Archived: The Lady Verdin Trust - Claremont

Updated 19 July 2018

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, 23 and 24 May 2018 and was unannounced.

The inspection was carried out by one adult social care inspector.

As part of the inspection, we reviewed the information available to us about the home, such as the notifications they had sent us. A notification is information about important events which the provider is required to send us by law. We also spoke with the local authority’s quality assurance and contracts team to gather feedback. They told us that the service was subject to an improvement plan and progress had been made

During the inspection we spoke with two people who used the service and contacted two relatives to seek their feedback over the telephone. We also spoke with six members of staff, including four care support workers, the house manager and the registered manager. We checked three people's care records and four medicines administration records (MARs). We also checked records relating to how the service is run and monitored, such as audits, recruitment, training and health and safety records. Throughout the inspection, we observed how staff supported people with their care whilst in the communal areas.

Updated 19 July 2018

This was an unannounced inspection carried out on 22, 23 and 24 May 2018.

At our last inspection on 5 and 7 September 2017, the service was in breach of regulations relating to person centred care, consent, safe care and treatment, safeguarding service users from abuse and improper treatment, staffing and governance. The service provider was also in breach of the regulation requiring them to display their rating.

We rated the service as 'Inadequate' and placed it into Special Measures. We asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) effective, responsive and well-led to at least good. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe.

During this inspection the service demonstrated to us that improvements have been made and is therefore no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. At this inspection the overall rating for the service is 'Requires Improvement'. The service had made some improvements and was no longer in breach of the regulations. However, we found that these improvements needed to be ongoing and sustained.

The lady Verdin Trust - Claremont is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to four people in one adapted building. At the time of our inspection there were four people living at the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager, however they were about the leave the service. An application to register a new manager was in progress. 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.

Since the last inspection each person’s support plan had been reviewed and re-written. Risk assessments had also been reviewed. However, assessments were not always in place for all areas of identified risk. Work was ongoing on these. Despite gaps in the records, we found that appropriate actions had been taken to mitigate areas of identified risk.

Work had been undertaken to support staff to understand and apply The Mental Capacity Act 2005 (MCA). Information about people’s communication needs was included within their support plans. We saw that mental capacity assessments had been undertaken in a number of areas. Further work was needed to ensure that any best interest decisions were fully recorded. All Deprivation of Liberty Safeguards (DoLS) applications had been made since the last inspection and everyone living at the service had an appropriate authorisation in place.

People continued to receive their medication safely. Staff undertook training in the safe administration of medicines and records demonstrated that competency checks were completed. We identified some minor shortfalls in the recording around medicines and the management team took steps to address these.

Staff were trained in safeguarding procedures and understood their responsibilities to report any concerns of this nature. Since the last inspection the registered manager confirmed they had not needed to make any referrals to the local authority in relation to safeguarding concerns. However, there were procedures in place which staff understood should they need to do so.

We reviewed staffing levels during the inspection to ensure people were receiving a safe level of care to meet their identified needs. The management team told us that staffing remained under review and that whilst they were fully staffed they were considering the recruitment of staff for the weekends.

At this inspection we saw that action had been taken to ensure the provider could demonstrate how staff had completed appropriate training to meet people’s needs. Records showed that staff had undertaken training in topics such as health and safety, manual handling, safeguarding adults and MCA/DoLS. Staff told us that they felt supported. Regular staff supervision and appraisals were taking place.

People were supported to eat and drink sufficiently and maintain a balanced diet. They continued to be supported to maintain good health.

People appeared comfortable with the staff who supported them and we saw that staff were kind and patient in their approach. Staff knew the people they were caring for well and could explain people’s needs as well as their likes, dislikes and preferences. We found that people’s privacy and dignity were respected.

Since the last inspection each person’s support plan had been rewritten, with the input of support staff. Reviews had been held in consultation with people and discussion with relatives. Support plans reviewed contained a good level of personal detail that helped to guide staff to meet people’s needs in a personalised way. We saw that people's care was considered in relation to a wide range of needs including information about the sort of things that helped people to feel happy.

Importance had been placed on promoting independence and maintaining people’s skills. Goal plans were starting to be introduced and Improvements had been made in supporting people to take part in activities and follow their interests.

The registered provider had a policy and procedure in place for recording and responding to complaints. We saw that an easy read complaints policy was now available for people to access.

The service had been merging with another care provider and changes to the management structure were being implemented. The house manage was now based at the service and a new supervisor had been introduced. Staff felt well supported and said there had been an improvement in the organisation of the service. We saw that systems had been introduced to monitor whether staff received regular supervision, appraisal and that training was kept up to date. The management team had focused on better communication with staff and we saw that several staff meetings had been held over the previous few months.

Quality audits were now being carried out and systems to monitor the quality of the care were more effective.

We saw that the latest rating was on display at the location and the registered manager was aware of their duty to display this rating.