Archived: Life Opportunities Trust - 9 Hitchin Road

We found the following examples of good practice.

Staff were heard engaging well with people. Staff told us that people were checked on frequently and they ensured they had something to occupy them while spending time isolating in their rooms.

The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID 19.

People who were in the higher risk groups were shielded throughout the pandemic. Two people who were in the older age range had been in a cohort (bubble) together and used a separate lounge to the others.

When people tested positive for COVID-19 they had to isolate in their rooms, for a set period of time. Staff were clear on what it meant to isolate and what symptoms of COVID -19 to look out for.

Staff had received training on putting on and taking off PPE, infection control and COVID 19. They told us they felt very supported and had enough information to do their jobs.

Further information is in the detailed findings below.

The service was set up prior to the Registering the Right Support guidance. However, the service worked in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service: People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People, their relatives and advocates were involved in discussions about their family members care. People’s support focused on them having as many opportunities as possible to gain new skills and become more independent.

Records CQC held about the service confirmed that the provider had not sent in all notifications as required. A notification is information about important events that the law requires the provider to notify us about such as safeguarding concerns, deaths, and serious incidents.

People’s rooms were individual and personalised, however areas of the service required decoration. A recent external fire risk assessment carried out found that two doors, needed replacing. There was a plan in place to replace these fire doors, but no timescales had been agreed.

People and their relatives were happy with the care and support they, or their family member received from staff. Staff encouraged people to complete tasks independently, or with minimal support where possible. Staff assisted people in a caring and respectful way.

Staff knew about safeguarding people from harm or poor care. Staff knew how to report their concerns internally and externally if needed.

Staff undertook a pre-assessment on people new to the service. This established what care and support a person required and whether staff were trained to meet these needs. People and their relatives were involved in their care decisions and the planning of their day-to-day care.

Staff monitored people’s assessed risks. Guidance and training were in place for staff on how to support people with these risks.

Staff respected and promoted people's dignity and privacy. Staff supported people with their prescribed medicines safely. People were supported by staff with their food and drink to make sure they were eating and drinking healthily.

There were enough staff to meet people`s needs. People were kept safe from risks of infection and cross contamination. New staff received an induction when joining the service. Staff received supervision, competency checks, appraisals and training to make sure that they could effectively carry out their role. Staff learnt lessons from incidents and near misses that happened to help reduce the risk of the incident happening again.

Staff worked with other external organisations to help support and promote people’s well-being. Staff gave people information in different formats, when needed, to help people with their understanding.

People and their relatives were given the opportunity to feedback on the quality of the service provided. People and their relatives were given information on how to raise a complaint and their concerns were listened to, investigated and resolved where possible.

Audits were carried out to monitor the quality of the service. These and any monitoring visits by either representatives of the provider and the local authority were reviewed, and actions taken or were in progress to make any necessary improvements required.

Rating at last inspection: Good. (Report published 16 December 2016.)

Why we inspected: This was a planned inspection as part of CQC’s routine inspection programme.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Life Opportunities Trust - 9 Hitchin Road is registered to provide accommodation and personal care for people with learning and physical disabilities. At the time of the inspection there were seven people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People were supported by staff who knew how to recognise and report abuse. We found that individual risks were assessed and staff were familiar with these. People’s medicines were managed safely.

People were supported by sufficient staff who were recruited through a robust process and received regular training. Staff also told us that they felt supported.

People had their consent sought and staff worked in accordance with the MCA 2005. Staff advocated for people on a day to day basis.

There was a variety of food available to help people maintain a healthy diet and people had regular access to health and social care professionals.

People were treated with dignity and respect and were involved in planning their care and staff were aware of their preferences. Staff were seen to be kind and attentive and people received care that met their needs. People’s care plans gave staff clear guidance on the support each person required.

People enjoyed their outings, activities and events.

Complaints were recorded and investigated to avoid any reoccurrence. Feedback about the management of the service was positive. There were quality assurance systems in place. We found that the staff and management team wanted to continually strive for improvement to improve the lives of the people they supported.

Life Opportunities Trust- 9 Hitchin Road provides accommodation and personal care for up to seven people with varying learning and physical needs. There were seven people living at the service on the day of our inspection. There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The previous manager was still registered at the home, however, the current manager had been in post for 18 months without submitting an application for their registration. This was an area that required improvement.

At the last inspection on 3 June 2013, the service was found to be meeting the standards. At this inspection we found they had continued to meet the standards.

The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS)

We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that most people living at the service were able to make their own decisions and those who were unable had their capacity assessed. The manager and staff understood their roles in relation to DoLS. DoLS applications for people who received constant supervision were pending an outcome.

People received care that met their needs and staff knew them well. People were involved in planning their care and the manager and staff team valued their views. There were arrangements for to seek their views through meetings and surveys.

People felt safe at the service and risks were reduced through good communication in the home. Medicines were managed safely. Staff knew how to help keep people safe and how to respond to any concerns. Staff had received appropriate training for their role, felt supported and regular one to one supervision had commenced. Staffing levels were set by the provider and these did not fluctuate depending on people’s needs. In addition the home had experienced recent staffing shortages.

People told us that staff were caring and they were supported to eat and drink as needed.

People had regular access to the community through day centres, church and clubs. Activities were available and people could choose how they spent their day.

There were systems in place to monitor the quality of the service and action plans developed to address any issues found. However, actions relating to the required refurbishment of the service had not yet been developed and the manager was awaiting the provider’s involvement to address these.

We found evidence that every effort had been made to identify and act on the wishes of people who lived there. However, suitable arrangements in line with published guidance relating to the Mental Capacity Act (MCA) 2005 were not in place where necessary to assess and document people's ability to make decisions.

Care plans we looked at showed that people's needs had been thoroughly assessed, documented and reviewed. A healthcare professional we spoke with told us, 'I have been very impressed with the levels of care provided to meet people's complex and changing needs.'

We saw evidence that people were provided with a good choice of food and drink in a way that both encouraged and promoted a healthy balanced diet.

The premises were safe, suitable and fit for purpose. Adequate emergency procedures were in place and the safety equipment we saw had been regularly checked and well maintained.

We saw that a complaints policy and procedure had been put in place. However, the way in which complaints had been handled did not always adequately reflect the policy which meant the system was less effective. The manager agreed that improvements were necessary in this area.

Personal records contained adequate information about people's health, personal care and personal preferences. Health care action plans demonstrated that people were supported to access appropriate health professionals to meet their needs such as speech and language therapist and optician.

Two people we spoke with indicated to us that they felt safe in the home and trusted staff.

Two relatives we spoke with said that they trusted staff to protect their family members.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Two relatives we spoke with told us that they felt staff were well trained for their roles. Staff received appropriate professional development and were able, from time to time, to obtain further relevant qualifications.

A person who used the service told us they had meetings every month called 'residents meetings' to discuss the running of the home, and that they always attended and contributed. They said they felt that staff listened to their views. People were also asked to complete surveys about their care and so were their relatives.