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Archived: Station Road Good

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Reports


Inspection carried out on 21 May 2015

During an inspection to make sure that the improvements required had been made

We inspected Station Road on 21 May 2015. This was an unannounced inspection.

Station Road provides accommodation for up to 12 people with learning disabilities who have nursing needs. The accommodation comprises of two purpose built bungalows, each with six single rooms. The service is located within the village of Clayton, on the outskirts of Bradford.

The service had 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.

We spoke with staff who told us they had received safeguarding training and could tell us what action they would take if they had a concern. The service had a safeguarding policy in place. Safeguarding was discussed in team meetings as a set agenda item.

The service used equipment to help in moving and handling. We saw equipment had been serviced. Staff told us they received training on how to use the equipment and felt confident when they used it. We observed staff completed visual checks on equipment each time they used it.

Staff told us they had received regular training and felt they were competent to complete their role. We looked at the training matrix. Although the majority of training had been completed by most staff, there were gaps where staff needed to update their knowledge on some courses.

The registered manager told us how they set the staffing levels in the service. Staffing levels were maintained to support people with their needs at all times. We saw morning shifts started with three members of staff with an additional fourth member joining later on in the day to support with the busier times. During the day of inspection we saw everyone had their needs met within a swift time frame.

People received their medicines in line with their prescription. Medicines were stored appropriately and administered by trained staff. We observed staff followed good practice. For example handing out one person’s medicines at a time and signing after people had taken it. All bottles with one exception had stickers on that listed the date of opening.

Staff were recruited in line with the provider’s policy. We saw staff had been interviewed and had been ID checked, references checked and criminal background checked. Staff told us they received an induction program to work through when they started with the provider.

We observed practices in the service. We saw people were given privacy and had their dignity respected. Staff knocked on people’s doors before entering and explained what they were doing before they did it. Staff told us they had a good knowledge of people and how they communicated. With this knowledge staff could identify if people did not want to do an activity or refused a request made by staff. This told us people had the opportunity to have their choices heard by staff who understood them.

People were encouraged to maintain a level of independence. Staff told us they get people to do as much as they can for themselves. We observed one person being supported to prepare their own lunch.

Before people moved to live at the service, an assessment of their needs had been carried out. One of the two properties was in the process of being decommissioned and people were moving to the second property or elsewhere. Checks to see if their needs could still be met had been completed.

Care records were reviewed on a regular basis. Records were written in a person centred way and reflected the person’s needs. Records and documentation were in the process of changing which could cause confusion. Staff felt the new documents were positive and easy to follow. Care records had involvement from health professionals and advocates. Daily notes reflected interaction with other health professionals. Staff told us they would refer people to health professionals if they felt they would benefit from professional advice. Care records included people’s personal preferences, goals and activities. Activities were on going and people were given a choice if they wanted to do an activity or not.

We saw the service had made Deprivation of Liberty’s Safeguard referrals which had been granted to deprive people of their liberty in legal way to keep them safe. We looked at the documentation and saw appropriate information had been captured.

People had individual meal plans created. Staff supported people to make their own food. We asked staff about the different way in which people ate their food. Staff were able to tell us people’s dietary needs and how they supported people with eating. We observed people eating their food over meal times. People had a choice of food or drink and could change their mind.

The registered manager completed quality audits to analyse performance and identify improvements. Audits completed created an action plan. Feedback to team members was given during team meetings.

The service had a complaints policy in place. We did not see any complaints recorded in the previous 12 months of the date of inspection. The registered manager told us that complaints would be responded to in line with their policy. The complaints policy was available as an easy read document for the people that used the service. The service notified the Care Quality Commission of events in line with their registration.

Inspection carried out on 2, 7 April 2014

During a routine inspection

We inspected to see if the service was caring, responsive, safe, effective and well led.

Is the service safe?

We observed staff treating people with respect and dignity and found that staff were following advice given in peoples care plans. The office had a keypad entry system and there were staff present at all times. We saw mental capacity assessments had taken place and where people were deemed not to have capacity, best interest meetings were held.

Is the service effective?

There was an advocacy service in place if people needed it; this meant when required, people could access support. Specialist needs had been identified within the care plan where required.

Is the service caring?

We looked through four care files and saw referrals had been made to other professionals. The acting manager told us they were conducting a full review of all care files and we saw evidence of this happening on the day of inspection.

Is the service responsive?

We found people were supported by kind and attentive staff. We saw staff were quick to react if someone was unhappy and would always be near in case someone using the service required something.

Is the service well-led?

On the day of inspection there were nine people using the service. There were a range of activities completed on a daily basis. The service had its own mini bus to go into the community but public transport was also used. We saw one person refuse to take part in an activity and their decision was respected.

Staff told us they were clear about their roles and had a good understanding about the ethos of the service.

Inspection carried out on 29 January 2014

During an inspection to make sure that the improvements required had been made

We carried out this visit to look at the arrangements for handling medicines. We checked the records and a sample of medicines for five people who lived in Station Road. We spoke with the manager and a nurse. We found it difficult to obtain the direct views of people who lived in the home about how medicines were handled.

Overall we found some improvements were required to help make sure medicines are handled safely.

Inspection carried out on 15 July 2013

During an inspection to make sure that the improvements required had been made

We were not able to speak with people who lived at Station Road because they had complex needs which meant they were not able to tell us about their experiences. We used a number of different methods to help us understand the experiences of people. We reviewed care records, observed care and spoke with people's relatives.

We spoke with one relative of a person who lived at Station Road. They told us �all the staff are very nice when I visit and I think my relative is very happy�. They also spoke about how their relative was rarely ill and this was �credit to the carers�.

We found the provider had procedures in place to protect the people who lived at Station Road from the risk of abuse.

We found people were being cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

However, despite the positive comments people made, we found evidence people were not always protected from the risk of inappropriate or unsafe care because care records were not fit for purpose.

Inspection carried out on 28 September 2012

During a routine inspection

We were not able to speak with people who used the service because they had complex needs which meant they were not able to tell us about their experiences. We used a number of different methods to help us understand the experiences of people using the service, such as reviewing care records and speaking to relatives of two people who lived at Station Road.

Both relatives told us staff kept them informed of changes and would often contact them to ask their views when making decisions about their relative�s care. However, both people said staff did not involve them in decisions regarding their relative�s holidays. One person said, �It would be nice to be involved in deciding where they go on holiday but staff usually only inform us once the holiday is booked�.

Both people said they were happy with the care and support their relatives received. They said staff provided their relatives with appropriate care and support. Whilst they had not been given the opportunity to provide formal feedback about the quality of the service, relatives said they felt able to make suggestions about how to improve the service and that staff listened to them when they did.

However, despite the positive comments people made, we found evidence that people did not always experience care, treatment and support that met their needs and protected their rights. We also found that people were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Also people were not being cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard because they had not received appropriate training to undertake their work.