135 Tennyson Road

135 Tennyson Road is a residential care home providing personal care to people aged 18 or over at the time of the inspection. The service can support up to 4 people in adapted residential property.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were happy with the care home and the staff that provided their care.

People felt safe living at the home because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced risks as much as possible, and there was equipment in place to help people remain as independent as possible. There were enough staff. The provider obtained key recruitment checks before new staff started work.

People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons to prevent the spread of infection. Staff followed advice from health care professionals and made sure they asked people's consent before caring for them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people's privacy was respected. Staff worked well together, they understood the home's aim to deliver high quality care, which helped people to continue to live as independently as possible.

Staff kept care records up to date and included national guidance if relevant. Complaints and concerns were dealt with and resolved. We have made a recommendation about obtaining end of life information.

Systems to monitor how well the home was running were carried out. Concerns were followed up to make sure action was taken to rectify any issues. Changes were made where issues had occurred elsewhere, so that the risk of a similar incident occurring again was reduced. People were asked for their view of the home and action was taken to change any areas they were not happy with.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (report published 11/01/19) and there was breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

135 Tennyson Road is a residential care home which provides accommodation and personal care for up to four people with learning disabilities and autism. On the day of our inspection three people were using the service.

135 Tennyson Road is a ‘care home’. 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.

At the last inspection in May 2016 this service was rated good. At this inspection we found the service to require improvement.

Window restrictors were not in place on the first floor of the building to ensure people’s safety.

A registered manager was 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.

People felt safe. Risk assessments were in place to cover any risks present. We saw that staff had been appropriately recruited in to the service and security checks had taken place. There were enough staff to provide care and support to people to meet their needs. People received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and ongoing professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People told us their relationships with staff were positive and caring. We saw that staff treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences.

People knew how to raise a concern or make a complaint and were confident that if they did, the management would respond to them appropriately. The provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open and honest culture. People and their family members were able to feedback about the service and any concerns identified were acted upon. The manager was present and visible within the home.

We found there to be a breach of the Health and Social Care Act 2008 Regulated Activities Regulations 2014.

Further information is in the detailed findings below.

135 Tennyson Road is a residential home in Luton providing accommodation and personal care to up to four people with learning disabilities or autism. At the time of our inspection there were three 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.

People were kept safe from avoidable risks of harm and there were risk assessments in place to minimise any risks to them and staff. People were supported to eat a balanced and nutritious diet and to access regular healthcare appointments. People’s medicines were administered safely and there were systems in place to ensure that these were audited and managed appropriately.

Each person had a care plan in place which included an assessment of their needs and guidelines for supporting them effectively. People were involved in regular reviews of their care and support and encouraged to give their views on their service and contribute to its development. People were treated with dignity and respect and cared for by consistent and dedicated staff who understood their needs.

There was a robust system in place for recruiting staff safely and they received a full induction into the service. Staff received a range of training which was relevant to their role and specialised depending on the needs of people using the service. There was a regular programme of supervisions and appraisals to support the on-going development of staff and encourage their input into developing the service. Staff understood the principles behind the Mental Capacity Act 2005 (MCA) and deprivation of liberty safeguards (DoLS) and sought consent before providing care.

People, staff and relatives were positive about the management of the service. Regular audits were carried out to identify improvements that needed to be made across the service. There were regular team meetings and residents meetings to discuss issues affecting the home.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that records relating to people's care and support and other records required to protect their safety and well-being were appropriately maintained and held securely.

The home ensured that its recruitment and selection processes were robust. Appropriate checks were undertaken before staff began work. This ensured that people were cared for and supported by staff who were appropriately qualified and physically and mentally fit to do their job.

Is the service effective?

People told us that they were happy living at 135 Tennyson Road and felt that staff were meeting their care needs. We found that people had been provided with activity planners which outlined the weekly activities they had agreed to participate in. This demonstrated that the activities provided were appropriate and available at the times which suited them best.

We found that people's health care needs had been kept under regular review. People had been provided with health action plans and a booklet called 'All about me'. These had been written in a pictorial format and were portable. This meant in the event of an emergency such as hospitalisation, information on their medical and care needs were readily available.

Is the service caring?

We observed that there were good interactions between people and staff. We found that people looked relaxed in the company of staff. We heard staff speaking to people in a polite manner. Staff spoken with were able to describe how they ensured people's privacy and dignity were promoted.

Is the service responsive?

We found that staff supported people to express their views and to be involved in making decisions about their care, treatment and support. People were made aware of the home's complaints system and this was provided in a format that met their needs.

Is the service well led?

We found that the home had systems in place to monitor the quality of the service that people received to make sure that it was safe and appropriate.

Staff spoken with said that they felt supported by the registered manager and were provided with regular staff meetings. At these meetings they were able to raise questions and make suggestions relating to the provision of care. This meant that staff felt supported and well-led.

Arrangements were in place to monitor complaints, accidents and incidents. This meant that lessons were learnt from mistakes, incidents and complaints investigations to ensure improvements with the service delivery.

We observed positive interactions between staff and people. People looked comfortable in staff's company. We heard staff speaking to people in a respectful manner. People told us that they were provided with food choices and were involved in cleaning their bedrooms with support from staff. One person said, 'The staff help me to clean and polish my bedroom'. Another person said, 'I have my own front door and bedroom key. I am free to come and go as I please'.

We found that the home had systems in place to gain and review consent from people who use the service and acted on them. Appropriate standards of cleanliness and hygiene were maintained in the home. People were protected against the risks associated with unsafe or unsuitable premises. The home had an effective recruitment and selection procedure to ensure people were looked after by suitably and qualified staff.

We observed that people were offered support at a level which encouraged independence and assured that their individual needs were met. The staff were friendly and professional in their approach and interacted confidently with people. There was a relaxed atmosphere in the home, and everyone had a responsibility to contribute to the household chores to ensure the environment was clean, tidy and comfortable.

We noted that people expressed their views and were involved in planning their care and making decisions about their support and treatment. People told us that they worked closely with their 'link worker' and were consulted about all aspects of life in this home. Within the care files we saw that care documentation was all clearly signed by the individual to confirm their involvement and agreement with their particular care needs.