Turning Point - Alfred Minto House Care Home

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.

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 is required to have a registered manager and at the time of our inspection a registered manager was 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 and associated Regulations about how the service is run.

Effective recruitment procedures helped to make sure staff had the required skills and were of suitable character and background. There were enough staff available to meet the needs of people living at the home at the time of our inspection.

Staff understood what it meant to protect people from abuse. They were confident any concerns they raised would be acted upon by the management team.

Care and support was planned and delivered in a way that ensured people were safe. People had been involved in planning their care. Support plans clearly outlined peoples' needs and any risks associated with their care, as well as their abilities and preferences.

People's medicines were managed and administered in line with best practice and staff had received medicines training and their competency had been assessed.

An effective induction and an ongoing training programme ensured staff had the right skills and knowledge to fulfil their role. Staff were supported through regular supervision and annual appraisal.

People were supported to maintain good health and have access to health and social care services. People were also supported to maintain a balanced diet that met their individual needs and choices.

Staff consistently put people at the heart of everything they did. Staff were clear they worked as a team and for the benefit of people living at Alfred Minto House. Staff provided enthusiastic and individualised support to people. People spoke highly of the support they received and were motivated to achieve their goals with positive staff input. People were supported by caring and compassionate staff who respected their privacy, dignity, preferences and independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Individualised social activities and events were promoted and available for people to take part in, if they wished to.

People were able to raise concerns or complaints and were asked for feedback about the service they received.

The service had a strong leadership presence with a registered manager and deputy manager who had a clear vision about the direction of the service and were spoken of highly by staff and people who used the service.

Regular quality systems were used to raise standards and achieve positive care and facilities for everybody living and working at the home.

The service understood their legal responsibilities for reporting and sharing information with other services.

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 ensured people were safe living at the care home and understood their responsibilities to protect people from the risk of abuse. Any risks to people’s health and safety were assessed and a management plan put into place. Action was taken following any incidents to try and reduce the risks of similar incidents happening again.

People were supported by a sufficient number of staff and staffing levels were flexible to meet people’s needs. Effective recruitment procedures ensured staff were safe to work with vulnerable adults. There was a focus on supporting people to manage their own medicines with the required level of support from staff.

Staff were provided knowledge and skills to care for people effectively and received regular supervision of their work. People received support from health care professionals when needed. People managed their own dietary intake with support from staff.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People had the capacity to make their own decisions and this was respected by staff. Procedures were in place to assess a person’s capacity to make a decision should this be required.

Positive and caring relationships had been developed between people and staff. People were in control of planning their own care and treatment and made choices which staff respected. Staff treated people with dignity and respect and ensured their privacy was respected.

People were provided with support that was responsive to their changing needs. Staff encouraged people to be as independent as possible and worked with them to improve their life skills. Activities were available which were tailored to people’s interests. There was a clear complaints procedure in place and people told us they felt able to make a complaint.

There were systems in place to monitor the quality of the service and these were well utilised and resulted in improvements being made. The registered managers led by example and staff felt able to speak with them about any concerns. There was an open and honest culture in the home.

The people we spoke with all said they were treated with dignity and respect and involved in planning their care and support. One person said, "This is a great place to live; the staff are really friendly and supportive. The staff are always respectful."

People received the care and support they needed to meet their individual needs. One person said, "I get really good support. I am doing so well."

All of the people we spoke with praised the staff for their liaison with other agencies to make sure their needs were communicated effectively and met. One person said, "They (the staff) liaise well with my clinical team and they will also liaise with my GP if needed to make sure I get the treatment I need. They support me." Another person told us, "My keyworker has been great about supporting me ready for (a legal meeting). They have spoken to my multi-disciplinary team and I feel really positive about it. I have all the support I need.

People felt safe with the staff and living at the service and said they would feel confident to raise any concerns about the way they were treated.

We found that medicines were given out safely and where people managed their own medicines there were checks in place to make sure this was managed safely.

We found that people had consented to care and support and that any restrictions which were legally imposed had been discussed and agreed with the person. People understood these restrictions and the reasons they were in place. This meant their rights were upheld.

The people we spoke with told us they received excellent care and support from the staff. One person commented, "The first year I needed intensive support from the staff and was provided with this. The staff have been wonderful to me." They told us they had seen their care and support plans and felt they were accurate and said they agreed with what was written.

People told us they liked living at the home, they felt it was clean and comfortable. They said the landlord did not always complete repairs quickly enough but they said they felt the managers did everything in their power to progress these issues.

We looked at three staff files to make sure they had been safely recruited and were suitable to work with people living at the service. Those we saw contained all of the information and documentation required and this meant that managers had taken all necessary steps to make sure staff were suitable to work with vulnerable people.

Complaints were taken seriously and investigated appropriately.