25 and 27 August 2015
During a routine inspection
The inspection took place on the 25 and 27 August 2015. This was the first inspection of the service since it registered with the Care Quality Commission on 17 October 2014, having been previously owned and managed by a different provider. Kadima Support UK Limited No.7 is registered to provide care and accommodation for up to five people with mental health problems. The service was at full occupancy at the time of our inspection and all of the people using the service were male.
There are four single occupancy bedrooms. There is a communal sitting room, kitchen, bathrooms and toilets. The rear garden and courtyard is shared with Kadima Support UK Limited No.7a, which is registered to provide care and accommodation for up to four people with mental health problems. People can use the conservatory at No.7, which is used as an indoor smoking area.
There was a registered manager in post, who managed both No.7 and No.7a. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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 and their relatives told us they were happy with the service. They said it was a safe environment with caring staff.
There were systems in place to identify and mitigate any risks to people’s safety and wellbeing, although the service needed to develop the crisis management plans.
Sufficient staff were deployed to meet people’s needs. Staff recruitment had been carried out by the previous provider and did not demonstrate rigorous systems to ensure references were authentic. The provider was aware of their responsibilities with the recruitment of new staff.
Staff received formal supervision and an annual appraisal. Staff told us they were enjoying the recently introduced programme of training, which focused upon how to meet the needs of people with mental health problems. However, we found that staff knowledge needed to be developed in regards to how to support people with their recovery.
Medicines were safely stored and protocols had been established to make sure medicines were safely administered.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. We found that staff understood how to protect people’s rights and no person was subject to a DoLS authorisation.
People’s needs had been assessed, and support plans had been developed in consultation with people. The support plans were well written but contained insufficient information about how to support people with their recovery.
People took part in some food preparation and cooking. However, we did not find sufficient evidence during our observations, and discussion with people and staff, that people were being supported to get involved in more activities of daily living. For example, food shopping and household chores.
Complaints and comments from people using the service and their relatives were properly investigated. Information about how to make a complaint was prominently displayed. People had been provided with verbal information about advocacy services to support them to express their views and comment upon services they received.
People told us the service was well managed. There were systems in place to audit support plans, staff training and support records, and health and safety checks. The registered manager was supported by other registered managers within the organisation, but there was no clear system for the provider to carry out detailed and meaningful audits and support the registered manager to improve the quality of the service.
We have made four recommendations. These are in regards to staff receiving training about the recovery model, for people and their representatives to be provided with comprehensive written information about advocacy services, and for support plans to demonstrate how people are being supported with achieving more independence with daily living activities. The final recommendation is for the provider to carry out detailed monitoring visits, which provide professional support for the registered manager.