Archived: Potensial Limited - 3 Sydenham Terrace

The building accommodated six people and conformed with the values that underpin the Registering the Right Support and other best practice guidance. The model of care proposed from 2015 and 2016 guidance that people with learning disabilities and/or autism spectrum disorder which proposed smaller community based housing. 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.

At our last inspection in August 2016 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.

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At this inspection we found the service remained good.

People said they felt safe and they could speak to staff as they were approachable. People and staff told us they thought there were enough staff on duty to provide safe care to people.

Staff knew about safeguarding procedures. Staff were subject to robust recruitment checks. Arrangements for managing people’s medicines that we inspected were safe.

Parts of the building were showing signs of wear and tear. An area of the combined lounge and dining room was being used as an office, which reduced the living area for people who used the service and also gave them no privacy from staff. We received an action plan straight after the inspection with timescales to show how the refurbishment would be addressed.

Staff spoke with people respectfully and most systems were in place to respect people's privacy. However, personal information about people was displayed on a noticeboard in the kitchen. This was addressed immediately during the inspection and people’s personal information was removed.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff knew the needs of the people they supported to provide individual care and records reflected the care provided.

People were involved in decisions about their care. 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 supported this practice.

Records reflected the care provided by staff. Care was provided with kindness and patience. Communication was effective to ensure people, staff and relatives were kept up-to-date about any changes in people's care and support needs and the running of the service.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received a varied and balanced diet to meet their nutritional needs. There were opportunities for people to follow their interests and hobbies.

Staff were well-supported due to regular supervision, annual appraisals and an induction programme, which developed their understanding of people and their routines.

People had the opportunity to give their views about the service. There was consultation with staff and people and their views were used to improve the service. People said they knew how to complain. The provider undertook a range of audits to check on the quality of care provided.

Further information is in the detailed findings below.

This inspection took place on the 28 and 29 June 2016 and was unannounced. The inspection was carried out by one adult social care inspector.

The service had a registered manager in post. 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.

People told us they felt safe living at the service with the support from the staff. Policies and procedures were in place to protect people from harm and to ensure staff understood their responsibilities with regarding to protecting people from and acting on suspected abuse or improper treatment.

Records were kept regarding accidents and were investigated and reported in a timely manner. These were analysed by the manager and used to review care needs, update risk assessments and implement preventative measures as necessary. There were no records of incidents as the manager told us they had not been any.

The service managed risks associated with the health, safety and wellbeing of people who used the service, including carrying out regular checks of the property and equipment in line with their legal responsibilities as the landlord. Individual care needs had been assessed for all aspect of people’s lives and we saw evidence which showed these were reviewed and monitored regularly.

Medicines were safely and hygienically managed and medicine administration records were detailed, thorough and accurate. Medicines were stored safely and securely. The staff followed procedures regarding the receipt, storage and disposal of medicines. All other records relating to the management of the service were well maintained.

There were enough staff employed at the service to manage it safely and to meet people’s needs. Although some consideration was needed to improve the provision of individual activities. Staff files showed the recruitment process was robust and staff had been safely recruited. Training was up to date and staff had a mix of qualifications, skills and experience. Staff had the opportunity to work towards qualifications which would develop their career. Competency checks were carried out by the manager to assess the staff’s suitability for their role.

Supervision and appraisals were carried out regularly and recorded which showed staff were supported in their role. Staff and ‘House’ meetings were held regularly and minutes were recorded. This demonstrated that everyone had regular opportunity to speak to the manager and discuss any issues.

There was evidence to show the manager and staff had an understanding of the Mental Capacity Act 2008 (MCA) and their responsibilities. The staff assessed mental capacity and reviewed it as necessary. Care records showed that whenever possible people had been involved in making some decisions, but more complex decisions that were made in the person’s best interests’ had been taken appropriately with other professionals and/or a relative involved.

Staff supported people with nutritious, well-balanced meals; individual dietary needs had been assessed and were catered for. We observed people enjoyed their food at mealtimes, which were a positive and interactive experience. People had choice around mealtimes and often chose from the menu plan, however we also saw people could choose alternatives if they preferred.

Staff displayed kind, caring and compassionate attitudes and people told us all of the staff were nice to them. We observed people were treated with dignity and respect and staff were pleasant and friendly.

Individual needs had been initially assessed and reviewed with the involvement of people, relatives and external professionals. Care plans were person-centred and contained in-depth information which included life history, family, interests and hobbies. These were accessible to people and easy to understand as they included photographs and pictures along with written words.

The service encouraged people to get involved with activities in which they showed a keen interest. People were accompanied by staff on day trips and to visit places of interest to them, however these group activities did not always cater to individual needs. The service was working with local authority staff to enable them to fully meet individual requests for activities.

There had been no complaints received by the service. The manager explained to us how the complaints procedure would be followed and we reviewed the guidance documentation in place. People told us they had nothing to complain about but would feel confident to tell the staff if something was wrong. Compliments had been received by the service and were shared with the staff.

Regular quality monitoring took place by the manager. Daily, weekly and monthly checks and audits were used to measure the quality and safety of the service. The provider had oversight of and audited records regularly. The service asked staff, professionals and relatives for feedback and gave them the opportunity to do so through surveys. Surveys were also issued to people to gather their opinions of how the service was managed and how it could be improved. We observed a good response to surveys, which allowed the manager to gauge an overall opinion. We saw action plans had been drafted to improve the service following audits and surveys.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them, and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The service was safe. People had assessments of risks associated with their care. They were cared for by staff who had suitable training. The manager ensured that safety checks were carried out regularly.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that assessments were underway in relation to examining people's access to the community (as most only want to go out with staff) to check to see if this needs an application being submitted to the local authority

Is the service effective?

The service was effective. There were processes in place to ensure that people received the medication they should when it was needed. We saw examples of the managers auditing systems, where actions were taken to improve the services provided.

Is the service caring?

The service was caring. People had comprehensive assessments and care plans which were adhered to by staff. It was clear from our observations that staff did care for people living at the service. And that they understood their needs by what was set out in the care plans. One person told us, 'It's great here I love it the staff look after your needs and you can always get things off your chest if you need to'

Is the service responsive?

The service was responsive. Records showed that people's needs were reassessed regularly and that their views were sought through surveys and meetings. One person told us, 'Staff were quick to get visits to the doctors if needed.' Staff had training that helped to meet the specific needs of the people there.

Is the service well-led?

The service was well lead. The manager was experienced and had completed in-depth training? She had good systems in place to monitor the service and both people living at the service and staff said she was kind, supportive and encouraging

We saw that staff provided whatever was needed in a way that demonstrated a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to enable people to do things as independently as possible.

We observed people being spoken with and supported in a sensitive, respectful and professional manner. We saw that staff included people in the day to day running of the care home. Whenever possible, it was the people living at the home that made decisions on what happened through the day and when.

People were seen to be relaxed and comfortable with staff. Staff were observed asking if they would like a drink or if they needed anything.

We looked at how the service recruited staff by checking three staff files. These showed that the appropriate checks and procedures were being followed.