May Morning

Updated 20 November 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 12 September 2018 and was unannounced.

The inspection was undertaken by one inspector, this was because it was considered that additional inspection staff may be intrusive to people’s daily routines.

Before the inspection, the provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at previous action plans and reviewed other records we held about the service, including the details of any safeguarding events and statutory notifications sent by the provider. Statutory notifications are reports of events that the provider is required by law to inform us about.

At inspection we met six of the people who lived in the service at various times during the day. Some people were not able to express their views: we made observations of people’s interactions with staff and with other people. We also observed how staff engaged with people and with each other in carrying out their care and support duties.

We spoke with the registered manager, deputy manager, one team leader and two staff. We received feedback from two social care professionals’ one health professional and two relatives.

We looked at two care plans and associated health plans, environmental and individual risk assessments, medicine records, and some operational records that included three staff recruitment and training, staff rotas, menus, accident and incident reports, servicing and maintenance records, complaints information, policies and procedures, survey and quality audit information.

Updated 20 November 2018

May Morning is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. CQC carried out an unannounced inspection of this service on 12 September 2018.

May Morning provides accommodation and personal care for up to eight people who have a learning disability, autistic spectrum disorder and some physical disabilities. The accommodation is accessible and appropriate to meet the needs of the people living in the service. At the time of our inspection there were seven people living at the service.

The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The values that underpin the guidance such as offering choice, promotion of independence and inclusion were evident in the support people received from staff so that they can live as ordinary a life as any citizen.

There was 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.

At the last inspection on 31 May 2017 the service was overall rated as requires improvement. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, responsive and well led to at least good.

At this inspection we checked that the action plan for the previous inspection had been implemented. We found that the previous breaches regarding completion of health and safety checks, an accessible complaints procedure and the effectiveness of quality assurance systems had now been fully met, and we have rated the service as ‘Good’.

There were enough staff to support people’s needs. Risks to people had been assessed and measures implemented to reduce these. Peoples medicines were managed safely and only trained staff administered these. Their competency to do so was assessed at regular intervals. People’s health and wellbeing was monitored by staff who were proactive in referring people appropriately to GP’s or for specialist support from other health professionals. Guidance was in place to inform staff how to support people’s specific health conditions such as epilepsy and recognise signs of deterioration.

People had care plans in place which detailed their needs and wishes. Where known people’s end of life choices and wishes were recorded to inform staff who would implement these if the need arose.

Staff were trained to recognise and respond to suspicions of abuse, they understood their responsibilities to act on their concerns. Staff knew how to escalate their concerns to protect people from harm. Staff understood how to report and act upon accidents and incidents. These were analysed and informed the development of strategies to reduce risk and avoid recurrence where possible.

Staff recruitment files showed that satisfactory processes were in place for the recruitment and selection of all levels of staff. Staff received the training they needed to ensure they had the right knowledge and understanding of people’s needs. Staff said that they felt supported and listened to, communication within the service between all levels of staff was good. New staff said they had felt fully supported by existing staff members and that there was good teamwork. Staff were given opportunities to express their views through staff meetings and one to one meetings. However, the delivery of an annual staff appraisal system needed improvement.

People lived in a clean safe environment that was maintained to a good standard. Equipment for the detection of fires and electrical and gas installations was tested and serviced at regular intervals. Staff were trained to take appropriate action in a fire. People had individual evacuation plans to inform staff what support they might need to affect a safe evacuation.

People were supported to make choices about their lives, including what social activities they wanted to do. Staff sought peoples consent to the everyday tasks they helped them with. Staff understood the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards DoLS. People were consulted about what they ate and drank, they were supported to make drinks and snacks for themselves. Where people showed a commitment to do so staff helped people to eat healthily and to lose weight.

A quality assurance system was in place this had been improved upon since the last inspection, this provided the registered manager with a good overview of service quality and where any shortfalls were identified. Relatives were surveyed for their comments, feedback from those received was universally positive with no comments for improvements.

An accessible complaints procedure had been developed for people and staff were proactive in supporting people to raise concerns. Relatives felt confident about raising concerns if they had any, and felt these would be acted upon.

We have made one recommendation in relation to staff appraisals.