Islington Social Services - 28a King Henrys Walk

The service is run by Islington Council social services department. The care service has 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 learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our previous inspection on 31 March 2016, we found that the service was meeting the regulations we looked at and the overall rating was Good.

At this inspection we found the service remained Good.

At the time of our inspection a manager was employed at the service and was undertaking the registration process with the Care Quality Commission. 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 service is owned and run by the London Borough of Islington and used the authority’s borough wide safeguarding vulnerable adults from abuse procedures. The four members of care staff we spoke with said that they had training about protecting people from abuse, which training records confirmed. All staff we spoke with had a good understanding of how to keep people safe from harm and how to respond if any concerns arose.

We saw that risks assessments concerning people’s day to day support needs, healthcare conditions and risks associated with daily living and activities were detailed, and regularly reviewed. The instructions for staff were clear. These instructions informed staff about actions to be taken to reduce these risks and how to respond if new risks emerged.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards [DoLS] to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required, which was rare, and informing the CQC when DoLS approvals had been granted.

Care was planned and delivered in a consistent way and the service had good procedures in place to plan for every stay that people had at the service. Information and guidance provided to staff was clear.

Care plans showed that the service developed methods of communication best suited to people’s needs. The care plans described how they could ascertain each person’s wishes to maximise opportunities for people to make as many choices that they were meaningfully able to make.

The service and the provider carried out regular audits of all aspects of the service. The provider carried out regular external reviews of the service and sought people’s feedback on how the service operated.

At this inspection we found that the service met all of the regulations that we looked at.

This inspection took place on 31 March 2016 and was unannounced. At our previous inspection on 19 May 2014 we found that the service was meeting the regulations we looked at.

At the time of our inspection a registered manager was not employed at the service, the previous registered manager having left in August 2015. However, the current acting manager informed us that they have begun the application to register and were compiling additional information required for the application. 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 service is owned and run by the London Borough of Islington and used the authority’s borough wide safeguarding vulnerable adults from abuse procedures. The five members of care staff we spoke with said that they had training about protecting people from abuse.Training records we looked at also confirmed this. We found that staff had a good understanding of how to keep people safe from harm and recognised potential harm issues related to people’s unique needs.

We saw that risks assessments concerning people’s day to day support needs healthcare conditions and risks associated with daily living and activities were detailed, and were regularly reviewed. The instructions for staff were clear. These instructions informed staff about actions to be taken to reduce these risks and how to respond if new risks emerged.

There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required and informing the CQC when DoLS approvals had been granted.

We found that people’s health care needs were assessed. Care was planned and delivered in a consistent way and the service had good procedures in place to plan for every stay that people had at the service. We found that the information and guidance provided to staff was clear.

The care plans we looked at showed that staff had developed methods of communication best suited to people’s needs. The care plans described how they could ascertain each person’s wishes to maximise opportunities for people to make as many choices that they were meaningfully able to make. We saw that staff were respectful towards people and knew how best to interact with each person.

The service complied with the provider’s requirement to carry out regular audits of all aspects of the service. The provider carried out regular reviews of the service and sought people’s feedback on how the service operated.

At this inspection we found that the service met all of the regulations we looked at.

At this inspection we sought to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

Is the service safe?

We found that people's activities were individually risk assessed, as was the way they were cared for. Care workers knew the potential risks that people faced in given situations.

We observed how people either communicated with, or reacted to, the staff who were supporting them. From this we saw that no one showed distress when staff were providing their support.

During our visit we talked with staff about their understanding of the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff demonstrated a knowledge and awareness of both of these areas.

The service had clear procedures in place to receive, record and store medicines that people needed to take during their stay.

Is the service effective?

The six people who were using this service t the time of our inspection each had a personal care plan. We looked at the care plans for four of these people. The care plans covered personal, physical, social and emotional support needs. These plans were updated prior to each person's stay to ensure that information remained accurate.

Staff we spoke with were all able to describe how they recognised people's needs, and believed that the staff team communicated well which was beneficial for responding to people's needs.

Is the service responsive?

We looked at systems for monitoring day-to-day matters at the service. We found that the provider regularly reviewed the effectiveness of the service and included partner organisations in this process.

Is the service well-led?

Each of the four support workers we spoke with spoke positively about the range of training opportunities available to them. The provider kept records which showed what training courses staff had done, and when they did them. We looked at these records and saw that staff attended regular training which included refresher training on standard core skills that staff were required to have.

When we asked staff about supervision meetings with their line manager we were told that mostly these took place approximately every six weeks, which records confirmed.

Aside from the external quality audits, the manager was required to compile regular reports for the provider about the conduct and events that happen within the service for monitoring purposes.

The provider sent us an action plan detailing the steps they were going to take to meet the requirements. We asked the service to provide us with evidence of the steps they had taken to become compliant with the relevant regulation and to demonstrate what work they had completed to make sure that people were protected from the associated risks. We found that the provider was now meeting this standard.

We spoke with two people who used the service and were told, 'I like everybody here' and that 'I would like to stay here more.' They also told us that the staff were always around and helped them with activities such as watching DVD or going shopping. We observed positive interactions between staff and people who used the service.

We spoke with three members of the staff team. Two of them had been working for the provider for over ten years. They told us 'We discuss problems when these arise', 'It's a good environment to work in' and that there was a good team spirit. We found that the service's staff were suitably qualified, skilled and experienced.

We found that the home was appropriately maintained and it was clean and tidy during our visit.

Although people's needs were assessed and their care was planned in a way to meet their needs and ensure their welfare and safety, we found that some records were inaccurate or not up to date which meant that people could have been at risk of receiving inappropriate or unsafe care.