26 and 30 November and 11 December 2015
During a routine inspection
This inspection took place on the 26 and 30 November and the 11December 2015. The You Trust – 5 Paddock Way is a care home registered to provide accommodation and personal care for eight adults with a learning disability. This location is also registered to provide personal care for people living in their own homes. At the time of our inspection there were eight people living in the service at 5 Paddock Way and four people supported in their own homes. Accommodation at 5 Paddock Way was provided within two houses that were joined. Each house had separate communal areas such as a lounge and kitchen and people were able to access both houses through a shared corridor. People supported in their own homes were living in Odiham in Hampshire.
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 inspection at 5 Paddock Way was unannounced. We gave 48 hours short notice of our inspection for the domiciliary care service because we needed to be sure that staff and people would be available when we visited.
Both services were registered at one location and managed by one registered manager. Staff supporting people in their own homes were based in the building where people lived in their own self-contained accommodation. In this report we have said which people, staff and team managers we spoke when this was relevant by referring to Paddock Way or people supported in their own homes.
We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005 and whether applications to deprive a person of their liberty had been appropriately made and authorised. We found the provider had not carried out an assessment of people’s mental capacity to agree to their care and treatment and any restrictions within this. No applications to deprive a person of their liberty had been made. This meant people’s rights under the MCA may not be met. We noted the provider had introduced guidance and procedures to assess whether an application was required. However, at the time of our inspection the provider had not completed mental capacity assessments and was unable to evidence people’s rights were being upheld.
People’s medicines were stored, administered and disposed of safely. We found some recording errors in people’s medication administration records. We saw action taken by the registered manager during our inspection to remedy this. The registered manager introduced a weekly audit to prevent a reoccurrence. Staff had been assessed as competent and completed training in the safe administration of medicines.
Staff understood indicators of abuse, and the procedures to follow to protect people from harm. Training and guidance ensured staff knew the actions required to report safeguarding concerns. People were supported to understand risks to their safety and how to stay safe.
Risks affecting individuals had been assessed and risk management plans were in place to describe how people should be supported safely. People were supported by staff who understood how positive risk taking could provide new and exciting experiences for people. Positive risk taking is about identifying and balancing the positive effects of taking risks against the potential of an adverse event occurring. Risks to people from emergencies were assessed and procedures were in place to manage these safely.
Checks were carried out to ensure the environment was safe and risks to people from care delivery had been assessed. Plans were in place to mitigate against identified risks.
There were enough staff to meet people’s needs. Staff responded flexibly to meet people’s changed or specific needs. All the required checks were carried out to ensure staff were recruited safely and people were protected from unsuitable staff.
People were supported by staff who completed the provider’s required training and additional training to meet people’s individual needs. Staff demonstrated understanding of their training in the delivery of the care people received. Staff were supported by managers in their role and received regular supervision.
People’s dietary needs and food preferences were catered for. People were supported to access healthcare as required and to maintain and improve their health.
People were treated with kindness and compassion by caring staff. People told us staff listened to them and respected their decisions. People and staff appeared to enjoy each other’s company and staff knew about people’s preferences and interests.
People’s care plans were focused on their individual needs to enable staff to provide person-centred care. Care and support was delivered in line with people’s assessed needs and to support people achieve the goals they had identified. People were supported to follow their interests and to maintain or achieve independence as much as they were able to.
A complaints procedure was in place and this was available in an easy read format for people to understand. People and their relatives were asked for their feedback about the quality of care provided. Quality assurance processes were in place to monitor and assess the quality of care people received and to drive service improvements.
There was a positive, open and caring culture within the service. Staff and managers knew people well and had worked together for several years. Staff understood the provider’s values and used these to underpin their work and relationships with the people they supported.
During the inspection, we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.