Archived: The Melanie Ann Trust Residential Home

This service is a care 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. There were three people using the service at the time of our inspection. People had a learning disability, autism or visual impairment.

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. Registering the Right Support CQC policy. 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.

The registered manager was employed at the service. 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.

At the last Care Quality Commission (CQC) inspection on 08 December 2015, the service was rated as Good in all of the domains and had an overall Good rating.

At this inspection we found the registered manager and provider had consistently monitored the quality of their service to maintain a rating of Good.

Melanie Ann Trust Residential Home is a charitable trust and continued offering an inclusive service. The staff followed policies about Equality, Diversity and Human Rights and continued to receive training about this.

The registered manager was consistent in measuring the quality of people’s experiences when they lacked developed communication skills and continued to work at putting people at the heart of the service. They continued to ask relatives, staff and external health and social care professionals for their views about the service.

We observed friendly caring staff who addressed people with respect and care.

The quality outcomes promoted in the providers policies and procedures were monitored by the registered manager. There continued to be multiple audits undertaken based on cause and effect learning analysis, to improve quality. Staff understood their roles in meeting the expected quality levels and staff were empowered to challenge poor practice.

The registered manager consistently understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA).

The registered manager checked staff’s suitability to deliver personal care during the recruitment process.

The registered manager continued to train staff so that they understood their responsibilities to protect people from harm. Staff understood the risks to people’s individual health and wellbeing and risks were clearly recorded in their care plans. People’s medicines continued to be managed and administered safely.

There continued to be enough staff deployed to meet people’s physical and social needs. Emergency backup systems continued to be operated to allow care to continue at all times. Staff consistently received training that matched people’s needs effectively and staff were supported with supervision and with maintaining their skills.

People had access to many different activities of their choice outside of the service and were supported to pursue and maintain these. Within the service, people were supported to take part in activities they said they wanted to do individually or together.

People were consistently supported to eat and drink according to their assessed needs. Staff supported people to maintain a balanced diet and monitor their nutritional health. Most people chose to have communal meals where they ate together. When people decided they did not want to eat their meal with the rest of the group or at the same time this was respected and supported. People were supported to access health care when they needed it and assisted to maintain their health.

Risks assessments continued to be updated and in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and carried personal protective equipment like disposable gloves and apron’s.

The Melanie Ann Trust Residential Home is a service registered for up to three people who do not require nursing care. It accommodates people with a learning disability and additional sensory impairments. The service is situated close to the Snodland town centre. There were three people living at the service at the time of the inspection.

The Melanie Ann Trust is a registered charity and operates another small service close by. Staff work across both services.

People had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the staff that were supporting them. Staff were attentive and communicated with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for care and support. We observed staff supporting people with their daily activities.

The service had a registered manager, who was also the nominated individual for the trust. 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.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff had been trained in how to protect people from abuse, and discussions with them confirmed that they knew the action to take in the event of any suspicion of abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

Where people lacked the capacity to make decisions the staff were guided by the principles of the Mental Capacity Act (MCA) 2005 to ensure any decisions were made in people’s best interests. Staff were trained in the Mental Capacity Act 2005 (MCA) and showed they understood and promoted people’s rights through asking for people’s consent before they carried out care tasks.

Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported them in making arrangements to meet their health needs.

Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.

People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.

There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People were involved in making decisions about their care and treatment.

There were systems in place to review accidents and incidents and make any relevant improvements as a result.

The registered manager investigated and responded to people’s complaints and relatives/advocates said they felt able to raise any concerns with staff.

Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served and at other times during the day.

People were given individual support to take part in their preferred hobbies and interests.

Staff were recruited using procedures designed to protect people from the employment of unsuitable staff.

Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were systems in place to obtain people’s views about the quality of the service and the care they received. People were listened to and their views were taken into account in the way the service was run.

Staff knew how to support people with their individual needs and guidance was being developed to ensure that a consistent approach was provided by the staff team. People were supported to take part in daily living skills and access the local community.

Staff supported people to maintain their health. People were offered a varied diet and their dietary needs were assessed and monitored.

The home was clean and procedures were in place to minimise the spread of any infection.

People were not protected by robust recruitment systems as a number of staff had been employed at the home with no references or only one reference, from their previous employment.

Systems were in place to monitor the quality of the home. Visitors to the home and staff were asked for their views about the service.

We observed that people living at the home were relaxed and comfortable, for example by choosing whether to sit in the lounge or their room, or by approaching staff if they wanted something. We saw that people living at the home were able to express their choices non-verbally, for example using body language or signing to show if they wanted to join in an activity, and to indicate what their choices of food and drinks were.