Archived: St Saviours Road

There was a registered manager 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.

This comprehensive announced inspection was carried out on 28 February and 02 March 2017.

At our last inspection in January 2016 we identified areas where improvements could be made. These areas related to the management of medicines and record keeping related to risk assessments and fire safety. In addition a number of the policies and procedures were out of date. At this inspection all these areas had been addressed. People’s individual support plans contained information that was no longer relevant. This was not a concern in that all staff working in the home knew people exceptionally well and had worked in the home a long time. However, the registered manager was aware that this was an area that needed to be addressed.

The registered manager and staff had a very strong understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure that people who cannot make decisions for themselves are protected. They also ensured that people were not having their freedom restricted or deprived unnecessarily.

Staff had an extremely good understanding of people as individuals, their needs and interests. Some people attended day centres and people were also supported with daily activities both within and outside of the home. Significant progress had been made in increasing and expanding the variety of activities of offer to people. Staff were acutely aware of people’s individual needs in relation to activities and supported people in a way that suited them. Staff were kind and caring in their approach and spoke with people in a way people could understand. People responded warmly to this.

Staff ensured that people were supported to be as independent as possible and they adapted their approach based on each person’s strengths and weaknesses. This included the provision of opportunities for people to develop skills in meal preparation and daily living tasks. Staff support was provided in line with people’s needs.

There were enough staff to meet people’s needs. Risk assessments were carried out to ensure that people were safe and that staff had clear guidance on how to support them. Staff knew what actions to take to mitigate these risks and provide a safe environment for people to live in. Staff understood what they needed to do to protect people from the risk of abuse. Appropriate checks had taken place before staff were employed to ensure they were able to work safely with people at the home.

Staff attended regular supervision meetings and told us they were very well supported by the management of the home. Staff meetings were used to ensure that staff were kept up to date on the running of the home and to hear their views on day to day issues. Staff attended regular training to ensure they could meet people’s needs. This included training on various aspects of autism. There was a thorough induction to the service and staff felt confident to meet people’s needs before they worked independently.

People were supported to have healthy and nutritious diets that were varied and met their individual choices. They were also supported to attend healthcare appointments in line with their individual needs.

The provider had good systems to monitor the management and quality of the home and through regular internal monitoring the registered manager ensured that a range of audits were carried out to monitor the care and support provided. Where shortfalls had been identified they were addressed in a timely manner.

The registered manager retired from their role in December 2015. A new manager was appointed in advance of this and worked alongside the manager for a period of time before they left. The new manager has applied for registration with CQC. As they are currently registered in relation to another care home, they divide their working week between both locations. 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 told the manager the evening before the inspection that we would be coming. We did this to ensure that there would be someone to facilitate the inspection as staff are often out of the home supporting people with daily activities. This comprehensive inspection took place on 13 and 14 January 2016.

Although we were told that staff had been assessed as competent to manage the medicines in use there was no documentation to confirm this. Liquid medicines and creams in use were only used as and when needed, however, there were no systems in place to record when they had been opened and staff could not tell us. If they had been open a long time this could have made them less effective.

Fire drills had been carried out, but records did not show the names of staff in attendance and the outcome had not been evaluated. The provider was therefore unable to demonstrate that they had monitored that staff knew what to do in the event of a fire.

Although people had detailed support plans, associated risk assessments were less detailed and did not clearly describe the level of risk and were not reviewed appropriately.

The home had a range of policies and procedures in place to give guidance to staff on the actions they should take in certain circumstances. However, there was no effective system in place to ensure that the policies and procedures were up to date and to confirm that staff had read them.

The manager and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

People had access to healthcare professionals when they needed it. This included GP’s, dentists, opticians and psychiatrists. A health professional told us that staff were friendly and they had no concerns with the home. Another professional told us that care plans were up to date, staff were caring and had a good relationship with their client.

Staff knew people’s individual needs and were able to describe to us how to provide care to people that matched their assessed needs. We could also see for ourselves that care was given in line with the guidance in people’s support plans. People were supported to attend a range of activities based on their individual needs and wishes. Relatives told us they could visit when they wanted and that there were good communication links with the home.

There were enough staff who had been appropriately recruited, to meet the needs of people. People were asked for their permission before staff assisted them with care or support, from staff that had the skills and knowledge skills necessary to provide people with safe and effective care. Staff received regular support from management which made them feel supported and valued.

One person told us, 'I'm doing well at work, I learn new things all the time.' They said that they were, 'happy with everything.' Relatives of one person told us, 'There is an open line of communication, it's very useful.' If they had a concern or wanted to discuss anything they would be able to mention it to the manager, or their relative's keyworker.

We found that care plans clearly documented the needs of people and how they should be met. Staff ensured that consent was obtained prior to providing care and support. Specialist advice and support was obtained to meet people's individual needs. There were safe systems in place for the management of medication.

Staff received training to meet the needs of people. There were detailed systems to ensure that the quality of care provided was monitored and reviewed on a regular basis.