We conducted an unannounced inspection of Turning Point - Marloes Walk on 14 January 2016. The service provides nursing care and support for up to eight people with learning disabilities. There were eight people using the service when we visited. Each person had their own bedroom and there were two shared lounges and dining room areas at 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 refer to the registered manager as the manager in the body of this report.
During the day there were four members of care staff on duty, a trained nurse, and a trainee nurse. Staff told us the staffing levels enabled them to spend time with people inside and outside the home, and respond to requests for assistance without delay.
Staff had received training in safeguarding adults and were able to explain the correct procedure to follow if they had concerns. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there.
Risk assessments around the provision of care and support had been carried out and action taken to reduce any identified risks. There were systems to ensure that medicines were stored and administered safely.
New staff completed a thorough induction programme when they started work. Staff received training and had regular supervision and appraisal meetings in which their performance and development was discussed.
The provider understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The provider had made applications to the local authority in accordance with DoLS and the MCA, and at the time of our visit was awaiting the outcome of some of those applications. Some applications had already been approved by the local authority.
People were encouraged to eat a varied diet that took account of their preferences and, where necessary, their nutritional needs were monitored. People were supported effectively with their health needs and had access to a range of healthcare professionals.
People were supported in a range of activities, both inside and outside the home. Activities outside the home enabled people to be part of their local community and to take regular holidays. Staff were caring and encouraged people to be involved in decisions about their life and their support needs. People were supported to make decisions about their environment and choose how their room was decorated.
Each person had a care and support plan with detailed information and guidance personal to them. Care plans included information on maintaining the person's health, their daily routines and preferences.
Staff told us they felt supported by the management team and by each other. Both staff and people were given opportunities to make suggestions on how the service was run. The service carried out regular audits to monitor the quality of the service and to plan improvements. Where concerns were identified, action plans were put in place to rectify these.