28 July 2018
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 6 June 2018 and was unannounced. The inspection was carried out by one inspector.
We used the information we held about the service to formulate our inspection plan. This included information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included statutory notifications that the provider had sent to us. A statutory notification is information about important events which the provider is required to send us by law. These include information about safeguarding concerns, serious injuries and deaths that had occurred at the service.
We spoke with relatives of a person who used the service. We did this to gain their views about the care and to check that standards of care were being met. Most people who used the service were not able to speak to us about their care experiences so we observed how the staff interacted with people in communal areas and we looked at the care records of three people who used the service, to see if their records were accurate and up to date. We also 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 spoke with a visiting professional, four members of care staff, the registered manager and the deputy manager. We also looked at records relating to the management of the service. These included five staff recruitment files, meeting minutes and quality assurance records.
28 July 2018
This inspection took place on 6 June 2018 and was unannounced.
At the last inspection the service was rated as requires improvement. We found the provider was not meeting all the requirements of the law. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve to at least good. During this inspection we found that the provider had done what they said they would do and were no longer in breach of regulations.
Choices Housing Association Limited – 17 Norton Avenue is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
17 Norton Avenue accommodates up to six people in one adapted building. At the time of this inspection there were four people using the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in post at the time 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.
People were protected from avoidable abuse and harm by well trained staff. Risks were assessed, identified and managed appropriately, with guidance for staff on how to mitigate risks. Premises and equipment were kept clean and tidy. Staffing levels were sufficient to meet people's needs and staff had their suitability to work in a care setting checked before they began working with people. Medicines were now managed safely, following improvements to the systems in place. The registered manager had systems in place to learn when things went wrong.
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 support this practice.
People were supported by well trained staff and received effective care in line with their support needs. Staff received regular supervision and appraisal which encouraged reflections on their practice with people and what they could do to further improve people’s experiences of receiving care and support. Staff had access to continuous training that was developed and delivered around people’s individual needs.
There was a good choice of food, which people enjoyed and they received support to meet their nutrition and hydration needs and to encourage independence. Staff were committed to supporting people to stay healthy and people achieved excellent outcomes resulting from staff’s commitment.
The environment was designed and adapted to support people effectively, including significant improvements being made to bathroom facilities to improve people’s choice, independence and comfort.
Healthcare professionals were consulted and staff worked collaboratively with them to help manage people’s complex health needs and to promote best practice. People were supported to access a wide range of healthcare services and were empowered to improve their quality of life and health. Innovative support was provided to encourage and support people to remain healthy. Links with health and social care professionals were excellent.
Staff were kind, caring and compassionate with people. People were supported to express their views and encouraged and supported to make their own choices with a range of communication aids. People were treated with dignity and respect by staff who knew them well.
Staff understood people and their needs and preferences were assessed and regularly reviewed. Activities were organised by staff and people were supported to participate in activities that they preferred. People's diverse needs were considered as part of the assessment and care planning process. Complaints were managed in line with the provider's policy. People were supported to consider their wishes about their end of life care.
A registered manager was in post and was freely available to people, relatives and staff. People, their relatives and staff were involved in the development of the service and they were given opportunities to provide feedback that was acted upon to improve the service. We found the registered manager and provider had systems in place to check on the quality of the service and use this to make improvements. Continual learning and improvements were encouraged.