Archived: Palm Care

Updated 22 August 2017

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 11 July 2017 and was announced. The provider was given 24 hours’ notice because the service was a small care home for adults who are often out during the day; we needed to be sure that someone would be in.

The provider 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. Before the inspection we reviewed all the information we held about the service, we looked at the PIR, the previous inspection reports and any notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the registered manager and three members of staff. We looked at three people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including three staff recruitment files, the staff induction records, training and supervision schedules, staff rotas and quality assurance surveys and audits.

During our inspection we spoke and spent time with all five people living at the service. We observed how people were supported and the activities they were engaged in. Some people were unable to tell us about their experience of the service so we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We last inspected this service in May 2016 when breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. At this inspection the breaches had been met and no further breaches were identified.

Updated 22 August 2017

This inspection was carried out on the 11 July 2017 and was announced.

Palm Care is registered to provide accommodation and personal care for up to six people. People living at the service had a range of learning disabilities. Some people were living with autism and required support with behaviours that challenged.

The service had 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.

We carried out an unannounced comprehensive inspection of this service on 19 and 20 May 2016 and Palm Care was rated ‘Requires Improvement.’ There were breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. We issued requirement notices relating to safe care and treatment, fit and proper persons employed, person centred care, need for consent and good governance. We asked the provider to take action and the provider sent us an action plan. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. At this inspection, improvements had been made and the breaches had been met.

Since the last inspection, the manager had registered with the Care Quality Commission. Staff and relatives had fed back that the registered manager had a positive impact on the service. The registered manager had asked for regular feedback from stakeholders to ensure they felt improvements were being made. All the feedback was positive, and included comments such as, ‘Since [the registered manager] took over the standard of care, facility cleanliness and communication has risen sharply. Palm Care really feels more like a home for its residents now.’ There was a positive, inclusive culture within the service.

People were relaxed in the company of staff and staff knew people well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. When people’s liberty was restricted the registered manager had made Deprivation of Liberty Safeguards applications (DoLS) to the local authority. There was enough staff to keep people safe and people received their allocated one to one hours from staff to ensure they receive the support they needed. Risks relating to people’s care and support were assessed and mitigated. Some people displayed behaviour that could be challenging and there was clear guidance in place to minimise the chances of people becoming distressed. The environment was safe.

Staff treated people with respect and dignity. People participated in weekly ‘my time’ sessions where they spent time with staff and identified goals and things they wanted to achieve. People took part in a variety of activities and led busy and active lives.

Staff had made prompt referrals to healthcare professionals when they needed additional support and advice. When people’s health care needs changed, there was clear guidance available for staff. People received their medicines as and when they needed them. People were supported to eat and drink safely.

Staff knew how to recognise and respond to abuse and the registered manager had reported any safeguarding concerns to the local authority. Action had been taken to ensure they did not occur again. Complaints were documented and responded to in line with the provider’s policy. People and their relatives told us they were happy with the support provided.

Staff received appropriate training and were supported by the registered manager to carry out their roles effectively. The registered manager completed a range of checks on the service, including care plan reviews, environmental checks and regular audits of medicines to ensure people were safe. Regular fire drills were held so people knew how to evacuate the service in an emergency. Staff were recruited safely. The Care Quality Commission had been notified of important events within the service, as required by law.