Archived: Minehead Road

We carried out an unannounced comprehensive inspection of this service on 17 December 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Minehead Road on our website at www.cqc.org.uk”

At the last inspection on 17 December 2015, the registered manager had not sent Care Quality Commission (CQC) notifications of the outcomes of Deprivation of Liberty (DoLS) applications. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Registration) Regulations 2014.

This focussed inspection took place on 17 February 2017 and was unannounced. We did not look at all of the Key Lines of Enquiry under each key question. We looked at is this service well-led? We followed up on the breach of regulation to see if the registered provider had made improvements to the service. We found action was taken to meet legal requirements in relation to that breach of regulation.

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.

The registered manager had informed CQC of other incidents that occurred at the service. People had a DoLS application made for them by staff. CQC were notified of DoLS applications made to the local authority and the authorisation. CQC received notifications for each of those authorisation outcomes.

At the last inspection on 6 July 2014 we found that the service had met requirements.

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 this inspection we found that the service had not sent the CQC notifications in relation to the outcomes of Deprivation of Liberty (DoLS) applications. This was a breach of Regulation 18 of CQC (Registration) Regulations 2009.

Staff had knowledge and skills to meet people’s care needs as required. They attended relevant training courses to ensure that the support provided was in line with good practice. Staff worked within the principles of the Mental Capacity Act 2005 (MCA). This meant that people received assistance to make their own decisions when needed. People chose what they wanted to eat and drink and were encouraged to cook meals for themselves. Records showed that people were up-to-date with their routine health appointments and received additional professional support as appropriate.

People were provided with safe care and support at the service. Staff supported people to identify and manage any risks to their well-being. This meant that people received assistance to stay safe from potential harm and injury. Staff attended induction to ensure they had the required knowledge to carry out their work safely. Staffing levels provided were sufficient, which meant that people had the support they required. Regular supervision and appraisal meetings were carried out to support staff in their role. People were supported with their medicines and received their medicines as prescribed.

We observed that people had good relationships with staff. People’s privacy and dignity was respected, which meant that staff respected feelings of the people they supported. People’s communication needs were identified and promoted. This meant that people had their wishes heard and acted on. People had support to maintain relationships and were encouraged to attend activities of their choice in the community. Staff encouraged people to learn new skills and helped them to maintain the skills they already had. Staff knew people’s preferences and supported them to make choices according to what they wanted.

People’s needs were individually assessed and reviewed which enabled the staff team to collect as much information as possible on people’s preferences and care needs. People were provided with support to plan their care whenever possible. They had one-to-one meetings with staff to discuss their needs and how they wished to be supported. Families and health and social care professionals had regularly provided feedback about the service and felt that issues raised were addressed. People were supported to talk about their concerns if they wished to.

The registered manager monitored the quality of care provided for people. Regular audits were carried out to identify changes and to make improvements were appropriate. Staff said they felt supported by the management team and were able to approach for advice when needed. The staff team were encouraged to question practice and make suggestions to improve where required. This meant that staff were supported to make suggestions and take initiative in providing good care for people. Appropriate systems were in place to monitor incidents and accidents, which meant that immediate support was provided for people when needed.

Below is a summary of what we found. The summary describes what people who used the service and the staff told us and the records we looked at.

Is the service safe?

There were effective recruitment processes in place for staff, which included obtaining references. Staff had undergone criminal record checks; however, some had not been recently updated. All staff were trained in emergency first aid and had attended safeguarding vulnerable adults training in the past year. There was a policy in place to deal with adverse incidents such as adverse weather.

Is the service effective?

There were up to date care plans in place for each person, which enabled staff to provide safe and effective care. Care plans were being reviewed every month and included details of health professionals involved in the delivery of each person's care. Monthly updates were being sent to relatives, which included activities undertaken by people who used the service.

Is the service caring?

People who used the service were involved in decisions about their care and support. Staff supported people and advised them, but allowed the person who used the service to make the final decision. A member of staff told us, "We always ask [people who used the service] what they want and give them choice." They went on to say that they never forced people to do anything.

Is the service responsive?

The service liaised with other health professionals to meet the needs of people who used the service. People's individual needs were assessed. The staff we spoke with were aware of the needs of people who used the service. The relatives that completed the annual questionnaire stated they were aware of how to make a complaint.

Is the service well-led?

We observed the handover between staff at the end of a shift and there was good information sharing. Daily care records were also being completed.

We saw evidence that there were processes in place to monitor and improve the quality of service delivery.

The provider followed appropriate procedures when someone did not have capacity to consent in relation to a specific decision about their health care.

People had access to the health care they needed, including mental health services. Staff worked in cooperation with other agencies and facilitated people's access to services to promote their health and wellbeing.

There were appropriate arrangements for the management of medicines.

The house was clean and tidy on the day of our visit. We saw that repairs were undertaken promptly. There were checks in place to keep people in the house safe and secure.