19 August 2015
During a routine inspection
This inspection took place on 19 August 2015 and was unannounced.
5 Park Hill Drive is registered to provide residential care and support for three people with a learning disability. At the time of our inspection there were three people using the service.
The service is based in a traditional detached property located within a residential area. The ground floor comprises of a kitchen, lounge and dining room which leads into a conservatory. The first floor provides three bedrooms and a bathroom.
The local authority and other authorities out of the area who fund people’s packages of care are in the process of assessing people’s needs. This is because concerns have been raised about the safety of people at another location the provider is responsible for. This affects the service at 5 Park Hill Drive as it is supported by staff who work across both locations. Records relating to staff recruitment, staff training, and policies and procedure are also common to both services, as are quality assurance systems.
The provider advised us that the registered manager of 5 Park Hill Drive has recently resigned their post with the provider. An application to cancel their registration with the Care Quality Commission (CQC) has not been submitted by the former 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 nominated person representing the provider 9 Grace Road Limited has also recently resigned from their position and another person is now acting on the provider’s behalf.
5 Park Hill Drive is one of three locations registered by the provider 9 Grace Road Limited. At the time of the inspection the three locations were being managed on a day to day basis by a consultancy firm. This was as a result of concerns being identified at one of the other locations, which had resulted in the resignation of the provider’s nominated person and registered manager.
A representative of the provider has entered into a contract with a consultancy firm to oversee and manage the service with a view to bringing about the required improvements identified by a range of external stakeholders. Reference to ‘the manager’ within the inspection report refers to the person managing the service who is employed by the consultancy firm.
People who used the service told us that they felt safe and that knew they could speak with staff or their relatives if they were worried about something.
Staff we spoke with were aware of people’s individual risks assessments with regards to tasks such as cooking or going out, which meant people were supported by staff who knew how to minimise risk and promote people’s safety.
Records, which included risk assessments for people using the service, accident and incident forms and policies and procedures for the promotion of people’s safety and wellbeing, were in the process of being reviewed and updated by the consultants.
People received their medicines in a timely manner.
People were supported by staff who are aware of their needs and are able to provide the support they required, both within the service and when going out into the wider community.
Staff told us they had attended supervision meetings with the manager about their work. They told us they had been encouraged to express their views about the care people received and to share their ideas as to how the service could be improved.
People’s mental capacity to make day to day decisions about aspects of their care had not been assessed using the MCA assessment tool, information about people’s capacity was detailed within people’s new plans of care stating they had capacity. This included their ability to manage their own finances or medicines. We discussed this with the manager and deputy manager who advised mental capacity assessments would be carried out to reflect people’s plans of care and their day to day decisions.
People told us they were supported by staff to prepare and cook meals. They told us that they had meetings to discuss the menu; however there were no recent records to support this. People using the service did not require support with eating and drinking and were able to access food and drink independently from the kitchen. People’s plans of care contain information about their dietary intake and the need to ensure their weight was monitored, however the information was not tailored to each person.
People spoke positively about the care and support they receive from staff and told us that staff were kind and caring. They told us that staff supported them with their day to day lives and encouraged them to undertake everyday tasks such as cooking and household chores, which supported them with their independence.
People’s independence was not fully recognised and their privacy and dignity was not always considered as aspects of their lives was managed from another of the provider’s services, which meant people have to access the other service for their finances and keys to the property.
People told us about their day to day lives and the activities they took part in, which included shopping, visiting friends and relatives, and attending local events and places of worship. People said they had been on holiday this year and had enjoyed themselves.
People sat with us and showed us their copies of their plans of care and we spoke with them about the information they contained. People had mixed views as to whether they knew what was written about them and in some instances the information was not up to date as people’s choices about their lives and what they did had changed.
Staff told us they were confident to approach representatives of the consultancy firm manager and representatives as well as the deputy manager and told us they were willing to listen to their ideas about how to improve the service.
The consultants had in conjunction with the provider undertaken an audit of the service, which had identified areas for improvement. An action plan had been developed which was in the process of being implemented.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report.