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Inspection Summary


Overall summary & rating

Good

Updated 6 July 2018

We undertook an unannounced inspection of Urmston House on 22 and 24 May 2018. When the service was last inspected in January 2016, no breaches of the legal requirements were identified.

Urmston House provides accommodation for people with learning difficulties, sensory impairment, those who could emit challenging behaviour and autism who require personal care to a maximum of six people. Urmston House is a purpose built care home. People have their own self-contained apartment on the ground floor of the home. The apartments include an ensuite and kitchen facilities. At the time of our inspection there were six people living at the 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.

At the last inspection in January 2016, the service was rated as good in all the areas of Safe, Effective, Caring, Responsive and Well Led. At this inspection, we found the service had improved and was now outstanding in effective. The overall rating was good.

There was registered manager in post. 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 2008 and associated Regulations about how the service is run.

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.

Outstanding and innovative care practices were delivered by staff to maximise people's independence and help them achieve significantly positive life experiences. This included making sure the environment was suitable for people with a visual impairment. The staff had been creative in their approach in reducing falls for one person because of the simple but creative adaptations that had been made to their environment. For another person their bedroom had been adapted to enable them to return from hospital because suitable training and equipment had been put in place to support them effectively and responsively. Relatives were extremely positive about the care and support that was in place. They described a unique service that was person centred with high levels of staffing. This meant that people were supported on a one to one basis enabling them to lead the life they wanted. People were at the heart of the service. Staff knew what mattered to people. They continued to explore options for people in respect of activities.

People remained safe at the home. There were sufficient numbers of staff to meet people’s needs and to spend time socialising with them. The registered manager had responded to a recommendation that was made at the last inspection to ensure there was a team leader working in the home at all times. This was in accordance with the staffing profile/assessment for the service. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others. People received their medicines safely.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes.

People were supported with their nutrition and hydration needs. People had access to healthcare professionals when needed and the home had a good relationship with the local GP. Care records contained guidance on how to support people who may not be able to communicate their healthcare needs.

The registered manager had ensured the Deprivation of Liberty Safeguards (DoLS) had been applied for when appropriate. DoLS is a legal framework to lawfully deprive a person of their liberty when they lack the capacity to make certain decisions in regards to their care and treatment. When a person lacked capacity to make a particular decision, a process was followed in line with the Mental Capacity Act 2005 (MCA). Staff showed good understanding of the principles of the MCA and how this was applied in their day-to-day role of supporting people.

People received support from staff who showed kindness and respect. Relatives were welcome at any time and people had access to an independent advocate. Care plans showed how people's dignity and privacy was maintained. They also showed people's personal preferences and how people would communicate these. They recognised how important it was for families and friends to be involved in people's care, support and wellbeing. Relatives confirmed they were kept informed and involved in care reviews.

Care records contained personalised information, which ensured the home was responsive to people's needs. Staff were knowledgeable about what was important to individuals. People and relatives had access to the complaints procedure in a format they could understand. There had not been any complaints in the last 12 months.

The home was well led and run. The registered manager communicated effectively with staff and relatives. The registered manager had systems in place to regularly assess and monitor the quality of the service provided to people.

Inspection areas

Safe

Good

Updated 6 July 2018

The service was safe.

Staffing numbers were sufficient to meet people’s individual needs. Improvements had been made to ensure there was always a team leader working in the service. Robust recruitment checks ensured staff were suitable to work at the service.

Staff knew how to identify and report safeguarding concerns.

Positive risk assessments were in place to keep people safe whilst promoting independence.

People’s medicines were managed safely.

Effective

Outstanding

Updated 6 July 2018

The service was very effective in meeting people’s needs.

Urmston House provided people with facilities that promoted people’s well-being enabling them to respond to their care and support needs. They had been creative in the way they had ensured the home was suitable for people with a visual impairment.

People’s rights were upheld and they were involved in decisions about their care and support. Staff were knowledgeable about the legislation to protect people in relation to making decisions and safeguards in respect of deprivation of liberty.

People were supported by staff that knew them very well and had received appropriate training. The registered manager was proactive in ensuring the training was suitable with bespoke training being organised. Other health and social care professionals were involved in the care of people and their advice was acted upon.

Caring

Good

Updated 6 July 2018

The service continues to be caring.

Responsive

Good

Updated 6 July 2018

The service continues to be responsive.

Well-led

Good

Updated 6 July 2018

The service continues to be well led.