Community Integrated Care (CIC) - 2 Seafarers Walk

Community Integrated Care (CIC) – 2 Seafarers Walk is a residential care home providing accommodation and personal care to five people living with a learning disability or autistic spectrum disorder at the time of the inspection. The service can support up to five 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 continued to receive safe care at Community Integrated Care (CIC) - 2 Seafarers Walk. People’s relatives spoke highly of the quality of care people received and told us their relatives were safely cared for. People’s risks were assessed, and staff knew how to support people to minimise risks to their health and wellbeing. Safeguarding concerns were acted on appropriately and checks were carried out to protect people from the employment of unsuitable staff. Some improvements were required in the management of people’s medicines and the registered manager acted to address these immediately following our inspection.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff completed training to enable them to effectively meet people’s needs and were supported in their role. Staff acted on healthcare concerns to ensure people received the treatment they needed and regular check-ups

People were supported by kind, caring and compassionate staff. A person’s relative said “They [staff] are angels, they are so nice.” Staff knew how to provide respectful care, to promote people’s dignity and right to privacy.

Person centred care plans described how people preferred to receive their care and included information on how to meet people’s communication needs. Activities in the service and the community were provided so that people could have new experiences and maintain their interests.

The provider, registered manager and senior support worker promoted a positive culture for people and staff. A system was in place to monitor the quality and safety of the service, some audits required action plans and more robust monitoring. The registered manager acted to address this.

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 28 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Community Integrated Care (CIC) - 2 Seafarers Walk on our website at www.cqc.org.uk.

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.

2 Seafarers Walk is a service provided by Community Integrated Care and is situated in a quiet residential area to the south east of Hayling Island. The home is a bungalow which was purpose built to provide accommodation and care to five people with learning and physical disabilities. At the time of this inspection there were five people living in the service. There were eleven permanent staff, which included two senior support workers and one registered manager.

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 received a safe service. Staff knew how to keep people safe from harm and had a good understanding of how to report safeguarding concerns. Safeguarding concerns had not been raised since the last inspection. People’s finances were managed safely.

Different types of risk assessments were in place for each person and risk management plans were implemented to ensure people and those around them were supported to stay safe. The service did not use physical interventions to support people who’s behaviours were deemed to challenge. Fire safety procedures were in place for the home and were followed to keep people safe.

There were sufficient staffing levels at the home, which were flexible to meet people’s needs.Safe recruitment and medicine practices were followed.

Staff were experienced and knew people well. Staff received induction training in line with the Care Certificate when starting work at the home. Staff received regular training, supervision and appraisal.

Staff had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and how to put this into practice.

People were supported to have enough to eat and drink and people who required specialised support with feeding were supported effectively. People regularly accessed healthcare services.

The service was caring. Staff treated people as individuals and encouraged them to do as much for themselves as possible. People’s privacy and dignity was respected.

There was a positive culture in the service which promoted personalised care and support. People received the care and support they needed, were listened to and had their choices respected. A variety of communication techniques were used to ensure people were engaged with and involved in making decisions about the support they wanted. People’s needs were regularly assessed and reviewed. Activities were personalised and meaningful.

People were given the information to tell them how to complain. Complaints had not been received about the service since the last inspection

Quality and safety audits were completed which supported the registered manager and senior managers to assess the overall safety and quality of the home.

2 Seafarers Walk is a service provided by Community Integrated Care and is situated in a quiet residential area to the south east of Hayling Island. The home is a bungalow which was purpose built to provide accommodation and care to five people with learning and physical disabilities. At the time of this inspection there were four people living in the service. There were sixteen permanent staff, which included two senior support workers. The service also used bank staff that were employed by the provider and were known to people living at the home.

There was no registered manager in post at the time of the inspection, however there was a service lead in post who was responsible for the day to day running of the service and had applied to become the registered manager. However the service lead was already registered with the commission in relation to the same regulated activity for a different location which is run by the provider. 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 not always safe at the service. Interim measures were not always taken to ensure people and staff were safe from harm. There were concerns about the cleanliness of the home and the home was in a poor state of repair. Although people’s day to day spending money was managed safely, people could be at risk of potential financial abuse and the appointees could be at risk of potential allegations of financial abuse because best interest decisions did not always include other appropriate professionals.

Staff knew how to keep people safe from harm and had a good understanding of how to report safeguarding concerns. Safeguarding concerns had not been raised since the last inspection.

Different types of risk assessments were in place for each person and risk management plans were implemented to ensure people and those around them were supported to stay safe. The service did not use restraint. Fire safety procedures were in place for the home and were followed to complete people safe.

There were sufficient staffing levels at the home, which was flexible to meet people’s needs.

Safe recruitment and medicine practices were followed.

Staff were experienced and knew people well. Staff received induction training in line with the Care Certificate when starting work at the home. Staff received regular supervision and one to one sessions.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA); however this was not always demonstrated when making best interest decisions for people who were deemed to lack capacity. We made a recommendation to refer to the Mental Capacity Act 2005 and its codes of practice. Staff demonstrated a good understanding of the Deprivation of Liberty Safeguards (DoLS) and how to put this into practice.

People were supported to have enough to eat and drink and meal times were flexible to meet people’s needs. People regularly accessed healthcare services.

The service was caring and people experienced care that was compassionate. Staff treated people as individuals and encouraged them to do as much for themselves as possible. People’s privacy and dignity was respected.

People received the care and support they needed, were listened to and had their choices respected. A variety of communication techniques were used to ensure people were engaged with and involved in making decisions about the support they wanted. People’s needs were regularly assessed and reviewed. Activities were personalised and meaningful.

People were given the information to tell them how to complain. Complaints had not been received about the service since the last inspection

There were clear visions and values in place and good leadership at the home. Quality audits were completed which supported the registered manager and senior managers to assess the overall quality of the home.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have also made a recommendation. You can see what action we told the provider to take at the back of the full version of this report.

We saw that care plans were clear and detailed and kept under regular review. There was evidence to show that people’s capacity to consent to their care had been assessed and suitable arrangements were in place to ensure decisions were made in their best interests.

The home was clean and information about hygiene and infection control was available to staff. Systems were in place to monitor the quality of care provided in the home and there was written evidence that actions were taken when improvements were needed.

Staff told us they loved their jobs and they thought the home was well run. They said people were well cared for and had fulfilling lives. One member of said about people who use the service, “They are always out, always doing things”. This was confirmed by what we observed and the documentation we looked at.

We saw that staff interacted well with people and assisted people with meals and care. We also observed staff supporting people to go out to activities. The health and social care professional told us the home provided a good standard of care. Comment was made that people attended a variety of community activities and that health care needs were met.

Each person had comprehensive care records detailing how people were supported with personal care, activities, medication and health needs.

Relatives told us they considered the home to be a safe place for people to live.

At the time of the inspection visit we saw the home had enough staff to meet people’s needs. We noted, however, that the for two days at weekends preceding our visit there were only two staff on duty when the home had assessed it should be providing three.

There home had equipment for moving people and these including ceiling track hoists in bedrooms and a mobile hoist. We observed a mobile hoist did not work correctly which caused considerable difficulties for the staff and person they were assisting.