St Anne's Community Services - Dewsbury 1

St Anne's Community Services - Dewsbury 1 (known to staff, people who used the service and their relatives, as Oxford Road) is a care home. The home provides support and personal care for up to five adults with a learning disability. On both days of our inspection, there were five people living in the home.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

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.

Right Support: 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. People were empowered have control of their daily living as staff gave them choices and where needed, supported them to make decisions. Staff knew people’s likes and preferences.

Right Care: The care provided by staff was person-centred and put people and their families at the centre of their care planning. The interactions between people and staff were entirely natural and gave the service a ‘family feel’. People were relaxed in each other’s company. Staff consistently knocked on people’s doors before entering their bedrooms, which respected their privacy and dignity. People’s protected rights were understood and met by the staff team who showed a strong insight into their care and support needs.

Right Culture: The management team developed a stable workforce which made for a positive culture. Staff felt supported through a programme of induction, training and regular supervision meetings. They felt able to discuss their own wellbeing as well as talking about the needs of people living in this home. Effective systems of governance meant the provider had oversight of the running of the home. People and their families provided positive feedback to us about the quality of care provided.

The management team responded appropriately to a misunderstanding regarding current infection control guidance. The home was found to be clean. People received their medicines as prescribed. We identified some recording issues which the management team responded to immediately. Staff received training in medicines management and were assessed as competent to administer.

There were sufficient numbers of safely recruited staff to care and support people. Risks to people were known and had been managed appropriately. People were supported to maintain a healthy and balanced diet and staff understood their dietary needs. Staff understood how to identify and respond to signs of ill health in people living at this service. Examples of staff working with a range of partners, including those specialising in healthcare, was seen throughout this inspection.

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 rated good (published 23 December 2017).

At our last inspection we recommended the provider followed good practice where people may lack mental capacity. At this inspection, we found this recording had improved as mental capacity assessments and best interests decisions were in place.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

St Anne's Community Services - Dewsbury 1 (known to staff, people who used the service and their relatives, as Oxford Road) 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 home provides support and personal care for up to five adult’s aged18 upwards with a learning disability. The service is on the outskirts of Dewsbury town centre, which is easily accessible by public transport. On the day of our inspection there were five people living in the home.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the time of this inspection the service had a registered manager. 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.

People told us they felt safe. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Robust emergency plans were in place in the event of a fire or the need to evacuate the building.

A system was on place to ensure medicines were managed in a safe way for people.

Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse.

Sufficient staff were on duty to provide a good level of interaction and safe recruitment and selection processes were in place.

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 home supported this practice; mental capacity had been assessed when some decisions needed to be made, however, some best interest processes had not been evidenced. We made a recommendation about good practice where people may lack mental capacity to consent to certain decisions.

Staff told us they felt supported. Records showed they had received an induction, role specific training and regular supervision and appraisal. This meant staff were supported to fulfil their role effectively.

People told us they enjoyed their meals. People’s nutritional needs were met and they had access to a range of health professionals to maintain their health and well-being.

The service worked in partnership with community professionals and used good practice guidance to ensure staff had the information they needed to provide good quality care.

Staff were caring and supported people in a way that maintained their dignity, privacy and diverse needs. People told us staff were caring and we observed staff interacting with people in a caring, respectful manner. Observation of the staff showed they knew people well and could anticipate their needs.

People were supported to be as independent as possible throughout their daily lives.

People were involved in arranging their care and support and staff facilitated this on a daily basis. Individual needs were assessed and met through the development of detailed personalised care plans which considered people’s equality and diversity needs and preferences.

People had access to social and leisure activities in line with their preferences and interests, so people were supported to live fulfilling lives.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

The registered provider had an effective system of governance in place and they had taken action to improve the quality and safety of the home. Everyone at the home knew their roles and welcomed feedback on how to improve the service.

The home was welcoming and comfortable and people told us they were happy. The registered manager had an overview of the service and knew people’s needs well. Relatives and staff were positive about their input.

People who used the service and their relatives were asked for their views about the service and these were acted on.

St Anne’s Community Services, Dewsbury 1 is registered to provide accommodation and personal care for up to five people aged 18 and over with a learning disability. Accommodation is provided over two floors with a lounge and dining room with seating areas and people can choose to spend their time in one of the communal areas or in their own room. The service is situated in attractive grounds and is on the outskirts of Dewsbury town centre, which is easily accessible by public transport.

The service had a registered manager in post. 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 registered manager was on holiday during this inspection and the service deputy manager supported us throughout the inspection.

We found that there was a quality assurance system in place, but this had not highlighted the concerns we found during the inspection with risk assessing, care planning and risks associated with the home environment. This was a breach of Regulation 17 (2) (a) (b) (e) 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 the full version of the report.

The registered provider had a system in place for ordering, administering and disposing of medicines and this helped to ensure that people received their medicines as prescribed. However, some improvements were needed in the way that medicines were stored and recorded.

There was a system in place to complete individual risk assessments for people who used the service although we found these had not always been implemented in response to their needs.

We found staff were recruited safely and were employed in sufficient numbers to meet people’s needs. Staff had access to induction, training, supervision and performance development reviews (PDR) which supported them to feel skilled and confident when providing care to people.

We found there were policies and procedures in place to guide staff in how to safeguard people who used the service from harm and abuse. Staff received safeguarding training and knew how to protect people from abuse.

People told us they were very happy with the food provided. We observed people’s individual food and drink requirements were met and people were supported to access healthcare professionals where necessary.

Staff understood and were working within the principles of the Mental Capacity Act 2005.

Staff were observed to be, and described by people using the service as, kind and caring. We observed that staff had developed meaningful caring relationships with the people they supported.

People told us that staff listened to them and treated them with dignity and respect.

People’s needs were assessed and their care plans set out how these should be met. Plans reflected people’s preferences and focussed on giving people as much independence as possible. Staff were knowledgeable about people’s support needs and their interests and this enabled them to provide a personalised service.

People who used the service were supported where necessary to undertake a variety of activities within the local community.

People told us they knew how to express concerns or make a complaint, and they were confident their concerns would be listened to. There was a process in place to manage complaints that were received by the service.

We received positive feedback about the registered manager and the service provided.

We saw that the menu planning showed choice and variety were offered to people. We saw people had unrestricted access to the kitchen and could help themselves to drinks and food, including fruit, throughout the day.

We observed that the home was clean and did not have any unpleasant odours. We saw there were cleaning schedules in place which detailed the standard of cleanliness required and the frequency of cleaning.

We looked at three staff files and found evidence to show appropriate training was provided to staff. The staff we spoke with told us they received regular training and said they could ask for further training if they felt this was needed.

The provider had systems in place to identify, analyse and review risks or incidents. Information about quality and safety was gathered and monitored to identify risks and areas for improvement.

The people who used the service told us that they found the staff treated them well. We saw the staff in the home treated people with respect and dignity. The staff were respectful of peoples rights to choose and were keen to ensure that all people in the home were given options in what activities they chose and how they wanted to be supported.

We found that staff in the home involved people as much as possible in care planning and although this was well documented it was not clear from one of the plans whether anything had been done to meet all of the needs of the people using the service.

The staff we spoke to told us that they felt that the personal care of people using the service was increasing, especially around mobility. The provider may want to start addressing this issue as the people living in the home are getting older and their physical and personal care needs will start to increase.