23 March 2016
During a routine inspection
Ocknell Park provides accommodation for up to twelve people who require personal care. They specialise in providingsupport for people who may have a learning disability and/or mental health needs. The service has three vehicles available to facilitate community access for people either as a small group or on one to one support. The service offers a variety of activities in the local community and can also support holidays and trips away.
The service did not have 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 and associated Regulations about how the service is run. The previous registered manager had recently transferred to another home within the Truecare Group. The deputy manager had now been promoted to the manager position and was in charge of the day to day running of the home. They had begun the process of applying for their registration with the commission.
There were robust systems in place to effectively manage the ordering, storage and administration of some medicines. However, the arrangements to manage controlled drugs (CDs) were not effective. CDs are drugs which require additional safeguards as required by the Misuse of Drugs Act 1971. During the inspection, the manager responded immediately to the issues we raised and put measures in place to prevent this from happening again.
People were safeguarded from harm. Staff had received training in safeguarding people and knew how to identify and report any concerns of possible abuse.
Staff understood the requirements of the Mental Capacity Act 2005 and best interest decisions were made, where appropriate, and recorded in line with the Act. We observed people’s freedoms were not unlawfully restricted and staff were knowledgeable about using least restrictive practice if physical interventions were required. Where close supervision was required, this was carried out respectfully and unobtrusively. Individual and environmental risk assessments had been carried out and measures put in place to mitigate risks to people.
Staff showed a good understanding of the needs of the people they supported. Records showed people’s hobbies and interests were documented and staff accurately described people’s preferred routines. Staff encouraged people to take part in activities in the local community which resulted in excellent outcomes for people, such as making new friends and learning new skills. For example, one person joined a local football club and received an award, which increased their confidence, self esteem and pride in their achievement.
People were offered a choice of food and drinks which were sufficient for their needs and that met their dietary requirements.
People, their families and their advocates were involved in planning and review of their care. Care plans were personalised and support was tailored to their individual needs. Risk assessments and care plans had been reviewed regularly to take account of their changing needs.
Staff were knowledgeable about people’s health conditions and made referrals to health care professionals quickly when people became unwell or if they had concerns. The home had access to an internal psychologist to support people with their mental health.
Relatives told us they were happy with the care people received. Staff treated people with kindness and compassion and respected people’s privacy and dignity. People’s confidentiality was maintained both in practice and in record keeping. An environment had been created which enabled people to maintain their physical independence and develop life skills.
There were sufficient numbers of staff on duty to support people safely and meet their assessed needs, including one to one supervision. The provider had appropriate systems in place to recruit staff and appropriate checks were carried out before they commenced employment to ensure they were suitable for the role. Staff received an induction before they started work, which included shadowing other staff. A comprehensive range of training was provided which ensured staff were appropriately trained and skilled to deliver safe care. Staff undertook reflective practice which helped them improve the way they supported and interacted with people.
There were systems in place to monitor the effectiveness and quality of the service provided. Incidents and accidents were recorded and analysed, and lessons learnt were communicated to staff to reduce the risk of these happening again. Complaints procedures were in place although the home had not received any recent complaints. Emergency plans were in place which had been implemented by staff during a recent, serious incident, and which received positive feedback from emergency services.
There was an open and transparent culture within the home. Staff and relatives said the manager was approachable and listened to and acted upon any issues raised. Staff understood the vision and values of the service and were actively involved in the development and improvement of the service. The provider understood their responsibility to inform the commission of important events and incidents that occurred within the service, such as safeguarding concerns and DoLS authorisations.