Station Road

The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.

People’s experience of using this service:

People and relatives told us the staff were kind, friendly and dedicated. Staff were knowledgeable around people's needs.

People were not always protected from the risk of avoidable harm as staff were not always providing care as per people’s care plan and risk assessment.

Processes were in place to ensure that people could raise concerns. Complaints were investigated and responded to.

The service was working to a service improvement plan with support from the local placing authority. Checks and audits were carried out to determine the quality of the care. The provider had acted on some areas already identified for improvement.

Overall staff morale was poor with concerns raised about staff and management working relationships. The management team assured us these concerns were being addressed.

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.

Medicines were safely managed.

There were enough staff available to ensure people’s care needs were met. Staff were safely recruited and received regular training.

People were supported to attend and engage in activities in the local community which were of interest or benefit to them.

Rating at last inspection: Good (report published January 2018).

Why we inspected: The inspection was brought forward due to information of concern that we had received in relation to people's care. The inspection was prompted in part by information we had received from the local authority where concerns had been raised around aspects of care delivery. At the time of the inspection, the service was subject to enhanced monitoring by the local authority safeguarding and quality team. The service was working on a service improvement plan.

However, the information shared with CQC about the incident indicated potential concerns about unsafe medicines management, risk management and staffing levels. This inspection examined those risks.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service had a registered manager, which 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.

At our last inspection on 14 December 2015, we rated the ‘safe question’ as requires improvement as urgent remedial electrical work had not been carried out following an electrical safety check carried out by an independent electrical contractor in July 2014. Following the inspection, the provider submitted evidence that the remedial work had been completed.

People told us they were well treated at the home and risks to their safety had been identified and ways to mitigate these risks had been recorded in people's care plans.

Staff were aware that the people they supported were vulnerable and they understood their responsibilities to keep people safe from potential abuse.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

The home maintained adequate staffing levels to support people.

We saw mostly friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans were person centred and reviewed regularly.

People told us they enjoyed the food choices on offer and played an integral part in menu planning and preparing their meals.

People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians. The service was pro-active in involving the appropriate health and social care professionals when they had concerns about people’s health.

We saw evidence of a comprehensive staff induction and on-going training programme. Staff had regular supervisions and annual appraisals. Staff were safely recruited with necessary pre-employment checks carried out.

People were supported to engage in regular activities. People were supported to develop and maintain their independence.

Quality assurance processes were in place to monitor the quality of care delivered.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. The policies and systems in the service support this practice.

Further information is in the detailed findings below.

At the time of this inspection there were eleven people living in the home. Six of them spoke with us and expressed their views about the service.

We observed the care provided and the interaction between staff and people who used the service. We spoke with four care staff, the registered manager, a relative and a social care professional visiting the home.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

People indicated to us that they were well treated by staff. One of them said, 'I am happy here. The staff treat me nicely.' Another person said, 'I feel safe here. The staff take care of me well.' A relative we spoke with was confident that people were safe in the home. The service had a safeguarding policy and procedure. Staff had been provided with safeguarding training. They were aware of action to take in response to safeguarding incidents or allegations. The home had been kept clean and tidy. Risk assessments of the premises had been carried out regularly to ensure that the premises were safe.

Is the service effective?

Feedback from a relative and people who used the service indicated that the service was effective and they thought highly of the home. One person stated, 'I attend different activities I like. I go bowling and I also have a job.' A relative stated, 'The staff know the preferences of my relative and what drink they like. My relative is always happy and well cared for.' People's care needs had been assessed before they arrived at the home and arrangements had been made to ensure that they were able to participate in activities they liked. The care plans were up to date and addressed various aspects of the person's care including their likes and dislikes of people. We noted that staff went about their duties in a calm and orderly manner and people interacted well with them.

Is the service caring?

People who used the service indicated that staff were caring and attentive. One person stated, 'They do take care of us. Food is lovely. The home is clean.' Another person said, 'I have seen the doctor and dentist. There are activities I like. I have been shopping and bowling.' A relative stated, 'The staff are very caring. Whenever I visit X was always happy and looked well cared for.' We observed that care staff were friendly and constantly chatting with people. When a person came up to a staff member and wanted reassurance, the staff member listened to them, gave them a cuddle and the person appeared happy. We saw a staff member and person sharing a joke. Staff said they were aware that all people should be treated with respect and dignity. They were knowledgeable regarding the specific care needs of people. Care plans were up to date and a relative informed us that they had been consulted regarding the individual needs of people. Staff had an understanding of people's cultural and religious needs and where appropriate, arrangements had been made to meet these needs.

Is the service responsive?

People told us that staff listened to them and their preferences and choices had been responded to. Regular meetings had been held where people could make suggestions regarding the meals provided and activities they wanted organised for them.These meetings were chaired by people who used the service and we noted that the minutes were also taken by one of them. We were informed by the registered manager that people were involved in the recruitment of new staff. This was to ensure that people have a say in areas that affected them.

Is the service well-led?

The manager was knowledgeable regarding her role and responsibilities. There were arrangements for monitoring the quality of care provided. A satisfaction survey had been carried out recently. The results indicated that there was a high level of satisfaction among people who used the service. We saw evidence that audits and regular checks had been carried out in areas such as cleanliness of the premises, medication and the health and safety of the premises. Staff meetings had been held and the minutes of these meetings indicated that staff had been updated regarding the management of the home and the care of people. Staff we spoke with informed us that they worked well as a team and felt supported by the manager.

We found the service to be clean and tidy with staff knowledgeable about infection control. Medicines were stored safely and stock was checked regularly. We looked at medicine administration records and found them to be fit for purpose.

Staff had received appropriate training to support them in their roles. We looked at training records and found that mandatory training was up to date for all staff members. We spoke with a senior support worker who told us that staff were also supported to take other courses specific to the learning disability field.

We found that the provider regularly assessed and monitored the quality of different aspects of the service using audit, inspection and discussion with staff and people who used the service. We saw evidence that people's opinions were actively considered and changes to practice were made when deficits in service quality were found.

There were a variety of activities designed to meet the needs of people. The care plans and risk assessments were up to date and relevant to their needs.

Systems were in place to ensure that people were protected from abuse. Staff said they had regular supervision and training. Records relating to people and their care were kept securely.