Archived: United Response - 9 Lavender Road

United Response - 9 Lavender Road provides accommodation and personal care for up to 6 people with a learning disability. There were 6 people accommodated there on the day of our inspection.

The service had a registered manager in post. 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.

Visitors told us they felt their relatives were safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.

The accommodation provided was suitably adapted for the people who lived there. The building was safe and well maintained. Risks associated with the building and working practices were assessed and steps taken to reduce the likelihood of harm occurring. Minor maintenance issues were dealt with at the time of the inspection. The home was clean.

We observed staff acted in a courteous, professional and safe manner when supporting people. Staffing levels were sufficient to safely meet people’s needs. The provider had a robust system to ensure new staff were subject to thorough recruitment checks.

Medicines, including topical medicines (creams applied to the skin) were safely managed. Records to account for emergency medicines supplied to a day centre required strengthening to ensure they could be reliably accounted for.

As United Response - 9 Lavender Road is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. People’s mental capacity was considered through relevant areas of care, such as with decisions about finances, the use of equipment and medicines. Where necessary, DoLS had been applied for. Staff routinely discussed proposed interventions before providing care to gauge if the person consented.

Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned to ensure their skills and knowledge were up to date. Staff were well supported by their managers and other senior staff. Staff performance was assessed annually and objectives set for the year ahead.

People’s nutritional and hydration (eating and drinking) status was assessed and plans of care put in place where support was needed. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to access healthcare services.

Staff displayed an attentive, caring and supportive attitude. We observed staff interacted positively with people. We saw that staff treated people with respect and explained clearly to us how people’s privacy, dignity and confidentiality were maintained. Staff were able to communicate effectively with people using a range of strategies and tools, such as cue cards.

Activities were offered within the home on a group and one to one basis. Staff worked collaboratively with local day care services. Staff understood the needs of people and we saw care plans and associated documentation were clear and person centred.

People’s relatives and staff spoke well of the registered manager and they felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers. The registered manager and staff team had worked hard to address areas for improvement identified at previous inspections.

We undertook this focused inspection on 19 August 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to these requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for United Response – 9 Lavender Road on our website at www.cqc.org.uk.

United Response – 9 Lavender Road provides accommodation and personal care for up to six people. Accommodation is provided over one floor in six single bedrooms. At the time of the inspection there were six people accommodated in the home.

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.

We found the provider had met some of the assurances they had given in their action plan but were still in breach with some of the relevant regulations.

Staffing levels had been reviewed and increased since our last inspection.

Staff had developed picture prompt cards to encourage and enable people to express more food choice. A wide range of fresh and ready-made food stocks were available to support people’s choices.

Improvements were still needed in the recording of people’s fluid intake where people were at risk of dehydration. Fluid intakes were recorded, but a target level was not set. Total fluid intake was not calculated and guidance for staff on what action to take should appropriate levels of fluid intake not be achieved was not in place. Staff had not adequately risk assessed and planned for people’s pressure area care where this was an area of need.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to care planning and nutrition. You can see what action we told the provider to take at the back of the full version of this report.

We found the building was clean, well maintained and in good decorative order. People's rooms had been personalised according to each person's preferences.

The provider had recruitment and selection procedures in place to ensure people employed were suitable to work with vulnerable people.

People who used the service, and their relatives, had opportunities to give their views about the care they received. The provider had audit systems in place to ensure that issues were identified and appropriate action taken to address them.

People knew how to complain if they were unhappy. People indicated they were happy with where they lived and their care staff. We found the provider had procedures to investigate any complaints received.

Relatives told us they were very happy with the care which was provided. One relative told us, "I work in the care industry so I know what I'm looking for. The care is good here. It's a lovely place for people to live." Another relative said, "Everything is done the way that it should be. It's a brilliant home. The quality of care is excellent. I know there is nowhere better out there."

We saw detailed and specific information had been recorded about how people expressed their wishes. This meant staff had a good understanding of people's communication methods, so they could ensure people had given their consent before staff provided any care. Where people did not have the capacity to consent the provider acted in accordance with legal requirements.

There were enough staff available to meet people's needs. One staff member said, "There are definitely enough staff here. People here have such active social lives. We have enough staff to support people to do whatever they want to do."

Records were well maintained and there were appropriate arrangements in place to manage medicines.