Choices Housing Association Limited - 103 Heath Street

103 Heath Street is a residential care home providing personal care to five people who had a learning and/or physical disability at the time of the inspection. The service can support up to six people in one adapted building.

The service has been developed and designed 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 the 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People living at 103 Heath Street experienced an excellent level of care and support which promoted positive outcomes for people. There was a strong focus of person-centred care within the service, which staff followed in practice to ensure people led a full and varied life.

People received exceptional care at the end of their life that met their wishes. Staff ensured people received caring support and attention in the final days of their life.

People and relatives were consistently involved in all aspects of their care to ensure support reflected their preferences. The positive outcomes for people using the service were reflected in the principles and values of Registering the Right Support, by promoting choice and control, independence and inclusion.

The registered manager had forged excellent working relationships with other professionals to ensure people received the best possible care in line with their individual needs and preferences. Continuous learning and improvement strategies were used to continually seek ways to improve the level of support people received.

People were supported by safely recruited staff, who had the skills and knowledge to provide effective support. Staffing levels were regularly reviewed to ensure there were enough staff available to meet people's needs. People's medicines were managed, and staff followed infection control procedures.

People were cared for by caring and attentive staff who supported people in a dignified and respectful way. People’s right to privacy was upheld. People had been supported to maintain friendships that were important to them. Staff and the registered manager respected people's diverse needs and promoted an open culture.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had access to complaints procedures and their feedback was used to inform service delivery. The registered manager had systems in place to ensure people’s risks were mitigated. The registered manager worked in line with the requirements of their registration.

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

Rating at last inspection

The last rating for this service was Good (published 13 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

103 Heath Street provides accommodation and personal care for up to six people who have a learning disability. On the day of the inspection the home was fully occupied.

The home had a registered manager who was present on the day of the inspection. 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.

Practices did not always safeguard people from the risk of harm. However, staff were aware of their responsibility to share concerns of potential abuse with the registered manager. There were sufficient numbers of staff provided to meet people’s needs and they were supported to take their prescribed medicines.

People were cared for by staff who were skilled and supported in their role by the management team. People’s human rights were protected because staff had adopted the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their care practice.

People were supported by staff to eat and drink sufficient amounts to promote their health. People were assisted by staff to access relevant healthcare services when needed.

People were cared for and supported by staff who were kind and attentive to their needs and their rights to privacy and dignity was respected.

People were present when their care assessment was carried out and where appropriate their relatives were involved. People had access to a variety of social activities and stimulation. Formal systems were in place to manage complaints so people could be confident their concerns would be listened to and acted on.

People were unable to say how they would like the home to be run. However, people’s relatives had the opportunity to tell the provider about the quality of service provided to people. The home was run by a registered manager who was supported in their role by the compliance and performance manager. Staff were aware of the management team and felt supported in their role. The provider had formal systems in place to assess and monitor the quality of service provided to people.

Most of the people who used the service were unable to tell us if they were happy living at the home due to their disabilities. Through a process called 'pathway tracking' we looked at three people's care records, observed the care those people received and spoke to the staff and their representatives about the care. We did this to see if people's needs were being met.

Relatives told us they were happy with the care being provided. One relative said, 'I can't fault the staff, they look after my relative brilliantly'. Another relative said, 'It's 100% better than I thought it would be. The carers' and the manager are all brilliant'.

We saw that people were offered choices about their care and treatment and when people could not make choices for themselves, staff followed the legal requirements to act in their best interests.

People's needs were met safely, because an effective recruitment process was in place to ensure that staff were suitable to work at the home.

Care records were informative and accurate, which meant that the risks associated with delivering care to people were reduced.

During our inspection we saw that people were encouraged to make day to day decisions. We saw that where people were unable to make decisions for themselves the provider did not always act in accordance with the legal requirements that ensure decisions are made in people's best interest's.

We saw that people were supported to engage in appropriate community activities and purposeful activities. People had access to health and social care professionals to ensure there health and well being needs were addressed.

We observed people receiving care and treatment by staff who had the required knowledge and skills to provide the level of care that people needed. Care records were accurate, up to date and were stored securely.

We saw that medicines were stored and disposed of safely, but appropriate arrangements were not in place in relation to the recording of medicine.

We saw that there was an effective complaints system in place to support people using and visiting the service.