Background to this inspection
Updated
25 August 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 22 July 2016 and was announced. We gave 24 hours’ notice of the inspection to ensure it was safe for us to visit while the final building ‘snagging’ work was being completed. It was carried out by one inspector.
Before the inspection we reviewed the information we held about the service. This included previous inspection reports, statutory notifications (issues providers are legally required to notify us about), and other enquiries received from or about the service. The service was last inspected on 13 March 2015. At that time, we found the service was not consistently safe, effective, or well led. Improvements were required in each of these areas.
During the inspection we were unable to have conversations with the people who lived at the location due to their speech and learning difficulties. We relied on our observations of care and our conversations with people’s relatives and the staff to help us understand people’s experiences of the service.
During the inspection we spoke with the registered manager, assistant team manager, and four support workers. We also looked at records relating to people’s individual care and the running of the home. These included three care plans, staff training records, medication records, complaints and incident files. Following the inspection, we telephoned three people’s relatives to obtain their views on the service.
Updated
25 August 2016
This inspection took place on 22 July 2016 and was announced. We gave 24 hours’ notice of the inspection to ensure it was safe for us to visit while the final redevelopment building work was being completed. It also ensured the service’s registered manager would be available to meet us.
At the last inspection on 13 March 2015 we found the service was not consistently safe, effective, or well led. Improvements were required in each of these areas. The shortcomings were primarily due to delays in starting the planned major site redevelopment work. At this inspection, the required actions had been taken to address our previous concerns. The redevelopment work was virtually complete and new systems had been introduced to ensure people received their medicines safely.
Relatives said the recent accommodation moves had gone better than they had anticipated. One person’s relative said “They built up their confidence and anticipate things before they happen. They don’t just chuck them in at the deep end”. Another relative said “I’m very happy where [person’s name] is. They’ve improved a lot since moving into their new place”.
The service is registered to provide accommodation and support for up to eight adults with a learning disability or autistic spectrum condition. The redevelopment of the site has reduced the capacity to a maximum of six people, accommodated in five self-contained flats (with two people sharing one of the large flats). On completion of the redevelopment the provider will apply to change their registration accordingly.
People who lived at the location needed one to one staff support at all times. Three of the people with more complex needs also required two to one staff support when going out into the local community. At the time of the inspection there were six people living at the location with complex support and communication needs. People had very limited or no verbal communication skills and required staff support with all of their personal care needs and to go out into the community.
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.
The registered manager told us the service philosophy was “To support each person to meet their individual needs and enable them to lead as full a life as possible”. Staff received training tailored to the personal needs of the people living at the location to ensure they were able to deliver the philosophy of care. This was further reinforced through staff meetings, shift handovers and one to one staff supervision sessions. There were sufficient numbers of staff to keep people safe and meet their needs.
All of the interactions we observed between staff and people were caring and supportive. It was clear the registered manager and the staff had people’s best interests in mind and tried to provide as good a lifestyle as possible for them. Relatives told us the staff and management were open and accessible and had a good understanding of people’s complex needs and behaviours. Relatives were always made welcome and were encouraged to visit as often as they wished. One relative said “Staff are really brilliant. I can’t fault them”. Another relative said “Staff come across as very professional and very caring, they have the balance just right”.
People had choice and control over their daily lives to the extent they were able to express their preferences. People were supported by their key workers to express their feelings and preferences. Staff respected and acted on the choices people made. The service knew how to protect people’s rights when they lacked the mental capacity to make certain decisions about their care and welfare. People also had access to external healthcare professionals to help them maintain their physical and mental health.
People were supported to visit relatives, access the community and participate in a range of social and leisure activities on a regular basis.
Staff said everyone pulled together as a team and the senior staff and registered manager were very flexible and supportive.
The provider’s quality assurance systems helped to ensure the service maintained and promoted good safe standards of care.