Archived: Raola House

This inspection took place on 17 November 2014 and was unannounced. We carried out our last inspection on 25 June 2013 and found the service was meeting all of the standards we looked at.

Raola House is located in a residential area of Wallington and provides care for up to six adults with learning disabilities. At the time of our visit, there were six people using the service. The service had a registered manager in place. 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.

We found that staff were aware of how to recognise abuse or potential abuse, but were not familiar with the provider’s reporting procedures and did not know where to find a copy to refer to, if required. This meant that people may be at risk of harm due to staff not following appropriate procedures.

People had risk assessments so staff knew how to protect them from risks specific to them. However, these were not all individualised and did not consider least restrictive ways of keeping people safe. People were at risk of receiving care that did not always promote their rights by enabling them to take positive risks.

The service did not always ensure that people’s capacity to make decisions about their care and support was assessed where appropriate. This is required by law and failure to do so can mean that people receive care that is unnecessarily restrictive or not in their best interests.

The provider took steps to ensure the premises were safe by carrying out regular checks on the environment and ensuring fire equipment was regularly serviced. The home was clean and well-maintained.

There were enough staff to keep people safe. Robust recruitment procedures helped ensure people were protected from the risks of having unsuitable staff care for them.

Medicines were kept safely and staff received appropriate training to ensure they were aware of how to administer and record them safely.

Staff received training, which included support and advice from specialist providers working with people who used the service. This helped staff to work consistently in line with best practice. Staff were appropriately supervised and received appraisals to encourage professional development.

People received enough suitable food and drink to meet their preferences and needs, including cultural needs. They enjoyed the food provided by the service and were able to choose meals according to their preference. There was a variety of nutritious food provided and staff knew people’s likes and dislikes.

Staff ensured that people had access to healthcare providers on a regular basis or when required so that their health needs were met.

People felt staff were kind and caring, knew them well and gave them the support they wanted. Although people were involved in discussing their care at regular interviews and had opportunities to express their views, they were not always involved in developing initial care plans. These did not contain information about people’s views, likes and dislikes or life history. People may therefore have been at risk of receiving care or support that did not take into account their individual views or preferences.

The service used a variety of methods to meet people’s communication needs, some of which were complex. They supported people in ways that valued their independence and which met their religious needs.

People felt that staff listened to them and they were given opportunities to express their views. Staff regularly ensured people knew how to make a complaint if they needed to.

Care plans were not always personalised and some information was duplicated across different people’s files. Some information was incorrect or out of date. This meant there was a risk that people did not receive personalised care that was responsive to their individual needs.

People were offered activities that were meaningful to them and allowed them to broaden their life experiences, including trips, holidays and outings within their local community as well as activities within the home. They received support to maintain contact with their family and others who were important to them.

There was a fair and open culture within the service. Staff and people who used the service were able to express their views and felt that senior staff and managers listened to them and took action where required to improve the service.

The provider carried out regular surveys so people and their relatives were able to have their say and comment on the quality of the service and how it could be improved. The provider acted on people’s comments to address areas where people or others were not fully satisfied.

Some personal information relating to people who used the service was not always kept securely, which meant their confidentiality could have been compromised. We recommend that the provider consider the guidance on the secure storage of records under the Data Protection Act and other relevant legislation.

There were systems in place to monitor the quality of the service and identify any service-wide risks or shortfalls. These were effective in identifying and acting on some areas for improvement, but had not picked up issues that we found at our inspection.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.