed to ensure these were safe.

People received their medicines safely and as prescribed. Staff received training to ensure they were competent in administering and managing medicines.

People were supported by regular staff, and there were no vacancies at the time of our inspection. The provider followed safe recruitment practices and ensured pre-employment checks were completed before new staff started working at the service. Staff were supported through induction, training, regular supervision and ongoing contact with peers and managers.

People's care and support needs were assessed before they came to the service. Care records were person-centred and gave information about individual needs and preferences. 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 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.

People were treated with dignity and respect and were able to spend time in private if they wished. People and their relatives were consulted about care needs and people were supported to be as independent as possible. People were supported to develop and maintain relationships and engage in activities they enjoyed.

Staff supported people to eat and drink enough to maintain a balanced diet which met their needs and preferences. Staff worked with other professionals to ensure people received healthcare and support which met their needs.

The service was well led by experienced and respected managers. Staff felt supported by the management team and there was a commitment to the service from the staff we met. Quality and performance were monitored, and feedback about the service was requested. Actions taken when lessons could be learned, or improvements made.

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 02 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The inspection was announced. We contacted the provider 24 hours before our visit to tell them we would be coming. We did this as we had previously been informed that one person found it upsetting when someone new came to their home. Giving staff some notice allowed them to prepare the person for our visit. This inspection was carried out by one adult social care inspector.

At our last inspection in December 2015 we rated the service overall as Good. However at that inspection we found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not regularly reviewed their policies and procedures and environmental risk assessments to ensure they were kept up to date.

Following that inspection we told the provider to send us an action plan detailing how they would ensure they met the requirements of that regulation. At this inspection we saw the provider had taken the action they had identified in their action plan. As a result improvements had been made and the service was no longer in breach of this regulation.

As a result of this inspection we have rated the service Good.

Why the service is rated good;

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

The service was based upon the individual needs of people, provided by caring staff who were well supported by the registered manager and, was continually seeking to improve. We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection.

People were safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed. Measures to prevent the spread of infection were in place.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The service complied with the requirements of the Mental Capacity Act 2005 (MCA). The physical environment was personalised and met people’s needs.

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager provided good leadership and management and was well supported by the provider. The safety and quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

Ann Coleman Centre provides personal care and accommodation for up to seven people with autism. At the time of our inspection there were five people living at the home.

A registered manager was 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.

The home ensured people were safe by having thorough and robust recruitment procedures. Staffing levels were safe and the use of agency staff was planned carefully. Risk assessments were in place to enable people to maximise their independence whilst remaining safe.

Medicines were administered safely and regular checks were undertaken. People were involved in ensuring support they needed in regards to nutrition and hydration was in place. There were effective systems to regularly monitor and test equipment to ensure it was safe for the intended use.

There was a comprehensive induction programme to support staff when they started in post. Staff received regular training.

The registered manager was aware of their responsibilities in regards to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the capacity to consent to care or treatment or need protecting from harm. Senior staff members kept clear records of the steps taken in the DoLS process. Conditions made as part of the authorisation were being met. Staff were aware how the Mental Capacity Act 2005 was relevant to their role and applied the guiding principles through choice and enablement.

Care and support was person centred. People were supported in their access to healthcare in individual ways that suited people’s needs. Records kept about people’s healthcare were clear and accurate. People and relatives spoke positively about the activities and opportunities on offer at the Ann Coleman Centre.

We observed positive relationships between people and staff. Staff knew people well and respected people’s dignity and privacy. Positive comments were made by relatives about staff’s kind and caring approach. Care records described people’s preferred method of communication.

The home was not always well-led. Policies, procedures and assessments had not always been kept up to date or reviewed when specified by the home. There were limited systems in place to gain feedback from people living or involved with the home. Regular staff meetings were arranged. This enabled staff to provide consistent care. Staff felt valued in their roles and commented about the positive support given to them by senior staff members. The current management structure was not always clear to people outside the home. A range of audit systems were in place to check the quality of care provided to people.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.

Below is a summary of what we found. This is based on our visit to the home when we met with the people who used the service and with members of the staff and management team. Not everybody who used the service was able to express their views verbally and our observations in the home helped us to make judgments about the support that people received.

Please read the full report if you want to see the evidence supporting our summary.

Is the service caring?

For much of the day during our inspection, people who used the service were outside of the home on trips. However we were able to make some observations that suggested staff and people in the home shared a positive and caring relationship. One individual was particularly anxious at the time of our visit and we saw a member of staff reassuring them in a calm and appropriate tone.

People were encouraged to be independent and to take responsibility for their own care, for example by making meals and being supported to cook meals.

People were supported with communication that was appropriate to their needs. For example, one person was using PECS (Picture Exchange Communication System).

Is the service responsive?

People were supported to access healthcare services when they required them. We saw that appointments were made with the GP when staff noted potential health concerns. People were supported to access annual health checks.

People were asked for their opinions and any concerns they had on a regular basis and these concerns were responded to. One person told us they had raised a concern about a maintenance issue in their flat. We were told that builders were being arranged to address the issue.

Is the service safe?

Staff at the home were aware of legislation relating to consent and depriving people of their liberty. This meant that people's rights were protected. For one person using the service, a DoLS (Deprivation of Liberty Safeguards) application was being made, as a result of recent changes in guidance.

Risk assessments were in place to ensure that people were cared for in a safe way. The measures that were in place to reduce the risks were clear for staff to follow.

There were certificates in place to show that the safety of the environment was monitored. For example, we viewed copies of certificates relating to fire safety and PAT testing (Portable Appliance Testing).

Is the service effective?

People had clear support plans in place and these were reviewed regularly to ensure they were up to date and reflective of people's needs.

People had identified goals that they were working towards and clear records were kept of how these goals were being achieved. Monthly key worker reports were completed for each person as a way of monitoring the care and support that people received.

Is the service well led?

At the time of our inspection there was a registered manager in place at the home. There were systems in place to monitor the quality and safety of the service. This included gathering the feedback of people in the home. A programme of audit was in place to look at specific areas of the service and this was being developed further.

During our inspection we observed people wandering freely around the home and they appeared confident and comfortable in their environment.

Care records showed that people's needs were assessed and care plans put in place to meet their individual needs.

We saw that care records were up to date and reviewed monthly. People were supported to attend medical appointments where appropriate and health records were maintained.

The home had appropriate arrangements for the management of medications. People's medications were reviewed regularly by their psychiatrist and records of these reviews were maintained by the home.

Staff received regular training in safeguarding adults. They were aware of how to raise safeguarding concerns with the management of the home and external organisations.

The home had effective recruitment procedures in place. This included pre-employment checks which ensured that people were protected from the risks of the provider employing staff who were not suitable to work in health and social care.

The home had effective systems in place to monitor the quality of the service provided.

People told us they were involved in making decisions about their care, and were supported to be independent both in the home and the local community.

We observed staff supporting people in a positive way, involving them in making decisions about what they wanted to do.

People were provided with structured activities both in the community and in the home. People told us they could choose whether they wanted to participate or not. Some of the individuals accessed the community independently.

Staff spoke about people in a person centred way, having a good understanding of the needs of the person. Care information we saw recorded in the care plans was tailored to the person.

Systems were in place to ensure people were consulted about the care and support that was in place on a monthly basis. People told us about the monthly meetings and how they were asked about the care and support they received and what they would like to do with their time. They also told us that they were asked if they had any concerns.