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Inspection carried out on 24 October 2018

During a routine inspection

This inspection took place on 24 October 2018 and was unannounced.

At our last inspection on 11 April 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Apton Road is a ‘care home’ for people offering short break respite support for up to four adults with learning disabilities and physical disabilities in an adapted building. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

People felt safe and were confident to approach the staff. Detailed health and support plans had been developed to ensure that staff knew how people wanted their needs to be met. Risks to people’s safety and welfare had been identified and support planned to enable people to enjoy their respite stay as safely as possible. There were sufficient numbers of staff available to meet people’s needs. People’s medicines were managed safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff understood their individual roles and responsibilities and were supported by the management team to maintain and further develop their skills and knowledge. People enjoyed a varied healthy diet and their health needs were well managed.

People enjoyed a good relationship with the staff team supporting them. People were involved in all aspects of their support as much as they were able. Relatives and friends were encouraged to visit at any time and people were actively supported to maintain family relationships. Staff promoted people’s dignity and treated them with respect.

People’s support was arranged around their needs and they were involved in decisions about their care where possible with support from family members and professionals. The provider had arrangements to support people and their families to raise concerns and there were opportunities for people to discuss all aspects support provided.

The registered manager promoted a positive culture that was transparent and inclusive. Robust systems had been developed to continuously check and monitor the quality of the service people received. Staff felt valued and were encouraged to contribute any ideas for improving the service.

Inspection carried out on 11 April 2016

During a routine inspection

Apton Road is a short break respite care service that offers support and care for up to four adults with mild, moderate and severe learning difficulties and people with physical disabilities. There was one person using the service when we inspected.

We last inspected the service on 11 April 2014 and we found the service was meeting the required standards at that time.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe and were confident to approach the staff. Detailed health care and support plans were in place to ensure that staff knew how people liked their needs to be met. Risks to people’s safety and welfare had been identified and support had been planned to enable people to live as safely as possible. There were sufficient numbers of staff available to meet people’s care and support needs. People’s medicines were managed safely.

Staff members understood their individual roles and responsibilities and were supported by the management team to maintain and develop their skills and knowledge. People enjoyed a varied healthy diet and their health needs were well catered for.

The atmosphere in the home was welcoming and there was a warm interaction between the staff and people who used the service. People were involved in all aspects of their care and support as much as they were able. Relatives and friends were encouraged to visit at any time and people were actively supported to maintain family relationships. Staff promoted people’s dignity and treated them with respect.

People’s care and support was planned around their needs and they were involved in decisions about their care with support from family members and professionals. The provider had made arrangements to support people and their families to raise concerns and there were opportunities for people to discuss all aspects of the care and support provided.

The registered manager promoted a positive culture that was transparent and inclusive. The registered manager and provider had developed robust systems to continuously check the quality of the service provided. Staff felt valued and were encouraged to contribute any ideas they may have for improving the service.

Inspection carried out on 29 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

The inspection was unannounced. The service was found to be meeting the required standards at their last inspection in October 2013.

Apton Road is a short break respite care service provided by Hertfordshire County Council. The service offers support and care for up to four adults with learning difficulties and people with physical disabilities. There is a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were supported by staff who knew them well and had the necessary skills to support them appropriately. Staff had a good understanding in regards to people’s safety and welfare in addition to protecting people from the risk of abuse.

Care plans were written in a way that demonstrated the involvement of the person, and  where appropriate their relatives, in the planning and reviewing of their care and support. People experienced care that was delivered in accordance with their plan. People had regular access to health care professionals.

People, their relatives and visiting professionals were positive about the staff. Staff were kind, caring and responsive.

The service had clear values in what they wanted to achieve. Staff were clear on what their roles were and shared the managers view of the type of service they wanted people they supported to receive. There were systems in place to gain people’s feedback and monitor the quality of the service. The manager responded to issues appropriately and this planned actions were communicated through the team.

During a check to make sure that the improvements required had been made

This inspection did not include a visit to the service, and therefore we did not speak directly with people using the service as part of this inspection.

At our review of compliance undertaken in April 2013 we identified shortfalls in some areas of staff training such as food hygiene, infection control and adult safeguarding. In October 2013 the manager provided evidence to show what steps had been taken to address the shortfalls in training.

Inspection carried out on 3 April 2013

During a routine inspection

During our visit we spoke with two people who used Apton Road for planned respite stays. They said they were happy with their surroundings and the support they received. One person said, “I’m independent, I get up by myself, and they support me to be as independent as I can be.”

Relatives of people using the service said that staff were very helpful and supportive. One person said, “They do everything they can to help families, they seem to have people’s needs at heart, they treat people as people which is really nice, they are really committed.”

People said that freedom of choice was integral to their stay at Apton Road. They said they were consulted about their care and support and had the opportunity to ask questions of staff and the manager at any time and were always provided with thorough explanations.

Staff were respectful when speaking with people. They were patient and tried to help people to understand what they wanted to do and did not rush them.

We saw that refresher training was not routinely provided to ensure people’s skills were kept up to date. This meant that people could not be confident that the staff team had the up to date knowledge and skills to be able to support them safely.

We asked people using the service about the manner in which complaints were handled at Apton Road. They told us they were happy with the way any concerns were dealt with and said they would be confident to raise concerns with any member of staff.

During a check to make sure that the improvements required had been made

At our previous inspection visit to this service on 04 July 2012 we found that the provider did not have an effective system to regularly assess and monitor the quality of service that people received.

Information provided for this review on 07 December 2012 showed that the provider had undertaken a quality assurance survey involving the views of the people using the service and their families and representatives.

Inspection carried out on 4 July 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with the relatives of three people, who told us they were pleased with the support the service provided because staff made the time to spend with people so that they were kept engaged and stimulated.

People told us they were satisfied with the care and support they, or their relative, received at 34 Apton Road. One person said, “X is very well cared for here and I know when I am not here that X is safe and well cared for.”

A professional with whom we spoke told us they had great confidence in the staff team and said, "They do an excellent job with the resources available to them. They are incredibly flexible and helpful, second to none, they bend over backwards to support the people who use the service."

Relatives of people who used the service told us that they felt comfortable to raise any concerns they may have directly with the staff and management team. One person said, "If I have any issues concerning me I would ring up and speak with someone, they always sort it out for me."

Reports under our old system of regulation (including those from before CQC was created)