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Archived: The Lady Verdin Trust - Claremont Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 22 May 2018

During a routine inspection

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

Inspection carried out on 5 September 2017

During a routine inspection

This inspection took place on 5 and 7 September 2017 and was announced.

The Lady Verdin Trust – Claremont, provides personal care for up to four people with a learning disability. At this inspection they were providing care and support for four people.

A registered manager was in post and was available to us during day one of this inspection. However, owing to pre-arranged annual leave they were not present during day two. 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.

At the last inspection the service was rated overall good. At this inspection we found 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.

People did not have their individual rights protected. This was because the provider did not understand and apply their requirements to appropriately assess and submit applications for the Deprivation of Liberty Safeguards.

The provider had failed to assess the risks to the health and safety of service users of receiving the care or treatment.

People did not have information presented to them in a way they understood preventing them from making fully informed decisions. People’s individual capacity to make decisions was not assessed. As a result decisions were being made for people by the provider without the correct authority to do so.

People did not have effective, up to date or comprehensive care and support plans which reflected their individual needs. This put people at risk of inappropriate care.

The provider did not have effective quality monitoring systems in place to identify and respond to poor practice.

The provider had failed to display the previously rated performance.

People took part in a number of social and leisure activities, however, these were not extensive and there was little drive to increase people’s abilities, skills and interests. Individual goals and aspirations were not identified or promoted.

People were not consistently involved in decisions or changes in their home. People were not asked for their views and the provider did not have systems in place to consistently obtain people’s opinions.

People did not have up to date and accurate assessments of risk associated with their care and support. Assessments in place had not been effectively reviewed and did not account for changes in the person or their physical environment.

Staff members were not provided with specific training to enable them to support people with their individual needs

People were supported by enough staff to safely meet their needs. People received help with their medicines from staff who were trained to safely support them. The provider followed safe recruitment practices and completed checks on staff before they were allowed to start work.

The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures.’

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line

Inspection carried out on 14, 15 and 18 October and 15 November 2015

During a routine inspection

This inspection was unannounced and took place on the 14 October 2015. Following this an announced visit to the head office of the Lady Verdin Trust [The Trust] to look at training and recruitment records and phone calls to the family members of the people living in the home took place on the 15 and 18 October and the 15 November respectively.

Claremont is part of the Lady Verdin Trust and is registered to provide accommodation for four people who require support and care with their daily living. The home is located in a residential area on the outskirts of Crewe. The single storey domestic property is close to shops, bus stop and other local amenities. Staff members are available twenty four hours a day. At the time of our visit there were four people living in the house.

Claremont had 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 registered manager, (their job title within the organisation was community services director), did not work in the home on a daily basis. Day to day management was provided by a community support manager who had responsibility for additional services operated by the Trust and a house manager who was solely responsible for Claremont.

Because of their communication needs we were unable to ask the people living in the home about whether they thought the staff members supporting them were caring. Although neither relative expressed any concerns about the care being provided to their family members they both commented on the recent staff changes.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This meant that the staff members were aware of people's rights to make their own decisions. They were also aware of the need to protect people's rights if they had difficulty in making decisions for themselves.

We asked staff members about training and they confirmed that they received regular training throughout the year, they described this as their CPD [continuous professional development] training and that it was up to date.

Whilst we did not identify that the needs of the people were not being fully met we did see that some of the review timescales within individual care plans had slipped, for example, a number of care plans written in August 2014 and January 2015 had not been reviewed since being written. Other care plans were fully up to date so it was not a consistent issue. We discussed this with the community support manager who has since provided written confirmation that all of these issues had been discussed with the new house manager who had been given some supernumerary hours to update and if necessary re-write any care plans.

Staff members we spoke with were positive about how the home was being managed. Throughout the inspection we observed them interacting with each other in a professional manner. All of the staff members we spoke with were positive about the service and the quality of the support being provided.

We found that the provider and the home used a variety of methods in order to assess the quality of the service they were providing to people. These included regular audits on areas such as the care files, including risk assessments, medication, individual finances and staff training. The records were being maintained properly.

Inspection carried out on 21 November 2013

During a routine inspection

We did speak to two relatives on the phone and they told us they were kept informed about any changes to the care and welfare needs of the person using the service. They also told us they were fully involved and consulted about their relatives care needs.

We spoke to two relatives on the telephone during our visit. They both spoke very positively about the quality of care being to their relative and about the staff members working there. Comments included; �staff are brilliant�. One person spoke very positively about their relative�s keyworker describing her as; �exceptional�.

The home had an adult protection procedure [now called safeguarding] that was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

The staff we spoke with confirmed that they regularly attended training and that this was up to date.

Because of its small size the home manager and staff members were able to react quickly to any issues that may arise. These could include support or care needs, medication issues or any problems with the facilities.

Inspection carried out on 16 January 2013

During a routine inspection

During our inspection we spoke with one person who used the service. However, because of their care needs they were unable to comment on the care and treatment they received.

We spoke to two family members on the telephone. One person told us staff were very good keeping them informed of their relatives care and of any changes to their health. They told us they were very involved in any decisions made in respect of their relatives care and treatment. They said they �like all the staff� and they were �very happy� with the care and they had �no problems at all�. They also told us the care was �brilliant� and they knew their relative was happy living in the home and they knew they were ok.

Another person told us their relative�s key worker was �very good� and often brought their relative to visit them at home. They told us they went to meetings about their relatives care and were �always consulted� regarding their care and informed. They said they were �very happy� now their relative was living at the home.

Inspection carried out on 19 December 2011

During a routine inspection

During our inspection we spoke with all the people who use the service. However, because of their care needs they were unable to comment on the care and treatment they received.

We spoke with a relative who told us the staff were very good at keeping them informed about the welfare of the person using the service. They also told us they knew how to raise any complaints, concerns or worries they may have about the care and treatment of people using the service.

They told us that before their relative came to live in the home staff had spoken with them about the person�s background history and how they would like to be cared for and supported.

They also told us they felt the Lady Verdin Trust listened to them and provided people with safe care and treatment.