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Inspection report

Date of Inspection: 1 July 2014
Date of Publication: 22 July 2014
Inspection Report published 22 July 2014 PDF


Inspection carried out on 1 July 2014

During a routine inspection

The inspection team consisted of one adult social care CQC inspector. On the day of our inspection nine people used the service. One of these people lived in the community and received support from the provider through an outreach service. We spoke with three people, one relative of another person, two support workers, the deputy manager, and registered manager. We reviewed records relating to the management of the home which included four people�s support plans and two staff files.

We considered all the evidence we had gathered under the outcomes we inspected, which related to people�s care and welfare, cleanliness and infection control, supporting workers, assessing and monitoring the quality of service provision, and records. We used the information to answer five key questions; is the service safe, effective, caring, responsive and well-led.

This is a summary of what we found.

Is the service safe?

People who use the service told us they felt safe at the service. Personal evacuation plans were in place for each person to ensure their safety in the event of a fire at the service.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to this type of service. The service was safe because requirements in relation to the DoLs had been met. The deputy manager had received training in relation to DoLs and was aware of the recent case law. They told us most of the people they provided care for did not have the capacity to determine where they wanted to live and all received a high level of support and supervision within the service. The deputy manager informed us that they had started the process of submitting DoLs applications for these people following consultation with three local authorities. This was confirmed in records we looked at during the inspection.

People had been cared for in an environment that was safe, clean and hygienic. People were protected from the risk of infection because protocols based on current Department of Health guidelines were followed.

A system of staff supervision and appraisal was in place to support workers. Staff

received appropriate training and professional development to enable them to deliver care and treatment to people safely and to an appropriate standard.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others in relation to incidents. There was a system for monitoring and learning from incidents. The provider could identify possible trends that may require additional actions, such as risk assessments and the implementation of appropriate actions. This meant they took appropriate steps to minimise the risk of occurrences to people and others.

There were processes in place to ensure staff and people�s confidential records were stored securely and could be located promptly when requested. People�s records were accurate and fit for purpose.

Is the service effective?

The service demonstrated effective practices through the assessment of people�s health and care needs. People's views about the type of care they wanted had been sought. People confirmed their involvement in the development of their care plan. We noted people�s involvement in annual reviews of their care. We found staff had a good understanding of people�s care and specific support needs, for example, in relation to autism, asthma and diabetes.

All three people and a relative of another person we spoke with were complimentary about the care received. One person said �Staff know what to do. They know me well.�

Is the service caring?

People were supported by kind and supportive staff. People and a relative told us staff were very caring. One person told us �Staff are nice when they are helping me.� All interactions we observed between the staff and people were respectful and courteous. We saw that support workers gave encouragement when supporting people. People were able to do things at their own pace and were not rushed.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People�s preferences, interests, aspirations and diverse needs had been recorded in their support plans. Care and support had been provided in accordance with people�s wishes, for example arranging preferred activities, holidays and colour schemes in bedrooms.

The compliments folder we looked at recorded three responses from health and social care professionals visiting the service. We saw feedback was positive. Visitors rated staff support and care for people highly. All three visitors commented that they were made to feel welcome when visiting the service.

Is the service responsive?

We found the service was responsive to people because their needs had been assessed before they used the service. In records we looked at we saw people met with their key workers monthly to discuss what was important to them. Records confirmed people�s preferences, interests, aspirations and diverse needs had been documented. Daily notes confirmed that care and support had been provided in accordance with people�s wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

People knew how to make a complaint and who to go to if they were unhappy. We looked at how complaints had been dealt with by the provider, and found that the responses had been thorough, and timely. People could therefore be assured that complaints were investigated and action was taken as necessary.

Is the service well-led?

We found the service was well led because the provider acted on feedback received to improve the service. We saw people�s and relative�s feedback was sought through meetings and surveys. The provider was responsive to comments from people, such as a planned refurbishment of people�s rooms to meet their wishes and suggestions. One person told us �If I want to talk about anything they (staff) listen to me.�

Audits and checks ensured people�s safety and wellbeing was promoted. Where issues were identified, an action plan was formulated. Progress and completion of this was monitored. We saw issues were identified and actions completed appropriately.