29 and 30 June 2015
During a routine inspection
This inspection took place on 29 and 30 June and was unannounced. Portal House is a 16 bed service registered to provide care for adults who experience mental illness. This includes an apartment which can accommodate up to two people, whilst they develop the skills to live independently. At the time of the inspection there were 10 people using the service.
The service had 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 2008 and associated Regulations about how the service is run.
At our previous inspection on 4 August 2014 the provider was not meeting the requirements of the regulations in relation to staff recruitment. Following the inspection the provider sent us an action plan to tell us they would make the required improvements by 31 January 2015. During this inspection we found the provider had made their recruitment processes more robust in order to ensure people’s safety and thereby meet the requirements of the relevant regulation.
People’s needs were met by a sufficient number of staff to deliver their care even though the provider was struggling to recruit staff. The provider accomplished this through the use of agency staff on long term contracts. People had continuity of staff to ensure they received a service from staff who knew them and understood their needs.
People felt safe with staff, who had undergone relevant safeguarding training and understood how to safeguard people from the risk of abuse. The provider had ensured learning took place following incidents to ensure people’s safety. Risk assessments were in place to identify and manage risks to people. The provider had taken appropriate measures to ensure people’s security, and their safety in the building.
Staff were trained and had access to guidance to ensure people’s medicines were managed safely. People were actively involved in making decisions about their medicines and were supported to self-medicate where possible.
People received effective care from staff who had been adequately supported by the provider to carry out their role. Staff had requested additional training to develop their mental health knowledge. The provider was in the process of commissioning this training.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No-one at Portal House needed to have an application made on their behalf. Staff had received training on the Mental Capacity Act 2005 and understood the principles of the Act.
People were happy with the food they received. Staff involved people in meal choices. People were encouraged to make their own meals where possible. Staff knew who was at potential risk of malnutrition and supported them to maintain sufficient nutrition.
People were supported by staff to meet their day to day health care needs. People were seen by health care specialists as required to ensure their specific health needs were met.
Everyone we spoke with told us staff treated them in a caring and kindly manner. People told us they were treated with dignity. Staff spoke with people respectfully. People felt they could speak freely with staff and that their views were listened to. People were supported both as individuals and as a group to express their views about their care.
The service had communal bathroom facilities; there were not any ‘women only’ facilities. The provider was looking at the feasibility of changing the configuration of bathrooms later in the year. No-one expressed dissatisfaction with the facilities and women were made aware of them before they made a decision to move into Portal House.
People’s needs were assessed before they were offered a service to ensure staff could adequately support the person. People’s care was tailored to meet their needs. Those who wanted to live more independently were supported to do so whilst others were supported to achieve smaller goals that had meaning to them. People were involved in planning their goals and identifying any potential barriers to achieving them. Staff met regularly with people to keep their goals under review. Staff had guidance about the signs that might indicate people were experiencing a relapse of their mental health. People received care that was responsive to their needs.
Processes were in place to enable people to make any complaints about the service. People met regularly to provide their feedback on the service, and were consulted about changes that impacted upon the service. People were actively involved in the running of the service and their views were sought in a variety of ways.
The provision of people’s care was underpinned by a set of values staff learnt about during their induction and through training events. Staff and the registered manager displayed these values during their work with people.
The registered manager audited various aspects of the service in order to drive service improvement for people. The communal areas of the service were noted to be quite stark with limited furnishings in the communal areas for people. The provider had plans in place to address this.