St Anne's Community Services - Foxview

St Annes community services- Foxview offers a nursing short break service for people living with learning disabilities, physical disabilities and autistic people this enables a mutually beneficial service for people to have a good experience and their relatives to receive a break too. Up to 16 preregistered adults aged 18 and over are registered to use the service. Up to 4 people can be accommodated at any one time. At the time of inspection 4 people were using the service. There is also crisis accommodation attached which is currently not in use. St Anne's Community Services - Foxview is part of St Anne's Community Services, a Voluntary Sector Service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People's experience of using this service

Right Support: Care plans contained sufficient detail for staff to support people to lead the lives they wanted. Staff knew people well and we observed positive interactions. Staff demonstrated a good level of understanding of people’s strengths and promoted what they could do.

Right Care: The registered manager and staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. Staff engaged with people in a respectful and compassionate manner. One relative told us, “They’re brilliant 100%, very good at their job.” Another said, “Everything [name] needs is there.”

Staff understood how to protect people from abuse. The service worked with other agencies to do so. Staff had received safeguarding training and could describe the principals of it.

Right Culture:

Feedback was sought from people, one relative told us, “I’d be comfortable to speak to the manager. We’re all very involved as a family. We don’t hesitate to speak up we are {name] advocates.

The registered manager and staff ensured the quality and safety of the service had been fully assessed to ensure people were safe. Safe recruitment practices were followed. Staff knew and understood people well. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

For more details, please see the full report which is on the CQC website at www.cqc.org.

Rating at last inspection

The last rating for this service was requires improvement (published 11th March 2019).

Why we inspected

This was a follow up inspection. We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Enforcement: At the last inspection we identified a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; staffing. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 18.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Anne's Community Services – Foxview on our website at www.cqc.org.uk.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

St Anne's Community Services – Foxview is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this 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 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 coordinated person-centred support that is appropriate and inclusive for them.

At the time of our inspection, the home had a registered manager, although they were taking a leave of absence. Covering managers from other homes operated by the same registered provider visited the home to provide support. A full time, interim home manager was due to start later in the same week we carried out this inspection.

People’s experience of using this service:

Staff had not consistently received formal support through supervision and appraisals. Some gaps were seen in training records which the management team were addressing.

Records we saw and our discussions with staff showed they felt communication from the management team could have been better. However, staff consistently said management were approachable and they felt listened to.

Audits we looked at were not always effective. For example, concerns identified by the area manager were not picked up in the medication audit. Care plan audits were not taking place, but had been scheduled to start when the interim manager took day-to-day control of the service.

Staff understanding of fire safety was satisfactory. However, staff had not experienced a fire drill in the last 12 months. The area manager told us they would address this immediately. Key building and equipment checks were carried out.

The premises appeared worn, although infection control was well managed.

The storage, administration and disposal of medicines was managed appropriately.

Our observations during this inspection confirmed staff were friendly, kind and compassionate. People were treated with respect and dignity.

Lessons were learned when things went wrong. Staff told us these learning opportunities were shared with them.

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.

There were sufficient numbers of staff to meet people’s needs. The recruitment of staff was found to be safe and checks to ensure nursing staff were safe to practice had been completed.

Care plans were extremely detailed and contained information about people’s care preferences, needs and how they communicated.

Complaints and concerns were well managed and relatives knew how to raise issues if they were dissatisfied. An annual satisfaction survey had recently been completed.

People received timely access to healthcare when they needed this support. People received adequate nutrition and hydration which supported a healthy and balanced diet.

More information is in the full report.

Rating at last inspection: This service was rated good in July 2016 (published September 2016).

Why we inspected: This was a planned inspection based on the rating awarded at the last inspection.

Enforcement: We identified a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; staffing. Please see the ‘action we have told the provider to take’ section towards the end of this report.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Fox View provides respite care for adults aged 18-65 with a learning disability and associated complex health needs. There are six places available and there are a total of 23 people who regularly use the service. There are four regular respite places and two emergency places.

The service provides personal care and support to people with physical disabilities, learning disabilities and long term health conditions. The service covers the Dewsbury area and at the time of our inspection the service was supporting three people.

The service had 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.

We spoke nursing staff and care staff who told us that the registered manager was always available and approachable. We spoke with people who used the service on the day of the inspection and their relatives.

We saw that people’s prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the registered manager and area manager about how staff were trained to administer medicines and we found that the medicines administering, recording and auditing process was safe.

From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans made good use of personal history and described individual’s care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the registered manager.

People who use the service received person centred support and their needs regarding cultural beliefs were met, respected, and valued.

Individual support plans contained personalised risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and regular contact made to other health care professionals where necessary for example with their GP.

Our conversations with people who use the service and their relatives during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.

We looked at the recruitment process and found that relevant checks on staff took place and this process was safe.

We looked at the staff training records we could see staff members were supported and able to maintain and develop their skills through training and development opportunities. Staff we spoke with confirmed they attended a range of learning opportunities. They told us they had regular supervisions with the registered manager, where they had the opportunity to discuss their care practice and identify further training needs.

People were encouraged to plan and participate in activities that were personalised and meaningful to them. People were supported to play an active role in their local community by accessing local facilities.

We saw compliments and complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed it.

We found the service had been regularly reviewed through a range of internal and external audits. We saw action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views via phone calls and surveys.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the 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. When 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. Any applications must be made to the Court of Protection. At the time of this inspection no applications had been made to the Court of Protection.

The service provided regular engagement opportunities for families, carers and people who used the service.

Peoples nutritional needs were met and people had individualised support plans to support this.

We reviewed two care records and saw each person had a care plan and risk assessment which covered their needs. Care plans included sections on areas such as: communication, nutrition incorporating religious and cultural needs, personal hygiene and community access.

We looked at the menu planning which showed people had a variety of food and could choose what to eat. The menu was clearly displayed in the dining room, including a pictorial version of the meals.

On the day of our visit we found the home was clean, tidy and odour free. We looked at six bedrooms and found they were all clean and tidy.

We saw there were cleaning schedules in place which detailed the standard of cleanliness required and the frequency of cleaning. We found that infection control audits were being undertaken, which included mattresses and deep clean of bedrooms.

We looked at all the staff training records and found evidence to show appropriate training was provided to staff. The registered manager explained that staff received annual appraisals and regular supervisions.

The area manager attended the service on a monthly basis to carry out spot checks on areas such as: nutrition, medication, fire safety, staffing, client's monies and infection control. We saw documentary evidence which confirmed this.

The staff we spoke told us that they enjoyed working at the unit. They felt that the people who used the services were treated with dignity and respect.

We saw that staff interacted well with people and people responded positively to the contact.

The care plans we looked at were developed to meet the needs of the individual and were comprehensive.