Archived: Disabilities Trust - 3 Water Meadows

This focused inspection took place on 19 May 2017 and short notice was given to the registered manager. This was because it is a small service and we needed to ensure people would be available to speak to. At the last inspection, in August 2016, the service was rated overall as good, with safe rated as requires improvement as we found a breach of regulations in relation to infection control practice. At this inspection we found the provider had taken action to address the issue. This meant the service remained rated overall as good, and the safe domain was also rated as good.

A registered manager was in place. The registered manager was also registered as the manager of two other small community based residential services. They divided their working hours between the services. 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 was not present during this inspection.

The service was safe and clean and action had been taken to reduce the risk of infection. The washing machine and tumble drier had been relocated to an enclosed utility area outside the kitchen. This meant staff were not accessing the kitchen with soiled laundry, which greatly reduced the risk infection.

People felt safe living at the service. They said staff were kind, caring and friendly and everyone got along well together. One person said, “I am safe and perfectly happy…” Another said, “I get on with staff and they keep me safe.”

There were enough qualified, skilled and experienced staff to meet people’s daily care and support needs. The registered manager was liaising with commissioners to increase funding for additional staff hours to enable people to have more individual social activities.

Risks to people’s health and safety had been assessed and measures were in place to reduce any risk without restricting people’s freedom and independence. People’s medicines were safely managed. Staff had received training in the safe administration, storage and disposal of medicines.

People were protected by the provider’s systems for safeguarding them against abuse or neglect. Staff understood what they needed to do to keep people safe and report any concerns.

The provider operated safe recruitment processes to ensure only staff that were suitable to work with vulnerable people were employed.

This unannounced inspection was carried out on 2 and 8 August 2016. At the last inspection on 5 June 2013 we found the provider was meeting the regulations we looked at.

At the time of the inspection there were two people using the service. The service aims to support people to live as independently as possible.

A registered manager was in place. The registered manager was also registered as the manager of two other small community based residential services. They divided their working hours between the services. 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.

People benefited from a clean home with no unpleasant odours. However, due to the current laundry arrangements there was a risk that cross infection was not fully controlled.

Not all aspects of the recruitment process were robust. Recruitment checks for one staff member did not include information about their full employment history to ensure they were suitable to work with people.

People enjoyed some group social events, and outings, but could not always pursue their individual hobbies and interests due to the way staff were deployed.

People received effective care from a small team of staff, who were familiar with people’s needs and preferences. People were very happy at the service and described it as “home”. One person said “I am perfectly happy here. It is just like living in a normal house – this is home.” People enjoyed positive and respectful relationships with staff. Staff treated people with dignity and kindness. People spoke highly of the staff, one saying, “Staff are all perfect here…they are a bunch of really nice people.”

People's care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and/or health related issues. They helped to promote people's independence whilst minimising the risks. People’s medicines were managed safely and administered as the prescriber intended.

People's health and wellbeing were maintained and they received specialist input from a range of health professionals. People's nutritional needs were met and there was a collaborative approach to meal planning and preparation.

Staff received the training and development they needed to care for and support people's individual needs. Staff were supported through regular supervision, staff meetings and training.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people's rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care.

An open culture had been developed and people were encouraged to contribute to the running of the service. The provider sought people's views on the service in order to develop and improve. Effective auditing systems were in place to monitor the quality and safety of the service. There were arrangements in place to monitor accidents and incidents.

We found one 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.