21 June 2016
During a routine inspection
There are five single occupancy bedrooms. There is a communal sitting room, kitchen, bathrooms and a conservatory where smoking is permitted. The rear garden and courtyard is shared with a neighbouring property owned by the provider, which is used as a supported living service for men with mental health care needs.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
At the previous inspection on 25 and 27 August 2015 we made four recommendations. Following the inspection, the provider sent us an action plan which highlighted the actions they would take in order to improve. At this inspection we found that the recommendations had been achieved. Staff had received training about the recovery model, and people and their representatives had been provided with written information about advocacy services. Support plans demonstrated how people were supported to gain more independence with daily living activities, and the provider had developed and implemented a more rigorous model for carrying out monitoring visits at the service.
Staff understood how to safeguard people from abuse. They had attended safeguarding training and were familiar with the provider’s policy on how to whistleblow about poor practice by employees.
Risks to people had been identified and guidance was in place to mitigate these risks. Crisis management plans had been developed to support people who experienced a crisis in their mental health. Staff knew people well and were aware of behaviours that people might present if their mental health was deteriorating. The provider had developed good relationships with local health and social care professionals and were able to quickly access professional support for people.
There were enough staff deployed to safely meet people’s needs. Staff supported people to attend health care appointments if required and supported people to access community resources including gyms, restaurants and retail facilities.
Safe practices were in place for the management of medicines. People were supported to manage elements of their own medicine programme, where applicable.
Staff received relevant training and supervision, which included training to work effectively within the recovery model. The provider offered courses to staff to enable them to develop their careers and progress to senior and managerial roles.
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.
Healthy food and drinks were offered to people to enable them to meet their nutritional needs. Staff supported people to take part in cooking and other tasks related to food preparation.
People were provided with verbal and written information about how to access support from independent advocacy services, and they knew how to make a complaint.
Staff were regarded as being kind and caring by people and their relatives. We saw that people had developed positive relationships with the staff team and the registered manager.
There were practices in place to enable people to give their opinions about how the service was managed. People were asked to suggest items for discussion at the residents’ meetings and their views were sought through the provider’s surveys.
The provider assessed people’s care and support needs when they moved into the service and used this information to create people’s care and support plans. These plans were kept under review and updated as necessary.
People had been provided with a copy of the complaints policy, which was also displayed on a communal noticeboard. People knew how to make a complaint and some people chose to raise informal issues at the residents’ meeting.
People and their relatives thought the service was managed well.
The deputy manager was receiving management training and mentorship from the registered manager, so that they could manage the service.
Staff reported that they felt fully supported by the registered manager and this had eased any concerns during a period of organisational change.
Monitoring visits by the provider had been improved since the previous inspection and were now detailed, with the views of people who used the service reflected.
Regular audits of documents and practices within the service were carried out, to make sure that people benefitted from using a safe and well organised service.