Archived: St Anne's Community Services - Newhaven

The service is a two-storey house, on a quiet road close to Boroughbridge town centre. There are a wide range of public amenities including shops, churches and pubs nearby. At the time of our inspection there were five people using 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 so that people with learning disabilities and autism can live as ordinary a life as any citizen.

This inspection took place on 17 and 25 September 2018 and was announced. We gave 48 hours’ notice of the inspection because the location was a small care home for adults who are often out during the day, and we needed to be sure people would be in when we visited.

At our last inspection in February 2016, we rated the service ‘good’. At this inspection, 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.

The service had a registered manager. They had been the registered manager since February 2012. A registered manager is a person who has registered with the 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 registered manager also managed another of the provider’s locations and split their time between the two services. They were supported by a deputy manager and area manager.

People told us they felt safe. Staff were safely recruited and sufficient staff were deployed to meet people’s needs. Agency staff were used when necessary to maintain staffing levels and were effectively integrated into the team.

People’s medicines were managed and administered safely. The registered manager and provider had made plans to replace furniture and redecorate the service. We made a recommendation about strengthening environmental cleaning and audits.

Staff had regular training and were supported through supervisions and appraisals to provide effective care. 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. Applications had been made when necessary to deprive people of their liberty.

Staff provided safe support at mealtimes and encouraged people to have a varied and healthy diet. They helped people to attend medical appointments and consulted with healthcare professionals when needed.

Staff were kind and caring. They treated people with dignity and respect. Care plans included detailed information about how people communicated. This helped staff to share information and support people to make decisions.

Care plans were detailed and person-centred. Staff understood what was important to people and encouraged them to engage in wide range of activities pursuing their hobbies and interests. Staff promoted people’s independence. People told us they felt able to speak with staff if there was anything they were worried or concerned about. There were systems in place to manage and respond to complaints.

We received consistently positive feedback about the management of the service. Staff told us management were approachable and supportive. There was effective teamwork and a person-centred culture within the service.

The registered manager and provider had systems in place to monitor the quality and safety of the service. They effectively shared information with the staff team and took action to continually improve the service.

Further information is in the detailed findings below.

Newhaven is a care home that is registered to accommodate up to five people with learning disabilities. The home consists of a two storey detached property, located on a quiet road in the town of Boroughbridge. There are a wide range of public amenities, including shops, churches and pubs, nearby. The home has a garden to the rear and hard standing for parking to the front.

The registered provider is required to have a registered manager in post and there was a registered manager at this service who had been in post since 2012. 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.

There were robust policies and procedure in place with regard to safeguarding adults from abuse. Support workers told us who they would contact if they were concerned about abuse of people who used the service. The service had a core team of permanent support workers. These experienced support workers knew the needs of people who used the service and were employed in sufficient numbers to be able to meet people’s needs. Medicines were administered safely by the support workers and the arrangements for ordering, storage and recording were robust.

The support workers received induction, training and supervision from the registered manager and we saw they had the necessary skills and knowledge to meet people’s needs.

We found that support workers were able to communicate well with people who used the service. We saw people asking for meals, drinks and personal care and these requests were promptly responded to. Support workers were respectful and patient with individuals. All interactions we saw put the wishes and choices of people who used the service first and they were included in all conversations.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided.

Records about the people who used the service enabled the support workers to plan appropriate care, treatment and support. The information needed for this was systematically recorded and kept safe and confidential. There were clear processes in place for what should happen when people moved to another service, such as a hospital, which ensured that each person's rights were protected and that their needs were met.

The service was well managed. The registered manager monitored the quality of the service, supported the members of staff and ensured that the people who used the service, their families and the support workers were able to make suggestions and raise concerns.

Below is a summary of what we found. The summary describes what people using the service told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Risks to people's health and wellbeing were known by the staff. These risks were kept under review to help to maintain people's wellbeing.

The service had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Staff had been trained in this area to help to protect people's rights.

Systems were in place to make sure that the manager and staff learnt from events such as accidents and incidents, complaints and concerns. This helped to reduce the risk to people and ensured that the strived to service continually improve.

Is the service effective?

People's health and care needs were assessed with them or with their chosen representative. People were encouraged to live their life even if there were risks attached to this. This helped to promote people's independence. A relative we spoke with said 'X is so lucky where X is living now. We cannot fault it. The staff know X's needs very well.'

Help and advice was gained from relevant health care professionals. This helped to ensure that people received the help and support they needed to maintain their health and wellbeing. A relative we spoke with said 'If X is unwell staff get the GP.'

People were provided with a choice of nutritious food. Snacks and drinks were available to people at any time. People's special dietary needs were well known by all the staff. Health care professionals were involved in monitoring people's health and wellbeing. A member of staff said 'People can have anything to eat at any time.' This helped to ensure that people had their nutritional needs met.

Is the service caring?

People were seen to be supported by staff who appeared to be patient and kind. Staff appeared to know people's need well. Staff offered assistance and support to people in a timely way. We asked people if they felt cared for, they nodded or said 'Yes'.

We saw staff spent time with people. For example we saw a member of staff sitting and speaking with a person whilst encouraging them to eat. People living at the home looked relaxed and comfortable in the presence of the staff.

Staff understood how people used sounds and body language to communicate their needs. We saw staff understood people's individual communication methods well.

People using the service and their relatives were asked on a yearly basis to complete a satisfaction survey. Where shortfall or concerns were raised these were addressed.

Is the service responsive?

Staff were provided in enough numbers to support people to attend outings and appointments. Staff told us how they completed the staff rota to accommodate peak times of activity and events. This ensured that people had the support they needed to receive. A relative we spoke with said 'X does a lot of day time activities. We ring up and see if X is going to be there first before we come to visit.'

Information was provided to people and their relatives about how to make a complaint. Staff spent time observing people and asked people for their views. We saw that staff acted upon comments made to them to ensure they remained happy with the service they received.

Is the service well led?

The service worked well with other health care professionals to ensure that people could receive the care they needed.

Quality assurance systems were in place. The quality of the service provided was constantly being monitored by the manager of the service. Improvements were made where necessary.

Staff we spoke with were clear about their roles and responsibilities. They told us they were very happy working at the home. The ethos of the home was to maintain and improve the quality of the service provided to people so that people enjoyed their lives there. A relative we spoke with said 'The manager and staff are there for us. We get a questionnaire each year to gain our views.'

We confirmed that people were involved in making decisions about their care wherever possible. Where people did not have capacity or needed support to make decisions, appropriate arrangements had been put in place.

We found that the systems for helping people to manage their medication were safe and well organised. We looked at the systems in place to support the staff. We confirmed that that they were well supported to do their jobs. We also saw that good training was in place. This included induction mandatory and specialised training. We saw that there were regular checks in place monitor the quality of the service and that the service annually reviewed people's 'satisfaction' with the service.

Care records showed that people's needs were assessed and had been reviewed recently. The records also showed that people had access to relevant health professionals, such as their doctor or dentist. However, the service could record information about capacity and consent better, to ensure that people's legal rights are upheld. We found that staff had been trained on administering medication and that this was done safely.

Staff knew people well and could describe their needs. Staff also said that they were well supported by their manager and provided with relevant training. Comments made by staff included 'she's the best manager we've ever had in this house' and 'the support we get from the manager and deputy is fantastic'.

We found that the provider could make some minor improvements to the premises, to make the home a more homely and pleasant place for people to live. For example, by redecorating, replacing floor coverings and improving cleanliness in some areas.