Archived: McGillicuddy House

McGillicuddy House offers accommodation, care and support for up to 10 people with learning disabilities from those that are independent to those needing more support. The accommodation was provided over three floors in a semi-detached house with a communal living room and kitchen diner, bedrooms and communal bathrooms. There is a communal outdoor area at the rear of the property with a garden and summer-house. There were seven people living in the service when we inspected.

We last inspected the service on 10 and 11 November 2015. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to Regulation 11, Need for consent; Regulation 12, Safe care and treatment; Regulation 13, Safeguarding people from abuse and improper treatment; Regulation 17, Good governance; Regulation 18, Staffing and Regulation 19, Fit and proper persons employed. Following the inspection the provider sent us an action plan to show how they intended to improve the service and meet the requirements of the regulations.

At this inspection we found that the provider had implemented their action plan and improvements had been made.

There was a registered manager employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was not available on the day of the inspection, and the deputy manager assisted with the inspection process.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Management understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

The registered manager and staff had received training about the Mental Capacity Act 2005 and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care.

People said they felt safe and relatives told us that they knew their relatives were safe. People were protected against the risk of abuse. People told us they felt safe. Staff had recently had updated training and recognised the signs of abuse or neglect and what to look out for. Management and staff understood their role and responsibilities to report any concerns and were confident in doing so. Staff told us they knew what to do if they needed to whistle blow, and there was a whistleblowing policy available.

People had varied needs, and some of the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy by showing warmth to the provider, deputy manager and staff who were supporting them. Staff were attentive and interacted with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Gaps in applicants employment history had been followed up and DBS checks had been updated as appropriate. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments had been updated and were individual for each person. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice, such as doctors, speech and language therapist (SALT) and dieticians.

There were policies and a procedure in place for the safe administration of medicines. People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.

People could easily access food and drink and snacks during the day. People were involved in shopping. Staff knew people that lived in the service well and were engaged in meaningful and fun conversations with people. Staff encouraged people to be as independent as possible.

There were regular minuted ‘housemates’ meetings where people were able to talk about things that were important to them and about the things they wanted to do. We saw evidence of people going to regular activities in the community and in the home.

People were aware of the complaints procedure and they knew who to talk to if they were worried or concerned about anything. Relatives said that they knew who to complain to if they had any concerns and provided positive feedback on the service as a whole. The deputy manager said there had been no complaints made since the last inspection in November 2015.

The registered manager had sought the views of people living in the service as well as relatives. The results of these surveys were positive.

The provider and registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The providers and registered manager understood the requirements of their registration with the CQC.

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

Is the service safe?

The staff that we spoke to understood the procedures they needed to follow to ensure that people were safe. During our inspection we saw that staff delivered the care outlined in people's plans. For example staff ensured people were safe using kitchen equipment. Staff involved people in household tasks ensuring that they followed the risk assessments that were in place to keep the person safe.

Procedures for dealing with emergencies were in place and staff were able to describe these to us. Fire drill were practiced and people knew what to do in an emergency. Staff had access to support and advice at all times from a manager.

The registered manager ensured that staff underwent checks before starting work at the home. For example they checked a person's criminal record through the Disclosure and Barring Service. (DBS). This was formally known as a Criminal Records Bureau check. Staff were trained in safeguarding people from abuse. They could describe to us what they would do if they witnessed or suspected abuse.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff had received training and knew how to submit one if required.

There were systems in place for making regular checks on the safety of the premises. Risk were assessed, reviewed and recorded. The registered manager ensured that the staff had the required skills and knowledge to care for people in a safe way.

Is the service effective?

People all had an individual care plan which set out their care needs. We saw that people had been fully involved in the assessment of their health and care needs. They had contributed to the development of their care plan. People's care plans were reviewed regularly to check they were still effective. During our inspection we saw staff delivering the care outlined in people's plans. People who used the service talked positively about the care they had received. One said, 'I like living here, staff help me with my medication and they are taking me to the opticians this afternoon'. They also said 'Staff are very good at helping me get my shopping.'

Is the service caring?

We found that people were treated with respect and their dignity was maintained. People appeared relaxed and comfortable with the staff that supported them. We saw that people had a positive relationship with staff and staff took time to chat with them about day to day matters. One person told us 'The staff look after me well'. Another person said, 'I can ask for support when I need it'. We observed that staff were caring and kind towards people they were supporting. We talked with three staff and they demonstrated that they knew the people who used the service well. One member of staff said 'People are well cared for'.

Is the service responsive?

The service reviewed people's care plans regularly. There was always a nominated person in charge of the service who had the required training to make decisions on a day to day basis about people's care. The registered manager or their deputy were available via telephone for further advice when needed.

We found examples of how people's requests for information were responded to. One relative had asked for information about staff training and qualifications. The provider had sent out information to all the relatives with staff skills, qualification and experience.

People received information in formats that they would understand. People were asked their views about the service. They were able to tell us how they would complain. Staff understood how they should respond to complaints. The provider analysed information and feedback about the service. They then fed this back through housemate meetings. These meetings were recorded.

Is the service well-led?

The provider continually monitored areas of risk in the service and made regular checks on quality. There was evidence that the registered manager updated care plans and risk assessments as people's needs changed.

There was a staff training policy in place and a training matrix. The training matrix demonstrated that staff training was planned and booked in advance. We found that staff understood their roles and how they would meet people's needs.

The manager ensured that monthly checks of the quality and safety of the service were carried out. Regular reviews of people's care plans took place to ensure their needs were being met.

People who lived in the house spoke positively about their experiences. They said "I like living here. I choose where I want to go." "Staff support me when I want to go out." "We choose our own meals, we can have what we like." "The staff here are really nice."

We looked at relative's comments in their recent survey responses. These were all very positive. They included, "I consider X lucky to be living at McGillicuddy House as it is such a well run, stimulating and caring environment". "McGilicuddy House has a pleasant family atmosphere". "X has plenty of choice and also can choose not to do things".

During this inspection we found that people or their representatives were asked for their consent before any care and treatment was given.

People were provided with appropriate care and support that met their needs and protected them from harm.

People received the medication they needed at the time they needed it.

Robust recruitment procedures ensured that people were protected through the appointment of appropriate staff.

There were effective quality assurance systems which took account of the views of people who lived in the home