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Inspection carried out on 23 April 2019

During a routine inspection

About the service: Qualities Services Limited is a residential care home that was providing personal care to four people with learning disabilities or acquired brain injury at the time of the inspection.

People’s experience of using this service:

Staff knew how to keep people safe from harm and abuse. People had risk management plans to enable them to stay safe while doing the activities they wanted to do, although one person required a revised management plan to help ensure they interacted with visitors in a safe way.

One person with epilepsy did not have a detailed enough risk management plan to ensure staff knew how to keep them safe when they experienced seizures. However, the service managed other risks appropriately and promoted people’s independence by finding safe ways of enabling people to do potentially risky tasks for themselves. The premises were suitably adapted for the people living there and the home was clean and safe to use. Medicines were managed safely.

There were enough suitable staff to care for people safely, and staff received appropriate training and support.

People had a choice of suitable food and drink and received support to eat and drink enough to remain healthy. Staff consulted with other services, including specialist providers, to ensure people’s healthcare and other needs were met.

People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff gained people’s consent before providing care to them or, if people did not have capacity to consent, took appropriate steps to ensure care they received was in their best interests.

Staff were caring and respectful. They took the time to get to know people and their individual communication and emotional support needs. Staff respected people’s religious and cultural needs and supported them to spend time with their families and other people who were important to them. They promoted people’s privacy and dignity.

People had person-centred care plans that provided detailed information to staff about their needs, preferences, cultural backgrounds, interests, strengths and needs. People had opportunities to engage in a variety of suitable activities both at home and out in the community, including household tasks, games, hobbies and leisure activities. Staff supported people to go on holidays and day trips.

There was an appropriate complaints procedure in place. The service had not received any complaints but the registered manager used written compliments as part of monitoring the quality of the service and keeping staff motivated.

Staff, people and relatives described the registered manager as open and approachable. The manager continuously monitored the quality of the service through checks and observations, communicating any required improvements to staff and responding quickly to any concerns.

Rating at last inspection: At our last inspection, this service was rated “good.” Our last report was published on 29 October 2016.

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Inspection carried out on 3 October 2016

During a routine inspection

This inspection took place on 3 October 2016 and was unannounced.

8 King’s Road is a residential care home that provides accommodation and personal support for up to four people with a learning disability, or mental health related conditions. Three men were using the service at the time of our inspection. At the last inspection in November 2015 there were no breaches of regulations but the service required improvements in two areas, these related to recruitment and leadership. At this inspection the provider had addressed any shortfalls in the service and met all regulations.

There was 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.

Risks to individuals were identified and appropriate arrangements were in place to manage these which staff followed. Measures to manage risk were as least restrictive as possible to protect people’s freedom. Medicine management procedures were effective and ensured people received medicines as prescribed.

Staff were appropriately trained in procedures to safeguard adults from abuse and understood their responsibilities. Staffing numbers were sufficient to meet people’s needs. The provider had made improvements, and recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to care for and support vulnerable people.

The premises were comfortable and safely maintained. The manager had developed individual evacuation plans In case of any emergency arising.

People were cared for and supported by qualified and competent staff that were regularly supervised and appraised regarding their personal performance. Communication within the staff team and with external health professionals was good, this benefited people using the service.

Staff had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. Where a person lacked capacity to make their own decisions the registered manager used the legislation to work with other health and social care professionals and family members to ensure a decision was made in the person’s best interests.

People received suitable nutrition to help maintain their levels of health and wellbeing. People experienced compassionate care from kind staff that were familiar with their needs and preferences.

People’s wellbeing was promoted; their privacy, dignity and independence were respected. People were empowered to take control of their lives and staff worked hard to maintain these wherever possible.

People were supported according to their support plans which reflected their needs. People had opportunities to engage in pastimes, activities and occupation if they wished to; staff encouraged people to participate in events.

The service was well-led, the culture and the management style of the service was positive and inclusive. There were effective systems in place for checking the quality of the service using audits, satisfaction surveys, meetings and good communication, and for driving improvements. Continual improvements to care provision were made which showed the registered manager was committed to delivering high quality care.

Inspection carried out on 12 and 13 November 2015

During a routine inspection

This inspection took place on 12 and 13 November 2015, and day one was unannounced.

8 King’s Road is a residential care home that provides accommodation and personal support for up to four people with a learning disability. Two men were using the service at the time of our inspection.

This was the home’s first inspection since registering in October 2014. The home was unoccupied until four months ago.

There was no registered manager in post at the time of our inspection; the registered manager had left in May 2015. The manager advised us they were making an application to be the 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.

There was no registered manager in post, and the service required improvement in this area.

Risks to individuals were identified and appropriately managed by staff. Measures to manage risk were as least restrictive as possible to protect people’s freedom.

The manager and staff had the skills, knowledge and experience to deliver effective care and treatment, and to respond appropriately to individual needs. There were minor shortfalls in recruitment procedures which required improvement.

The Care Quality commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty. There were no restrictions on the liberty of persons using the service. People who used the service were assessed as having capacity in accordance with the Mental Capacity Act 2008 code of conduct.

Medicines were safely managed and processes were in place in relation to the correct storage and audit of people’s medicines.

Staff relationships with people were caring and supportive. People were treated with kindness, compassion and respect. Staff took time to speak with the people they supported. We observed that people enjoyed talking to staff and sharing their everyday views. People who used the service were positive about the care and support they received and found the place delivered the service they required.

People’s health was monitored closely and appropriate referrals were made to health care professionals. Individuals were supported to access a range of health care professionals, such as the GP, Community Mental Health team, dentist and opticians.

The service had a number of quality assurance processes in place to get people’s views and to drive improvement in the service. People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally.

People had a varied diet and were involved in planning their meals and doing other household chores. People were provided with freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day.

People were able to see their friends and families as they wanted and there were no restrictions on when people could visit the home.