Turning Point - Willes Road

The home was registered with the CQC prior to the CQC’s publication of ‘Registering the Right Support’ guidance for homes for people with learning disabilities and autism. However, the service provided at Willes Road is in-line with best practice identified in our publication. Four people lived at the home at the time of our inspection visit.

At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to be safe. Staff understood the risks to people’s health and wellbeing and took action to lessen each risk. There were enough staff on duty to meet people’s needs; and checks had been made on staff before working for the service to make sure they were safe to work with people. People received their medicines as prescribed. The home was clean and tidy.

The service continued to be effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principles of the Mental Capacity Act (MCA) were followed. People had access to different health and social care professionals. People received food they enjoyed, and were supported to have nutritious diets. Staff had received the training they needed to provide effective care.

The service continued to be caring. People received care from staff who were kind, and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. The service supported people to maintain relationships with their family.

The service continued to be responsive. People’s needs were assessed and planned for with the involvement of the person or their family. Care plans helped staff understand people’s care and support needs. People had daily opportunities to pursue their interests and hobbies. There was a complaint procedure although no complaints had been made to the service since our last inspection.

The service continued to be well-led. The registered manager and team leader worked hard to ensure a good quality of service was maintained. Staff and people received good support from the management team. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.

Willes Road is registered to provide accommodation and personal care for up to six people who have a learning disability or autistic spectrum disorder. The home has a lounge, kitchen, communal bathroom and two bedrooms on the lower ground floor. There is a further kitchen, lounge and dining area on the ground floor. The rest of the bedrooms are on the first floor. There were five people living in the home at the time of our inspection.

This service was last inspected on 16 October 2015 and we found three breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008. Breaches were found because there were not always sufficient numbers of staff to meet the individual needs of the people who used the service and staff did not always receive the appropriate support and training to enable them to carry out their duties competently. Systems and processes were not always operated effectively to prevent abuse and the provider had failed to monitor the quality and safety of the service provided. At this inspection we looked to see if the provider had responded to make the required improvements in the standard of care to meet the regulations. We found they had and they were no longer in breach of the regulations.

The service 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.

Staff felt there were enough staff to keep people safe and ensure, as far as possible, people could go out when they wanted to. During our visit we saw people coming and going throughout the day with staff support. Staff worked as a team to ensure people received the appropriate level of observation to keep them and others safe. The provider had recruitment procedures to ensure staff who worked at the home were of a suitable character to work with people who lived there.

Staff had been provided with safeguarding training so they had an understanding of their responsibilities to protect people from harm. The registered manager understood their responsibilities to manage any safeguarding concerns raised by staff.

Risk assessments and management plans covered all aspects of people’s activity and included safety when outside the home, travel, finances, health and daily routines. There were appropriate arrangements for the recording and checking of medicines to ensure people’s health and welfare was protected against the risks associated with the handling of medicines.

Staff had received training in the areas the provider considered essential for meeting the needs of people in a care environment safely and effectively. They had also received training specific to the needs of the people who lived in the home such as positive behaviour management and supporting people with autism. New staff received an induction which included working alongside more experienced staff. This helped them get to know people’s needs and establish a relationship with them before working with them on a one to one basis.

Staff worked within the principles of the Mental Capacity Act 2005 and had a good understanding of their responsibilities in making sure people were supported in accordance with their preferences and wishes. Staff knew people's individual communication skills and abilities and showed concern for people's wellbeing in a caring and meaningful way. They were observant of people and responded to their needs quickly.

Care records were personalised and each file contained information about the person's likes, dislikes, preferences and the people who were important to them. Plans around behaviours were written to reinforce positive behaviour rather than concentrating on the negative. Care plans also included information that enabled the staff to monitor the well-being of people. There were systems in place for staff to share information through very detailed daily records for each person.

Following our last inspection the provider had taken action to ensure standards within the home improved. The provider had invested in the induction and training staff received and care plans had been reviewed so staff had the information they needed to meet people’s needs. Staff told us the morale of staff had improved because they were felt better supported through regular one to one meetings with managers and team meetings. Staff were confident their ideas and suggestions would be listened to.

Audits and checks of the service were carried out by the management team and the provider. These checks ensured the service continuously improved. The provider had improved their systems to ensure all the notifications required by law had been sent to us in accordance with the legislation.

People living in the home were not able to communicate with us verbally, which meant that they were not able to tell us their experiences. We spent time during our visit observing care and support to help us understand their experiences.

We saw that people appeared comfortable in their environment and in the company of the staff. We saw that staff treated people with kindness and compassion, and clearly understood their non verbal methods of communication. In return we noted that people responded to the staff positively with smiles.

People had care records which included care plans and risk assessments in place. These identified their care and support needs and were kept up to date.

There were processes in place to ensure that medication was managed safely on people's behalf, to ensure that they received their medicines as prescribed.

There were sufficient staff available on a daily basis to be able to provide the levels of care and support required to meet people's individual needs.

The people using the service had complex needs which meant they were not able to tell us their experiences of care. When we met with them however they smiled when we asked them how they were. We found that staff knew people as individuals and understood their personal needs and ways of communicating their needs. We saw that people were relaxed and at ease with staff and within the home environment.

We spoke to the relatives of two people who used the service and they told us they were happy with the care their family member received and had no concerns. They said, 'Care is excellent ' I am very happy' and 'Staffing is consistent and that is good for XX.'

The environment was homely with framed photographs displayed of people enjoying their holidays and other activities they did.

Each person had a care plan and these were written in a way that was easy for them to understand with the use of photographs and symbols.

We found procedures were in place to protect people from harm. Staff told us what these were and how they would report any suspicion that a person who used the service had been at risk of harm.