Background to this inspection
Updated
28 September 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection. The inspection was completed on 10 and 11 August 2017 and was unannounced. The inspection team consisted of one inspector.
We reviewed the information we held about the service including safeguarding alerts and other notifications. This refers specifically to incidents, events and changes the provider and registered manager are required to notify us about by law.
Due to their complex needs, we were unable to speak with the majority of people using the service about their views and experiences. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also spoke with people’s relatives or those acting on their behalf to ascertain their views about the quality of the service provided for their member of family.
We spoke with three people who used the service, four people’s relatives, four members of care staff team, the registered manager and a visiting health professional.
We looked at a range of records which included four people’s care records, four staff recruitment, training and support records and records in relation to the safe management of the service, such as policies, audits, staff rotas, complaint and compliment records, medication records and quality assurance records.
We reviewed four people’s support plans and support records. We looked at the service’s staff personnel records for four members of staff. Additionally, we reviewed four staff members training and supervision records. We reviewed the service’s policies, their audits, the staff rotas, complaint and compliment records, medication records and quality assurance records.
Updated
28 September 2017
The service was last inspected in November 2016 were the Commission highlighted a number of concerns. This service was in ‘Special Measures’ at the time of this inspection.
The provider wrote to us with actions they had taken to improve the service. The service was previously rated inadequate overall and placed in special measures. Although improvements had been made since our last inspection, at this inspection the service has been rated as requires improvement, as the provider will need to show they can sustain the improvements and continue to provide good care for the rating to be changed.
A registered manager was in post. 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.
Although the service had a number of quality monitoring processes in place to ensure the service maintained its standards, these were new systems and not completely embedded in the service.
The service had made improvements to ensure staff delivered support that was effective and caring and this was in a way which promoted people's independence and wellbeing, whilst people's safety was ensured.
Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people's individual needs to be met adequately. Trained staff dispensed medications and monitored people's health satisfactorily.
Staff understood their responsibilities and how to keep people safe. People's rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
The registered manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.
Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks.
Systems were in place to make sure that people's views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals.
A complaints procedure was in place and had been implemented appropriately by the registered manager.