11 May 2015
During a routine inspection
The inspection took place on 11 May 2015, and was an announced inspection. The provider was given 48 hours’ notice of the inspection. The previous inspection on 4 July 2013 found that there no breaches in the legal requirements.
The service is registered to provide accommodation and personal care to three people who have a learning disability. There were no vacancies at the time of the inspection. The service is a semi-detached house, which stands back a little from a busy road. It is not suitable for those with physical mobility problems. Hythe town centre and a bus stop are within easy walking distance. There is limited on street parking. Each person has a single room and there is a communal bathroom, kitchen/diner, lounge and conservatory. There is an accessible garden with a paved seating area at the back of the house.
The service does not require a registered manager as the provider manages this service and another owned by her locally. 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 2008 and associated Regulations about how the service is run. The provider was not present during the inspection as they were on leave and in their absence the deputy manager was present.
People had lived in the service for many years and were involved in the planning of their care and support. Care plans contained information about people’s wishes and preferences and used pictures and photographs to make them more meaningful. However they did not detail people’s skills in relation to tasks and what help they may require from staff, in order that their independence was fully promoted. People had regular reviews of their care and support where they were able to discuss any concerns or aspirations. Risks were assessed and people were encouraged to participate in household tasks and access the community safely.
People benefited from living in an environment and using equipment that was well maintained. People’s needs were such that they did not need any special equipment. There were records to show that equipment and the premises received regular checks and servicing. Work was on-going to maintain the environment both inside and out. People freely accessed the service and spent time where they chose.
New staff underwent an induction programme and shadowing experienced staff, until staff were competent to work on their own. Staff training included courses relevant to the needs of people supported by the service. Staff had opportunities for one to one meetings, staff meetings and appraisals, to enable them to carry out their duties effectively.
People felt safe in the service and out with staff. The service had safeguarding procedures in place and most staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns.
People had their needs met by sufficient numbers of staff. Rotas were based on people’s need and activities. People received care and support from a very small team of long standing staff. Both the provider and the deputy manager worked on rota alongside staff.
People were protected by robust recruitment procedures. Staff files contained the required information.
People were happy with the service they received. They felt staff had the right skills and experience to meet their needs. People felt staff were very kind.
People told us their consent was gained through discussions with staff. People were supported to make their own decisions and choices and these were respected by staff. Staff understood their responsibility under the Mental Capacity Act (MC) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant.
People were in very good health and supported to attend appointments and check-ups, such as doctors, dentist and opticians.
People had access to adequate food and drink. They liked the food and enjoyed their meals. People were involved in the planning and preparation of meals. Staff understood people’s likes and dislikes and dietary requirements and promoted people to eat a healthy diet.
People felt staff were very caring. People were relaxed in staff’s company and staff listened and acted on what they said. People said they were treated with dignity and respect and their privacy was respected. Staff were kind in their approach and knew people and their support needs very well.
People had a varied programme of leisure activities in place, which they had chosen to help ensure they were not socially isolated. Staff knew people well and what activities they enjoyed as individuals. One person preferred outdoor physical activities and another person preferred indoor and cosying down in front of the television watching a movie and these were accommodated.
People told us they received person centred care that was individual to them. They felt staff understood their specific needs. Most staff had worked at the service for some considerable time and had built up relationships with people and were familiar with their life stories and preferences. This continuity had resulted in the building of people’s confidence to enable them to make more choice and decision themselves. People’s individual cultural and religious needs were met.
People felt comfortable in complaining, but did not have any concerns. People had opportunities to provide feedback about the service provided both informally and formally. Feedback received had all been very positive.
People felt the service was well-led. The provider adopted an open door policy and worked alongside staff. They took action to address any concerns or issues straightaway to help ensure the service ran smoothly. Staff felt the provider motivated them and the staff team.
The provider had a philosophy, which included providing a framework to enable people to maximise their potential, provide care to a high standard and maintain people’s happiness and their dignity. Staff were very aware of these and they were followed through into practice.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.