We carried out a review of the data available to us about Zinia House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Zinia House, you can give feedback on this service.
Zinia House is a care home that provides accommodation and personal care for up to five adults with a learning disability who may also have mental health conditions. At the time of the inspection, five people were using the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The home had safeguarding procedures in place and staff had a clear understanding of these procedures. Appropriate recruitment checks had taken place before staff started work and there were enough staff available to meet people’s care and support needs. Risks to people had been assessed to ensure their needs were safely met. The service had procedures in place to reduce the risk of infections. People’s medicines were managed safely.
People’s care and support needs were assessed before they moved into the home. Staff were supported through induction, training, regular supervision and annual appraisals. 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. People were supported to maintain a healthy balanced diet and they had access to health care professionals when they needed them.
The service applied the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
Staff were kind and caring and people’s independence was promoted. People’s privacy and dignity was respected. People and their relatives [where appropriate] had been consulted about their care and support needs.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People received person centred care which met their needs and preferences. People were supported to maintain relationships and engage in activities they enjoyed. The home had a complaints procedure in place. No one at the service was receiving end of life care.
The registered manager and staff worked in partnership with health and social care providers to plan and deliver an effective service. The service took the views of people and their relatives into account through satisfaction surveys and meetings. There were systems in place to monitor the quality and safety of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was good (published 21 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a registered manager in post at the service. A registered manager is a person who has registered with the 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 previous inspection of this service, in June 2016, breaches of legal requirements were found. This was in respect of safe care and good governance. At this inspection, we found these matters had been addressed. There were enough staff working at the service, and staff were no longer working long hours without sufficient breaks. People were supported by a consistent and stable staff team who had a calm approach.
There was now better management of restraint due to a review how the whole process worked in the service. This resulted in further staff training, clearer individualised guidance and better records. There was a safe approach towards people’s behaviours that challenged the service, with sufficient emphasis on encouraging and valuing positive behaviours.
There was now sufficient auditing of key aspects of the service to demonstrate that the provider was kept duly informed of how well the service was being managed and any emerging risks. This included better reviews of incidents, and more accurate record-keeping.
The service supported people well with physical and mental health needs. People accessed healthcare services with staff help where needed, and advice from this was followed. There was good feedback from community healthcare professionals about how the service helped people.
The service valued people and looked to emphasise their individual strengths. People’s communication abilities were understood and responded to. People were listened to but were respectfully challenged where their choices may not have been in their best interests.
People told us they liked the service. Most people were supported to go out daily, to a variety of community activities. They were treated respectfully and were involved in many decisions about their care. They were encouraged to eat a balanced diet through home-cooked meals that they sometimes helped to prepare.
The service was responsive to people’s needs and was influenced by people’s views and choices. People received personalised care and support based around individualised care plans.
Medicines were safely managed, infection control processes were sufficiently robust, and safety risks were kept under review and minimised. Staff were trained and supported to undertake their care and support roles effectively.
The registered manager had been in that role for many years and showed extensive knowledge of all aspects of the service. Their approach helped the service to promote a positive, person-centred and empowering culture.
There was a registered manager in post at the service. A registered manager is a person who has registered with the 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 and their family members told us that staff provided a supportive service that was focussed on their needs, and that they liked living at the service. People chose and joined in with a range of recreational and educational activities.
However, we found that the service was not consistently safe or well-led. There were insufficient actions in response to some incidents where some people’s behaviour challenged the service.
Restraint guidelines in one person’s case were not clear enough to ensure safe restraint took place, and records of instances of restraint were too brief. Reviews of incidents and restraints were not comprehensive.
We also found that some staff worked long hours at the service. This meant staff did not always have the competence and skills to provide consistently safe care.
People had good relationships with staff members who knew them well, understood their needs, and helped them to develop skills and independence. People were treated with consideration and respect. Staff and the registered manager demonstrated a positive and supportive culture at the service.
People were supported to attend routine health checks and their health needs were monitored within the service. The service was well stocked with fresh foods, and people’s nutritional needs were met effectively.
There were systems were in place for managing people’s medicines and finances safely. The provider had an appropriate recruitment system to assess the suitability of new staff, and there was a complaints procedure in place which was followed when needed.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.