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Inspection Summary


Overall summary & rating

Good

Updated 3 May 2017

This comprehensive inspection took place on 23 February 2017 and was unannounced. Fiorano is an eight bedded service for people with a learning disability and supports people to live within their community. On the day of our inspection there were five people using the service. There was a second similar service located on the same site managed by the same provider.

This inspection was to see if the provider had made the improvements required following an unannounced comprehensive inspection at this service on 03 February 2016. At the inspection in February 2016, we had found two breaches of legal requirements in relation to Regulation 12 and 18. Following the inspection, we received an action plan which set out what actions were to be taken to achieve compliance. The overall rating from the inspection in February 2016 was Requires Improvement.

At this inspection we found improvements had been made to meet the relevant requirements.

There was a newly appointed manager in post at the time of the inspection and an application for registration was in progress. A fit person’s interview had been scheduled for the following week and we received confirmation that the application had been approved on the 06 March 2017. 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 by staff who understood how to identify and report potential harm and abuse. Staff were aware of the risks to people and what they needed to do to help reduce those risks, such as helping people to move safely around the service. Risks to people’s health and wellbeing were identified, recorded and managed. Staff understood how to keep people safe and they helped people to understand risks. Medicines were managed safely by staff who were skilled to administer medicines.

Care and support plans provided a holistic view of people’s care and support needs. Staff demonstrated they had a good knowledge and understanding of people’s individual needs

People were supported by sufficient numbers of staff who had the skills and knowledge to meet their needs. There were sufficient numbers of staff to meet people’s care and support needs. Staff received regular training and supervision that provided them with the knowledge and skills to meet people’s needs. Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed. Staff had received appropriate training and supervision relevant to their roles and felt supported by the manager.

Staff respected and supported people's right to make their own decisions and choices about their care and treatment. People's permission was sought by staff from appropriate people and before they helped them with care tasks. Staff supported people to make decisions about their care by helping people to understand the information they needed to make informed decisions. People who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) were being followed.

People were supported to eat and drink enough to maintain good health. People told us they enjoyed the food, had plenty to eat and drink and had lots of choice. Where people needed support with eating, staff provided the level of support that each individual person required. Following assessment and as part of their enablement plan some people prepared their own meals.

People had access to other healthcare professionals as required to make sure their health needs were met. People were treated with kindness, consideration and respect and staff promoted people’s independence and right to privacy. P

Inspection areas

Safe

Good

Updated 3 May 2017

The service was safe.

Staff knew how to keep people safe and the actions they should take if they had concerns with people’s safety.

Staffing levels were sufficient to ensure people were supported in a timely way and upon request.

Risk assessments were completed when people were identified as being at risk.

Medication systems were safe and people received their medicines as prescribed.

Effective

Good

Updated 3 May 2017

The service was effective.

Staff respected people's right to make their own decisions and supported them to do so.

Staff had received training to enable them to meet people's needs effectively.

People were supported to eat a balanced diet of their choice and were enabled to access healthcare services as required to maintain good health.

Caring

Good

Updated 3 May 2017

The service was caring.

People were cared for by staff they were familiar with and had the opportunity to build relationships with.

People were involved in their own care as they were able.

Staff provided care and support for people that was thoughtful, sensitive, and respected people's privacy and dignity.

Responsive

Good

Updated 3 May 2017

The service was responsive.

People received personalised care and support which was responsive to their changing needs.

Personal care plans were developed with people. People spent their time how they wanted to.

People and their relatives knew how to raise concerns and make a complaint if they needed to.

Well-led

Good

Updated 3 May 2017

The service was well-led.

The manager promoted a positive and enabling culture in the home.

There was consistent and effective leadership from the manager.

Systems were in place to monitor the quality of care provided and identify any areas for improvement.