Background to this inspection
Updated
9 November 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 9 October 2018 and was unannounced. One inspector undertook the inspection.
The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted the local authority commissioning team to ask them about their experiences of the service provided and four visiting health and social care professionals. We also contacted one person’s relative for their experiences of the service provided.
Not everyone was able to tell us their experiences of the care and support provided. We spoke with people generally during the inspection and two people individually. We spent time observing how people were cared for and supported and their interactions with staff to understand their experience of living in the service. We spoke with the registered manager, the deputy manager and four care staff. We also spoke with a relative and an advocate who were visiting on the day of the inspection. We sat in on a staff handover meeting. We spent time looking at records, including three people’s care and support records, three staff recruitment files, staff training records, and other records relating to the management of the service, such as policies and procedures, accident/incident recording and audit documentation. We also ‘pathway tracked’ the care for two people using the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about people receiving care.
We previously carried out a comprehensive inspection on 22 September 2015 and rated the service overall ‘Good’.
Updated
9 November 2018
The inspection took place on the 9 October 2018 and was unannounced.
20 Windlesham Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 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. Care and support is provided for up to five for people with a learning disability or autistic spectrum disorder. At the time of the inspection five people were living in the service. The service is situated in a residential area with easy access to local amenities and transport links.
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At the last inspection on 22 September 2015 some of the records we looked at had not always been fully completed. At this inspection we found improvements had been made. However, the testing of the fire alarm system in between the regular maintenance by external contractors continued to be an area in need of improvement. People continued to be supported to have their medicine safely when they needed it. However, storage of medicines did not meet current guidance. There were some omissions in the recording of administration of prescription toothpaste.
Systems had been maintained to keep people safe. The building and equipment had been subject to regular maintenance checks. Infection control procedures were in place. People remained protected from the risk of abuse because staff understood how to identify and report it. People’s care and support plans and risk assessments continued to be developed and reviewed regularly.
Staff spoke of a difficult period with a number of staff absences and vacancies. To maintain the right level of staff support and a safe service support to maintain staffing levels had been provided from other of the provider’s services and there a high use of the providers bank staff. There was ongoing recruitment to address this
People and their relatives told us they had continued to feel involved and listened to. The culture of the service remained open and inclusive and encouraged staff to see beyond each person's support needs. The registered manager worked with care staff to develop the service with people at the heart of the service.
Staff continued to have the knowledge and skills to provide the care and support that people needed. Staff told us they had received supervision and appraisal’s. They had been supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.
People continued to live in a service with a relaxed and homely feel. They were supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had a good understanding of consent.
People were supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health and access healthcare professionals when needed.
Staff and relatives told us the service continued to be well led. Staff told us the registered manager was always approachable and had an open-door policy if they required some advice or needed to discuss something. Senior staff had carried out a range of internal quality assurance audits to ensure the quality of the care and support provided. People and their relatives were regularly consulted about the care provided through reviews, residents meetings and by using quality assurance questionnaires. Relatives told us staff kept in touch with them, and one told us of regular email contact with the registered manager and keyworker.