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Inspection carried out on 4 March 2019

During a routine inspection

About the service:

16 Crompton Street is a care home providing support to 6 people at the time of inspection.

People’s experience of using this service:

Everyone who lived at the home told us they felt safe. Medication was stored securely and administered by staff who were training to do so. There were recent checks that had taken place on the environment, and contractual checks to ensure the home was safe to live in. There was enough staff on duty to be able to support people safely. Staff were recruited and selected safely and recruitment checks were in place before staff started work. Staff were able to explain the course of action they would take if they felt anyone was being harmed or abused. Infection control procedures were robust, and there was information available for the use of COSHH products. The registered manager had identified their approach to incidents and accidents would benefit from being more detailed, they were in the process of changing this.

The registered manager and the staff were working in accordance to the principles of the Mental Capacity Act 2005. Where people’s liberty was being restricted, we saw the reasons for this had been clearly recorded. There were some instances were consent was not clearly recorded in people’s support plans, however when we spoke with people, they said their support plans had been discussed with them. People were supported to make themselves meals and snacks. People planned their menus and were supported by staff to partake in the cooking. We saw how consideration was given to people’s special dietary needs. The registered manager and the staff team worked with external organisations to ensure people had accessed health services when they needed to.

Everyone commented on the caring nature of the staff. Staff spoke positively and respectfully about the people they supported. There were polices in place which described the importance of diversity and inclusion and support plans evidenced that people’s needs and choices were recognised and supported.

There was information recorded in support plans with regards to people’s likes, dislikes and routines. Staff knew people well, and people told us they were getting support which was right for them. There was a complaints process in place. We saw there were no formal complaints recorded, and any complaints made were not escalated by the people who made them. The registered manager was in the process of establishing a way to record these as ‘niggles’ rather than complaints. There was no one accessing an end of life pathway at the home, however, staff had knowledge in their area.

There was a registered manager during this inspection. The registered manager was knowledgeable regarding their role and had reported any notifiable incidents to CQC in line with their regulatory responsibilities. There was a process in place to audit service provision, we saw that some audits had identified the need for some improvement to made to the communal areas. The registered manager had escalated the findings of these audits as required.

Rating at last inspection: The previous report was published 9 November 2016. The home has a rated of Requires Improvement in well led and Good in all the other key questions. The overall rating at the last inspection was Good.

Why we inspected:

This was a planned inspection based on the rating of the last inspection. The rating for this service is good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

Inspection carried out on 10 October 2016

During a routine inspection

This inspection took place on 10 October 2016 and was announced.

16 Crompton Street is a residential service which provides accommodation and personal care for a maximum of seven people. At the time of the inspection three people were living at the service.

A registered manager was not in post. However the manager of the service was in the process of applying to become the registered manager. The manager was unavailable on the day of the 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.

The provider had implemented an approach to quality monitoring which was appropriate for the size of the service. However, these processes had failed to identify issues relating to the completion of essential safety checks and missing references.

We have made a recommendation about this.

The service had processes to monitor safety and employed external contractors to service and check; gas safety, electrical safety and fire equipment. We saw that checks had been completed in each area within the previous 12 months.

Risk to the people living at the service was appropriately assessed and recorded in care records. Each risk assessment focused on maximising the person’s independence while safely managing any risks and had been recently reviewed. People told us they were involved in decisions about care and taking risks.

Medicines were safely stored and administered. However the service did not have an effective procedure in place to monitor stock levels.

Staff had the skills and knowledge to meet the needs of the people living at the service. Staff were required to complete a programme of training which included; first aid, administration of medicines, people handling and adult safeguarding. The training matrix provided indicated that all training required by the provider was up to date.

The people living at the service were actively involved in choices about food and drink and had free access to the kitchen. We were told that they were being supported to be more independent with shopping and food preparation.

People living at the service were supported to maintain good health by accessing a range of community services. We were told that they had a GP, optician and dentist and had regular check-ups. We saw evidence of this in care records. We also saw evidence of health action plans which detailed a range of healthcare needs and other important information.

Throughout the inspection we observed staff interacting with the people living at the service in a manner which was compassionate and caring. We saw that staff spoke regularly with the people living at the service. They explained what they were doing and discussed their needs and activities. Staff knew the care needs of the people well.

We saw that people had choice and control over their lives and that staff responded to them expressing choice in a positive and supportive manner. With the exception of the administration of medicines, it was clear that the provision of care was not task-led and did not adhere to a fixed timetable.

Information was provided in a way that made it easier for people to understand. Staff took time to re-word things when people didn’t initially understand. We saw that some important information, for example consent documents, were produced in plain English and made use of images to support people’s understanding.

Privacy and dignity were protected and promoted by staff. Staff spoke with respect about the people living at the service and promoted their dignity in practical ways. Each person had a lock on their bedroom door for additional privacy and security. All confidential information was stored securely in an office within the service.

We saw from our observa

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