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Inspection carried out on 5 June 2019

During a routine inspection

About the service

51 The Drive is a small residential home providing personal care, rehabilitation, therapy and support for up to three people with acquired brain injuries. At the time of inspection, two people were living in the home.

People continued to be cared for safely and with compassion. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. Medicines systems were well organised, and staff managed people’s medicines safely. One aspect of environmental safety required strengthening. We discussed this with the registered manager and support services manager and swift action was taken to address the shortfall in the area we identified.

Staff had access to the support, supervision and training they required to work effectively in their roles. Staff supported people to have a healthy balanced diet. People’s support was overseen by a wide variety of specialist health and social care professionals. People had prompt access to healthcare support when needed.

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.

Staff were caring, person centred and inclusive. People were treated with kindness, dignity and respect and staff spent time getting to know them and their specific needs and wishes.

People had personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences. Staff encouraged people to follow their interests and people were supported to access many varied activities and interests.

Information was provided to people in an accessible format to enable them to make decisions about their care and support. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received.

The service had a positive ethos and an open culture. The registered manager was approachable, understood the needs of people, and listened to staff. People that used the service and their relatives had the opportunity to feedback on the quality of the support and care that was provided. Any required improvements were undertaken in response to people's suggestions. There were effective systems in place to monitor the quality of the service and drive improvements.

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 12 November 2016).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

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.

Inspection carried out on 4 October 2016

During a routine inspection

This unannounced inspection took place on 4 October 2016. This residential care home is registered to provide accommodation and personal care for up to three people. At the time of our inspection there were three people with a brain injury living at the home.

There was not 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. A manager had been appointed however at the time of the inspection they were in the process of submitting an application to the Commission.

People felt safe in the home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required to keep them safe and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job. People had risk assessments in place which identified and managed people’s known risks, and appropriate arrangements were in place to manage and store people’s medicines.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person. People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People had their healthcare needs managed in a way that was appropriate for each person and people’s nutritional needs were supported and managed with each person.

People received support from staff that treated them well and prioritised their needs. People were relaxed and comfortable around staff and staff understood the need to respect people’s confidentiality. People were supported to maintain good relationships with people that were important to them and the home had good links with advocacy services to ensure people had the support they required.

Care plans were written in a person centred manner and focussed on empowering people. People were encouraged to make their own personal choices and to be in control of their own lives. Care plans detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People at the home reacted positively to the manager and the culture within the home focussed upon supporting people to be independent. Systems were in place for the home to receive and act on feedback and policies and procedures were available which reflected the care provided at the home.

Inspection carried out on 8 & 9 September 2015

During a routine inspection

This unannounced inspection took place on 8 and 9 September 2015.

51 The Drive accommodates and provides support for up to three people with a brain injury. There were three people living at the home on the day of our inspection, and these people had been living there for a long period of time.

A registered manager was 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.

Staffing numbers were sufficient to meet people’s essential needs. Appropriate arrangements were in place to ensure people were safeguarded from abuse and people were supported to be safe in the community with good risk assessments in place to manage risks to people’s safety. Medicines were sufficiently managed and people received them in a timely manner.

Not all staff had received timely supervisions to ensure they were effective in their role and whilst the service had completed Deprivation of Liberty Safeguards (DoLS) applications for some aspects of care there were still some they were required to submit. People provided consent for the support they received. Further input into meeting people’s nutritional needs was required to ensure these were adequately being met.

Staff showed great pride and passion for their job and maintained a caring and supportive relationship with people that lived at 51 The Drive. People’s dignity and privacy was respected and advocacy services were involved with supporting people.

People received support that was based on their personal needs and wishes. People were supported to identify their changing needs and the service showed flexibility to meet any new needs that were identified. Each person had a unique care plan which adequately detailed their needs and the support they required. People were involved in deciding the care they required.

The quality assurance measures that were in place were not embedded into practice and further improvements were required. Policies and procedures required updating to reflect current practice at the service. People were supported to contribute to making improvements to the service they received by attending regular meetings. Staff were recognised and praised for extra commitment to their job.

During a check to make sure that the improvements required had been made

During our compliance review in June 2013 we found that the provider was not meeting government standards in relation to outcome 10: Regulation 15: Safety and suitability of premises. This was because we found people who used the service were not fully protected against the risks of unsafe or unsuitable premises.

The provider sent us an action plan which set out a schedule of when work was to be carried out to improve the premises. In addition we saw copies of quotations, purchase orders and invoices. We spoke with the registered manager of 51 The Drive, who confirmed that all the improvements required to the premises had been completed as scheduled.

Inspection carried out on 20 June 2013

During a routine inspection

We had the opportunity to speak with two people using the service. They confirmed they were pleased with the support they received at 51 The Drive, they told us the staff treated them with respect and dignity. We found that each person had a care plan that gave details on the specific elements of people's care and support needs. We saw that people’s preference and daily routines were recorded and revisions had been carried out to care plans in response to people’s changing needs. The care plans were held on a computerised recording system with paper copies available.

We found that robust staff recruitment procedures were in place and staff had regular opportunities to discuss the needs of the service and review their work performance during regular supervision and annual appraisal meetings with their line manager.

We observed that people using the service appeared relaxed and comfortable with staff. We saw that people were fully involved in setting up their care plans and encouraged to make their own decisions about their lives. We also saw that regular meetings were held with people using the service, to provide the opportunity for people to share their ideas and opinions about the service provision.

We found that some areas throughout the premises were not adequately maintained. We brought the areas of concern to the attention of the provider during our visit.

Inspection carried out on 6 June 2012

During a routine inspection

During the inspection we spoke with three people who used the service.

All the people we spoke with told us that they liked living at the home and they liked the staff. One person told us “I really do like living here and I get on very well with all the staff”. They said the food was nice and they all choose the menus on a weekly basis with staff, and they had two choices. All the people told us that the staff respected their privacy and dignity when supporting them. One person told us “staff always knock on my door before they come in to my bedroom”.

We observed positive interaction between staff and the people living at the home and staff spoke to people in a dignified manner. The staff attended lots of training to help them meet the people’s needs. There were annual surveys, house meetings, review meetings and key worker sessions put in place to give people using the service the opportunity to feedback on the service provided and to contribute to the running of the home. This was also supported by regular visits from the independent advocate.

Reports under our old system of regulation (including those from before CQC was created)