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Inspection Summary


Overall summary & rating

Good

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

Inspection areas

Safe

Good

Updated 22 August 2017

The service was safe.

There was enough staff to keep people safe. People received their one to one staffing hours to ensure they received the support they required. Staff were recruited safely.

Risks relating to people’s care and supported had been assessed and mitigated. The environment was safe.

Medicines were managed safely.

Staff knew how it recognise and respond to abuse.

Effective

Good

Updated 22 August 2017

The service was effective.

Staff received the necessary training and support to carry out their roles effectively.

The registered manager had applied for Deprivation of Liberty Safeguards for each person living at the service. Staff supported people to make choices about their lives.

Staff sought advice from health care professionals if people’s health needs changed.

People were supported to eat and drink safely.

Caring

Good

Updated 22 August 2017

The service was caring.

Staff were kind and caring and knew people well.

People were supported to make their needs known.

People were treated with respect and dignity.

Responsive

Good

Updated 22 August 2017

The service was responsive.

Care plans were detailed and gave staff the information they needed to provide person-centred care.

People participated in a range of activities both in and outside of the service.

The registered manager had investigated and responded to complaints in line with the provider’s policy.

Well-led

Good

Updated 22 August 2017

The service was well-led.

The registered manager had made improvements to the service. They had informed the Care Quality Commission of important events happening within the service.

There was a positive, inclusive culture and one relative had described the service as now feeling like ‘home.’

Feedback had been sought from a variety of stakeholders regarding the service. The registered manager and senior staff completed a range of checks and audits to ensure that the service was providing safe, effective compassionate care.