Archived: Estuary Housing Association Limited - 16 Vista Road

We found the following examples of good practice.

¿ The deputy manager (responsible for the service as the registered manager was temporarily absent) was following the government's guidance on whole home testing for people and staff. This included using rapid testing, weekly testing for staff and monthly testing for people who used the service.

¿ Staff had received training on working during the pandemic in relation to COVID 19 and had received training in the correct use of personal protective equipment (PPE).

¿ The service was COVID 19 free and people using the service were well with no symptoms.

¿ Some communal areas in the service had been changed to encourage people to socially distance but this was difficult due to the layout and the service being small. There was clear guidance and signage in the service to help prompt staff to safely work whilst minimising the risk of spreading infection.

¿ Infection prevention control practices had been implemented such as increased cleaning rotas and a good supply of PPE and hand sanitisers. Information was cascaded to staff and reminders issued. Audits of cleaning and security were completed by staff. The cleaning of individual people's equipment needed to be included in the audit.

¿ People's well-being was supported by going out for exercise, telephone calls to relatives and staff continued to engage in individual activities of people's choice.

16 Vista Road is a residential care home providing accommodation and personal care without nursing for up to three people with learning disabilities. At the time of inspection, three people were using the service. The service is set in a house with large gardens in a residential area.

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

A relative told us they were very happy with the care their family member received at the service,

Care and treatment were planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff had received appropriate training. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medication was dispensed by staff who had received training to do so.

The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

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.

People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for people.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff promoted people’s independence through encouraging and supporting people to make informed choices.

People, their relatives and advocates were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner. People were supported to make plans for the end of their life.

The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection: The last rating for this service was Good (last report published 03/05/2017).

Why we inspected: This was a comprehensive inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 16 Vista Road on our website at www.cqc.org.uk.

The registered manager was present during our inspection. 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.

There were enough staff on shift to meet the needs of people who used the service and people were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service support this practice.

Staff understood how to keep people safe and could describe the correct steps they would take if they were concerned that abuse had taken place. Accidents and incidents were appropriately recorded and investigated and risk assessments were in place for people who used the service.

The registered manager and staff involved people to make decisions about the service they received and obtained people’s feedback on how the service should be run. People told us that staff understood their needs and preferences well, and they received effective care and support from well-trained staff.

Staff had developed caring relationships with the people they supported. Family members told us that there was a positive atmosphere and people were encouraged to take part in the activities they wanted to pursue. A wide range of activities were on offer to people.

Medicines were managed safely and staff members understood their responsibilities. The registered manager undertook regular audits and improvements were carried out when these were needed. The quality of the service was monitored and assessed consistently.

People who used the service, family members, and visitors were encouraged to make comments, complaints, or compliments about the service.

Further information is in the detailed findings below.

On the day of our inspection there were three people living in the service. All three people were not able to share their views with us verbally. They used facial expressions, gestures and body language to communicate with us. We also spoke with the manager and three members of staff.

We thought about what we found and asked the questions that we always ask; Is the service safe, effective, caring, responsive and well-led?

This is a summary of what we found:

Is the service safe?

When we arrived at the service we were asked to sign the visitor's book and our identity was checked. This meant that people were protected from unwanted visitors such as others who posed a risk to their safety.

Staff had received training in safeguarding vulnerable adults from abuse (SOVA), the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that staff had been given the information that they needed to recognise the signs of abuse, how to report suspected abuse and how to support people who are unable to make certain decisions without support.

All personal records were stored safely and securely for the protection of people's confidential personal information.

Is the service effective?

Although all three people who used the service did not communicate verbally they appeared relaxed and happy in staff's company and responded positively when asked if the service met their needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. The care records were well written and had been regularly reviewed and updated. This meant that the service was effective and staff knew how to meet people's needs.

Is the service caring?

We saw staff interacting with two of the three people who used the service during our visit on 27 August 2014 and their interaction was good. Staff spoke respectfully to people in a kind and caring manner. We saw that staff allowed people sufficient time to respond to any requests.

People responded positively when we asked if the staff were caring. This showed that people were cared for by kind and caring staff.

Is the service responsive?

People were supported to see other professionals such as a general practitioner, chiropodist, optician and district nurse when necessary. This showed that people's general health care needs were met and that the service was responsive to people's changing needs.

Is the service well-led?

The service had a manager in post who was in the process of registering with the CQC.

Staff had received a thorough induction to the service and they had received regular supervision and annual appraisals. Staff's competence to administer medication had been regularly assessed and recorded. This meant that staff had been fully supported to carry out their role.

We saw that people's care and treatment was planned and reviewed with their and their relative's involvement, wherever possible. Risks to people's health, welfare and safety were identified and well managed. Our inspection showed us that the service was generally safe, responsive and caring. We spoke with one relative who told us, "I can pop in whenever I like and I know them.'

The provider worked in co-operation with other providers to ensure the health, safety and welfare of people when more than one provider was involved in their care.

We found that there were systems in place to ensure that the premises were clean, and that people were protected against the risks associated with infections.

The provider had ensured that there was sufficient, well maintained equipment to meet the needs of people using the service

Staff were selected and recruited in a way that ensured they were suitably qualified and fit for the job.

We saw that records relating to people using the service, staff and day to day running of the service were accurate. However records relating to people were not stored securely and could be easily accessed by anyone visiting the service.

When we looked at the support plans for people, we found that Mental Capacity Act 2005 forms had been completed correctly and relatives, where available had been involved in the decisions made around consent. We found that the care and treatment given was of a good standard and one relative spoken with said, "I am very happy with the care that this home gives to my relative. The food is good and they like it there."

We looked at safeguarding procedures and found that staff had received regular training and updates and were aware of the procedures to follow. People we spoke with told us that it was a safe place for their relative.

We also looked at whether staff were supported in their roles and found that they had received supervision, training and appraisal. There was a clear, organised induction process and an openness culture amongst staff and management in order to achieve improvements.

When we looked at the complaints procedures we found that the policy was clear and informative and contained appropriate timescales for bringing issues raised to an outcome. This included identifying where there might be areas for improvement and learning.