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Hoffmann Foundation for Autism - 18 Marriott Road Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 January 2019

This inspection took place on 10 December 2018 and was unannounced. The service was last inspected on 2 May 2017, where we found the provider to be in breach of one regulation in relation to good governance. The service was rated Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions effective and well-led to at least good. At the inspection on 10 December 2018, we found the provider had made some improvements and were no longer in breach of the regulation in relation to good governance. However, we found there were issues with staffing and hence, the service remains Requires Improvement. This is the third consecutive time the service has been rated Requires Improvement.

The Hoffmann Foundation for Autism – 18 Marriott Road is a residential care home registered to provide accommodation and personal care support for up to six people who have a learning disability and may have autism, Asperger's Syndrome or display characteristics that fall within the autistic spectrum. At the time of our inspection, five people were living at the service.

The Hoffmann Foundation for Autism – 18 Marriott Road 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 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.

There was a registered manager in place. 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.

Relatives of people who used the service told us people were safe and there were enough staff. However, staff told us there were not enough permanent staff and found difficult to work with different agency staff. There was a lack of continuity for people who used the service.

Staff knew how to identify and report abuse, and escalate concerns outside the service where necessary.

Staff were recruited appropriately to ensure they were safe and suitable to work with people who were vulnerable. People’s medicines were managed safely. Staff maintained clear safeguarding and incidents records. The management learnt and shared lessons with staff to improve when things went wrong.

There were systems in place to assess people’s needs before they moved to the service. People’s needs were met by staff who were appropriately trained. Staff received regular supervision to do their jobs effectively. People’s dietary needs were met and were supported to access ongoing healthcare services. The building was not suitable for people due to accessibility issues and the provider was in the process of moving people to a more appropriate setting. The provider sought people’s consent to care and treatment in line with the legislation and guidance.

Relatives told us staff listened to people and were caring. Staff encouraged people to express their views and supported them to be as independent as they could be. People’s cultural and religious needs were identified, recorded and met by staff. Staff were knowledgeable about the importance of maintaining people’s confidentiality.

People’s care plans were in accessible format and gave staff sufficient information to provide personalised care. People’s care was reviewed regularly and relatives were involved in the process. There were systems and processes in pla

Inspection areas

Safe

Requires improvement

Updated 24 January 2019

The service was not consistently safe.

There was a lack of continuity for people living at the service due to shortage of permanent staff.

People’s relatives told us the service was safe and that they were safely supported by staff. Staff knew how to safeguard people against harm and abuse.

The provider followed safe recruitment practices. Staff were trained in safe medicines handling and supported people safely.

The service was clean and staff knew how to prevent the spread of infection.

The provider had systems in place to learn lessons and improve when things went wrong.

Effective

Good

Updated 24 January 2019

The service was effective.

Relatives told us people’s needs were met by staff. There were systems in place to assess people’s need before they moved to the service.

Staff received sufficient training and regular supervision to provide effective care.

People were supported to maintain a nutritionally balanced diet. Staff supported people to access ongoing healthcare service to live healthier lives.

The provider was in the process of moving people to a new service as the current service’s building was not suitable for people.

The care was delivered as per the Mental Capacity Act 2005 principles.

Caring

Good

Updated 24 January 2019

The service was caring.

Relatives told us staff were caring and kind, and provided person-centred care.

Staff were trained in dignity in care, and relatives told us they treated people with respect.

People’s cultural and religious needs were identified and recorded in their care plans.

Staff encouraged and supported people to be independent. People’s confidentiality was maintained.

Responsive

Good

Updated 24 January 2019

The service was responsive.

People were supported with their personalised care needs. Staff were knowledgeable about people’s likes and dislikes.

People’s care plans were comprehensive and regularly reviewed. Relatives and relevant healthcare professionals were involved in people’s care reviews.

People were supported to participate in a range of activities.

The provider welcomed lesbian, gay, bisexual and transgender people to use the service.

People and relatives were encouraged to raise concerns. There were systems in place to address people’s complaints in a timely manner.

The provider’s end of life care policy did not detail how to assess and support people’s end of life care wishes.

Well-led

Requires improvement

Updated 24 January 2019

The service was not consistently well led.

Relatives spoke positively about the management about the service. However, staff told us they felt less valued and they felt there was lack of management presence. The provider's quality assurance systems had not picked up issues related to lack of continuity of staffing.

There were monitoring and auditing systems in place to ensure the safety and quality of the service.

The provider sought feedback from people, relatives and staff to improve the service.

The management worked in partnership with other organisations.