Archived: United Response - 5 Cedar Avenue

We previously inspected the service on 20 and 22 January 2016 and at that time we found the registered provider was not meeting the regulations relating to consent, staffing and keeping accurate records. We asked the registered provider to make improvements. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we found improvements had been made.

The service is required to have 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 service had a registered manager in place.

Cedar Avenue provides personal care and accommodation for up to four people who have both learning and physical disabilities. The registered provider is United Response. The home is an adapted bungalow set within its own grounds and is located in a residential setting close to Huddersfield town centre.

There were enough staff on duty to meet people’s individual needs and keep them safe.

Staff had a good understanding about safeguarding adults from abuse and knew who to contact if they suspected any abuse. Detailed risk assessments were in place to support staff to deliver safe care.

Medicines were managed in a safe way for people.

The provider had effective recruitment and selection procedures in place. Medicines were managed in a safe way for people.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service promoted this practice. People’s capacity was always considered when decisions needed to be made. This helped ensure people’s rights were protected in line with legislation and guidance.

Staff had received an in depth induction, supervision, appraisal and specialist training to enable them to provide support to people who lived at Cedar Avenue. This ensured they had the appropriate knowledge and skills to do this effectively.

People enjoyed the food and were supported to eat an individualised balanced diet. A range of healthcare professionals were involved in people’s care.

The home had a warm homely atmosphere and was tailored to meet each person’s individual needs and preferences.

We observed staff interacting with people in a caring, friendly and respectful manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews.

People were able to make choices about their care. People’s care plans detailed the care and support they required and included detailed information about their likes and dislikes.

People engaged in social and leisure activities which were person centred. Care plans included measures to protect them from social isolation.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time.

Accurate records were maintained in relation to care that was being delivered.

The culture of the organisation was open and transparent. The manager was visible in the service and knew the needs of the people in the home.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard.

We previously inspected the service on 29 January 2014 and at that time we found the registered provider was not meeting the regulations relating to keeping accurate records. We asked the registered provider to make improvements. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked to see if improvements had been made. We found some improvements had been made, however the provider was not meeting the regulations related to keeping accurate records.

The service is required to have 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 service did not have a registered manager in place at the time of the inspection. The current manager had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

Cedar Avenue provides personal care and accommodation for up to four people who have both learning and physical disabilities. The registered provider is United Response. The home is an adapted bungalow set within its own grounds and is located in a residential setting close to Huddersfield town centre.

There were not always enough staff on duty to meet people’s individual needs and keep them safe due to an inadequate staffing contingency system. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

The provider had effective recruitment and selection procedures in place.

Medicines were managed in a safe way for people

People’s capacity was not always considered and recorded when decisions needed to be made. This was a breach of Regulation11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff had received an in depth induction, supervision, appraisal and specialist training to enable them to provide support to people who lived at 5 Cedar Avenue. This ensured they had the knowledge and skills to support the people who lived there.

People enjoyed the food and were supported to eat an individualised balanced diet. A range of healthcare professionals were involved in people’s care.

Throughout our inspection we observed staff interacting with people in a caring, friendly and respectful manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation and needs changed.

People were able to make choices about their care. People’s care plans detailed the care and support they required and included detailed information about peoples likes and dislikes.

People engaged in social activities which were person centred. Care plans considered people’s social life which included measures to protect people from social isolation.

Relatives told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

Accurate records were not always maintained in relation to care that was being delivered, for example there were some gaps in recording the daily care that was being provided. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The new manager was addressing this and some improvements had been made.

The culture of the organisation was open and transparent. The manager was visible in the service and knew the needs of the people in the home.

The registered provider had an overview of the service; however the service’s quality assurance systems had not identified and addressed problems we found at the inspection.

You can see what action we told the provider to take at the back of the full version of the report.

We made this visit to see what actions had been taken.

On the day of our visit four people were using the services. We spoke with the Registered Manager (RM) and the Senior Support Worker (SSW) on duty.

Since our last visit we found that compliance had been achieved in the management of medicines. Whilst we noted some improvements relating to records further improvement was needed.

For example during the course of our visit, we had the opportunity to observe the staff speaking with people who use the service using a range of verbal, non-verbal and signing communication techniques to support each person to maintain their independence, involvement and establish their preferences.