Archived: Poppy Cottage

We previously inspected the service on 08 October 2014. The service was meeting the requirements of the regulations at that time.

Poppy Cottage is registered to provide personal care. It provided this within supported living accommodation. At the time of our inspection sixteen people were being supported by the service.

The service had 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.

We received some outstanding feedback from people and their relatives. Comments included, “In our opinion Poppy is excellent, and the care she receives is outstanding and she has improved in so many ways due to the care she is given”, “Our opinion of the way Poppy is managed we feel it is of the highest standard”, “We definitely recommend the service”, “I feel safe, as the staff are always around” and “It’s a safe haven for her, I am reassured that she is looked after.”

People were protected from avoidable harm as the service had safeguarding procedures and staff knew what to do should a safeguarding concern be raised.

Poppy Cottage prides itself on providing a personalised service which helped people to achieve their maximum potential. We received many examples of how the service had supported people to move from supported living to more independent living. The registered manager told us “One of the main reasons were all so passionate about our work is because all our staff including myself are equal. I’ ve always maintained each of us are on the same level, some of us have more qualifications and experience but our work ethic is the same, it's the way I've always worked with staff and I believe it works, our staff are always willing to go the extra mile.”

People were supported by staff with the right skills and attributes as the service had a robust recruitment process. All the required checks were made.

People received their medicines when required and staff only provided support with medicines after they had received the appropriate training.

People were supported to undertake activities of their choice. Staff met with each person every week to plan forthcoming events. This ensured there was enough staff on duty to make sure the activities took place. In the event of unplanned absences of staff, other staff were flexible to cover the shifts. Where possible people were supported to attend work placements and or college.

Care plans were written in a way to ensure staff knew how to support people; they were reviewed on a regular basis to ensure the information was up to date.

People were supported to maintain a healthy lifestyle and were supported to attend important medical appointments.

People and their relatives had confidence in the management team. Comments included “I have always found that (manager) and her team not only provide the care that you would expect from a Supported Living environment but are always willing to go the ‘extra mile’ to make sure their service users are happy and well adjusted” and “We are confident she is very good hands.”

We returned to the service on 8 October 2014 to check whether improvements had been made. This was after the date the provider told us all actions to improve the service would be completed.

We considered all the evidence we had gathered under the outcome we inspected. We used the information to determine whether Poppy Cottage provided a safe service to people.

This is a summary of what we found -

Is the service safe?

We found Poppy Cottage provided a safe service.

We found staff were no longer restricting people's access to the kitchen. This meant people could make use of all communal areas of the home without restrictions placed on them. Two of the senior staff team had attended training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards since our inspection. A further date was booked for the rest of the senior team to attend. This meant relevant staff were being trained to understand when an application should be made to deprive people of their liberty, and in how to submit one. This ensured there were proper safeguards in place at the service.

This is a summary of what we found -

Is the service safe?

We found Poppy Cottage needed to take action to provide a safe service.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The service had safeguarding procedures in place in the event of any suspected or actual abuse. Records showed staff and managers were trained in safeguarding people from abuse. This provided them with the knowledge and skills to recognise and respond to abuse appropriately.

We found the provider had responded appropriately to two allegations of abuse. This included reporting the concerns to the local authority and notifying CQC, to ensure relevant agencies were informed.

We saw the provider had systems for managing people's money. Individual records were kept to log all expenditure made on people's behalf. Receipts were kept to verify any expenditure. Staff told us a check was made of people's money at each handover session between shifts. We saw records which confirmed this. This ensured that any discrepancies were identified promptly and rectified, before staff left the building.

Staffing rotas were maintained at the service. These showed there were enough skilled and experienced staff to meet people's needs. Managers were available on site to provide any support staff needed. There were on call arrangements outside office hours. This ensured staff could access support at all times.

We observed staff were responsive to people's needs. They were patient when answering repetitive questions. We saw staff involved people in choosing and making a picnic, to make the most of the warm weather. The staff we met were knowledgeable about people's needs and were able to answer questions we had about their care. Staff told us there were good training opportunities. This included recent input on safeguarding people from abuse and another course on behaviours that may challenge the service. This helped ensure staff had the necessary skills and knowledge to meet people's needs.

CQC monitors the operation of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). We found the kitchen was kept locked at Poppy Cottage so that people could not go in there without staff supervision. The provider had not considered whether this action deprived people of their liberty under the legislation. Therefore no application had been made to the relevant authority to check it was lawful. We found relevant staff had not been trained to understand when an application should be made, and in how to submit one. This meant the service did not have proper safeguards in place in relation to the Mental Capacity Act 2005 and DoLS.

People told us they were happy with way the staff treated them and we saw staff speaking to people in a friendly and encouraging manner. One person told us "Staff treat me with respect... they are nice and polite." The Second person told us "I don't like being told what to do, I choose what I wear, when I go to sleep and what I want to do." We saw staff cared and supported people in respectful and friendly manner.

We found before people received any care or treatment they were asked for their consent. People told us staff asked their permission before supporting them. There were sufficient staff on duty to meet people's needs and to ensure continuity of care. Staff were able to interact with people in an unrushed manner.

We found the home had a system in place to assess and monitor the quality of the care that people were receiving. People's concerns were listened to, and action was taken to address any issues identified.

We found that risk assessments had been put in place for staff to support people with activities. This ensured people's safety and welfare were protected and promoted. Improvements had been made to the management of medicines to ensure medicines were recorded, administered and handled safely. The service had reviewed its recruitment process to make sure it was effective. A supervision framework had been developed to support staff to perform their duties appropriately. Records relating to people who used the service and staff were being appropriately maintained to ensure they were accurate and to promote confidentiality.