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Potensial Limited - 7-9 Park Road South Requires improvement

We are carrying out a review of quality at Potensial Limited - 7-9 Park Road South. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 October 2018

The inspection was carried out on 17 and 23 July 2018. The first day of the inspection was unannounced.

7-9 Park Road South 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. It is registered to provide support for up to 21 people. At the time of our inspection 17 people were living there.

7-9 Park Road South provides support to people who have a learning disability, some of whom also require support with their mental health. Situated close to Birkenhead town centre the home appears externally as a domestic property on a residential street. Originally a pair of semi-detached houses the building has been converted to make one larger house.

The home has a registered manager. 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 registered manager has been in post since 2015.

The last inspection of the service was carried out in April 2016 and the service was rated good in all areas. During this inspection we found breaches in relation to Regulations 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities). Regulations 2014.

This was because the provider had not ensured care and treatment was provided with the consent of the relevant person. It was not clear from records whether people’s capacity to make important decisions had been assessed and what if any support they had received to make the decision and review it afterwards.

Although systems were in place for monitoring the effectiveness and quality of the service provided these were not always effective. For example, medication audits highlighted a concern with recording of medication and records showed that this did not improve following the audit process. Systems had also failed to note that not all care plan information was up to date or reviewed. In addition, audit systems had failed to identify that the home was not operating in line with current best practice guidance for supporting people with a learning disability. This includes Registering the Right Support.

You can see what action we told the provider to take at the back of the full version of the report.

In June 2017 CQC published Registering the Right Support. This along with associated good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability. At this inspection we assessed the service in line with this guidance.

7-9 Park Road South did not meet the values and principles of Registering the Right Support and associated guidance. Current good practice guidance encompasses the values of choice, independence, inclusion and living as ordinary a life as any citizen. The size, layout, staffing arrangements at 7-9 Park Road South meant that it does not feel or operate as people’s home. Certain physical aspects to the building and staff practices felt institutional and detracted from a homely atmosphere. This included staff wearing disposable gloves for no identifiable reason and wearing bunches of keys around their neck. We also saw that the office was a hub within the home with staff and people living there spending a significant part of their time in or near to it. People who required support to learn or retain everyday living skills were not routinely provided with this support.

The registered manager had a good understanding of Deprivation of Liberty Safeguards and had applied for these were an assessment indicated it was in the person’s best interests.

Polices were in place for safeguarding people from the risk of abuse and reporting any co

Inspection areas

Safe

Requires improvement

Updated 17 October 2018

The service was not always safe.

Records were securely maintained but were not always up to date or complete.

People’s medication was generally well managed but records were not always completed.

Risks to people’s safety were assessed and action taken to reduce the risk of these occurring. There were not enough staff available to support people in line with best practice guidance including Registering the Right Support.

Systems were in place and followed to check new staff were suitable to work with people who may be vulnerable.

Effective

Requires improvement

Updated 17 October 2018

The service was not always effective.

Systems for assessing people’s capacity to make important decisions and record this information were not robust.

People did not routinely receive support to learn and retain independent living skills.

The home did not meet the values that underpin Registering the Right Support.

Staff received training and support to understand and meet people's needs.

Caring

Requires improvement

Updated 17 October 2018

The service was not always caring.

The provider was not always following the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence, inclusion and enabling people to live as ordinary a life as any citizen.

People liked and trusted the staff team. They found staff approachable and kind.

Staff knew people well and tried to meet their social as well as their physical support needs.

Responsive

Requires improvement

Updated 17 October 2018

The service was not always responsive.

People were not always supported in line with best practice guidance. Support was not always available for people to spend their time as they chose and be involved in everyday living tasks.

Care records were incomplete and did not provide a complete overview of the care people required or received.

People felt confident to raise any concerns or complaints that they may have and were confident they would be dealt with.

Well-led

Requires improvement

Updated 17 October 2018

The service was not always well-led.

Systems for quality assuring the service were not always effective at identifying and therefore improving the service people received. This included records and supporting people in line with current best practice guidance.

The registered manager was experienced and knowledgeable about people living at the home.

People living at the home and staff liked and trusted the registered manager.