Archived: 148 Hornsey Lane

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.

148 Hornsey Lane provides accommodation and personal care to a maximum of 12 people with long-term mental health needs. At the time of our inspection there were 11 people using the service.

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. The registered manager had been registered with the CQC since 14 May 2014. They knew the service well and they had appropriate skills and experience to provide the regulated activity.

There were systems in place to ensure people received their medicines in a safe way and as intended by a prescriber. Medicines were stored and managed well, and staff had received medicines administration training to ensure they knew how to administer medicines safely.

People felt safe at the service and staff took appropriate action to ensure people were safe from avoidable harm and abuse. Various systems were in place, which ensured that people were living in a safe environment and risks to their health and wellbeing had been regularly assessed. These related to regular health and safety and fire checks, infection control and management of incidents and accidents. Appropriate recruitment process helped to protect people from unsuitable staff.

People’s care needs and preferences had been assessed before they moved into the service. A thoughtful and planned transition process supported people in settling in the new environment after they came to live at the service.

Staff received appropriate training to ensure they had the right knowledge and skills to support people in a safe and effective way. The registered manager supported staff by providing them with regular supervision, yearly appraisal of their performance and regular practice reflection sessions.

People were supported to live a healthy life. Staff supported people to have a healthy and nutritious diet that was in line with their individual dietary needs and preferences. People had access to health professionals when needed.

The service’s design allowed people to spend their time on their own or in the company of others. There were communal areas to socialise with other people using the service and individual rooms to spend time on their own if preferred. The décor was homely and we saw people were comfortable in their environment.

The service worked within the principles of the Mental Capacity Act 2005. Staff had appropriate training and they had good understanding of the principles of the Act. Staff sought people’s consent before any care and support was provided.

People told us they were supported by kind and compassionate staff who respected their privacy and showed an interest in people’s health and wellbeing. Staff told us they empowered people to be independent and to continuously develop their life skills. Staff respected people privacy and dignity and we saw that people using the service were comfortable in staff presence.

People received care that was in line with their care needs and individual preferences, which were described in comprehensive care plans. Care plans included guidelines for staff on how to support people effectively. Staff knew people’s needs and preferences well and were able to give us numerous examples of how people liked to receive their support.

The service had a formal complaint procedure in place which was available to people. People told us they had not had any complaints and they felt listened to by staff who offered their advice when required.

Staff thought the service was well led. They felt supported by the registered manager who they described as approachable and willing to participate in support worker’s tasks to help when needed.

There was good communication between staff members at the service. Effective systems were in place to ensure formal discussion were recorded and agreed actions were followed. Staff were encouraged to participate in the running of the service. This gave them the opportunity to lead on allocated areas of responsibility and to develop their professional skills and knowledge.

There were regular residents’ meetings taking place at the service. In these meetings, people were encouraged to voice their opinion about the support they received and participate in decision making about day-to-day matters related to living at the service.

The registered manager had effective systems in place to monitor staff performance and various elements of the service provision. Regular audits helped to identify any gaps in the service delivery. When gaps in the service delivery were identified, action was taken to ensure required quality of the service at all times.

External health and social care professionals spoke positively about the quality of care and support provided by the registered manager and the staff team at the service.

We undertook this focused inspection to check that they had followed their plan and to confirm if they now met the legal requirement. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

148 Hornsey Lane provides accommodation and support with personal care for up to 12 older men and women with mental health needs. At the time of our inspection there were 11 people living at the home.

A registered manager was in place at the time of the inspection. 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.

At the last inspection on 28 January 2016 we saw risk assessments had not been undertaken for people around accessing support if the lift was out of action. Steps had not been put in place to minimise such risks. All of the bedrooms are on the first and second floor except one which was on the ground floor.

At this inspection steps had been taken to assess risks for people and measures were in place to minimise the risks identified, particularly around the use of the stairs if the lift failed. Risk assessments were in date and were reviewed regularly.

A business continuity plan had also been introduced that outlined how risks would be managed in the case of unexpected incidents or emergency situations.

At this inspection we looked specifically at the previous breach of regulation 12 in the key area of safe. The service had been rated as good overall at the previous inspection and this rating has not changed.

We undertook this focused inspection to check that they had followed their plan and to confirm if they now met the legal requirement. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

148 Hornsey Lane provides accommodation and support with personal care for up to 12 older men and women with mental health needs. At the time of our inspection there were 11people living at the home.

A registered manager was in place at the time of the inspection. 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 found that there had been improvements made in staffing levels. A tool and other information had been used to assess the dependency levels of people at the service and to ensure adequate staff were supporting people. However, we also found the lift was out of order and risk assessments to access the ground floor safely had not been completed for people that lived on the first and second floor. This meant that the risk of potential risk of harm to people had not been identified and steps had not been taken to minimise such risks. We identified a breach of regulations relating to safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.

We found that action had been taken to assess people’s changing needs through regular reviews of care plans and care programme approach review plans.

Disturbances at night had been significantly reduced. Hydraulic door hinges had been fitted to all doors in communal areas to minimise noise from closing doors. There was a noise book that recorded any disturbances and we saw minimal reports, for example one of the noises came from radiators and another about people talking in lounges.

A joint working protocol had been agreed with the local mental health team to ensure that appropriate strategies were implemented when a change in a person’s need was identified and extra resources, including more staffing input could be deployed to support people if the need arose.

People were cared for by staff who were supported to deliver care safely and to an appropriate standard and people who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

We concluded that the provider had an effective system to regularly assess and monitor the quality of service that people received.

'This home is almost perfect'

'Staff let you be independent and give you your freedom'

'The staff are very friendly and approachable'

'Everything is fine here'

People we spoke with understood the care and support options available to them, and were able to express their views. People's needs were assessed and care was planned and delivered in line with their individual care plan. A range of activities were provided within the home. People who use the service told us that they enjoyed the meals on offer, and that they decided what meals would be on the menu.

People who use 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. Medicines were kept safely, and given to people appropriately.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The provider had an effective system to regularly assess and monitor the quality of service that people received.