Archived: United Response - 85 Highfield Avenue

People’s experience of using this service:

The service worked 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 possible 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 received a service that was safe, effective, caring, responsive and well led.

People using the service received planned person-centred care and support that was appropriate and inclusive for them. The service worked closely with other health professionals to ensure people’s health needs were met.

Systems were in place to keep people safe from the risk of harm and abuse. People’s needs were met by suitable numbers of staff who knew them well. People received their medicines as prescribed and were protected from the risk of infection.

People were treated with kindness and respect and staff spoke fondly about them. People’s privacy and dignity were respected, and they received personalised care which was responsive to their individual needs.

People enjoyed a range of activities which they chose to do. People had support plans in place which covered a range of information about them, their life histories, preferences, likes and dislikes and their support needs. The provider sought feedback from people and their families to improve the service.

The registered manager had a sound overview of the service and had effective systems in place to monitor safety and quality.

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

Rating at last inspection:

At the last inspection the service was rated Good (3 December 2016).

Why we inspected:

This was a planned inspection to check that this service remained Good.

Follow up:

We did not identify any concerns at this inspection. We will therefore re-inspect this service within our published timeframe for services rated good. We will continue to monitor the service through the information we receive.

United Response 85 Highfield Avenue is a residential care home which is registered to provide a service for up to six people with learning disabilities. There were six people living there on the day of the visit, including one person who was in hospital. The service offers accommodation in a domestic sized house, over two floors. Only people who are physically able have their rooms on the first floor which is accessed via a staircase. A stair lift is available for emergencies.

There is a registered manager running the service. 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.

People were kept safe from harm or abuse by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and followed the relevant procedures. General risks and risks to individuals were identified and action was taken to reduce them. There were enough staff, on duty to ensure people’s needs were met and they were supported safely. The recruitment procedures were robust and made sure, that as far as possible, staff were safe and suitable to work with the people who live in the home. Medicines were given safely, in the right amounts and at the right times by trained and competent staff.

People’s health and well-being needs were met by staff who responded effectively to people’s changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s health and well-being needs.

Peoples’ human and civil rights were understood, and upheld by the staff and registered manager of the service. The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who may not have capacity to do so. People were supported to make as many decisions and have as much control over their lives as they were able to.

People’s care was provided by kind and caring staff who were attentive and knowledgeable. Individualised care planning ensured people’s equality and diversity was respected. People were provided with activities, according to their needs, abilities and preferences.

People’s care was overseen by a registered manager who listened and responded to them and others. The registered manager was described as approachable and supportive. The quality of care the service provided was assessed, reviewed and improved, as necessary.

The provider told us that people who use the service were supported to maintain their full potential and be as independent as they could be. All of the people were funded by local authorities and we evidenced that health and social care professionals had been fully consulted about the care needs of people who use the service.

Representatives of people who use the service told us that the provider ensured that their relatives had plenty of choice about how they lived their life and that they were given opportunities to engage in a range of community activities. Representatives told us that their relatives were very happy whenever they visited the home.

We evidenced that the provider used a variety of methods to ensure that people who use the service were fully involved and where possible to, were able to consent to the care, support and treatment they received. However the provider may wish to note that the assessments and care plans did not always specify enough what care and treatment the people who use the service had the mental capacity to consent to.

One representative of a person who uses the service told us that 'the staff handle my relative's complex medical problems well and always consult medical professionals appropriately'. Another representative told us that their relative liked interacting with the staff and that staff helped their relative remain calm and contented. Representatives also told us that they were kept fully updated about their relatives care needs and were involved in reviews of their relative's care and support needs.

The provider had a good understanding of adult safeguarding and staff understood their role and responsibilities in the safeguarding of adults at risk of harm. The staff we spoke with had all received training in adult safeguarding and the Mental Capacity Act and spoke confidently about how to raise concerns and how to minimize the risk of harm for people who lacked capacity to understand risks.

The provider had sufficient levels of staff in place and provided additional staff for people who required one to one support to engage in community activities. The provider had a number of regular bank staff they could call on but they were rarely used which meant that continuity of care for people who use the service was good.

The provider had an audit framework and audits were carried out quarterly as to ensure that the quality of the service was maintained to a high standard. Audits were carried out by the manager and additional audits were carried out annually by the area manager as well as a peer audit by a manager from another service.

Following the visit we spoke with three people's relatives. They told us their relatives were looked after well. One relative said "There is a nice atmosphere at the home". Another relative said "On the whole the care is good, but communication could be better".

Local authority professionals told us the staff were proactive regarding identifying people's changing care needs and involved them as required. One care manager told us "I have no concerns about the care provided at the home, staff know what they are doing". Another said "I have no real concerns regarding Highfield, I feel the service users are well cared for and they have always been quick to inform me if there are any problems and work to resolve them".

Staff recruitment practices and procedures were robust and ensured that people were cared for by staff that were fit to do their jobs.