The Care Quality Commission
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Archived: 49 Regents Park

Overall: Good read more about inspection ratings

49 Regents Park, Heavitree, Exeter, Devon, EX1 2NZ (01392) 209109

Provided and run by:
Regents Park Limited

All Inspections

14 April 2016

During a routine inspection

This inspection was unannounced and took place on 14, 21 and 22 April 2016. The inspection was carried out by one inspector.

The service provides accommodation and personal care for up to three adults with learning disabilities. At the time of this inspection there were three people living there. The service was last inspected on 11 and 20 May and 2 June 2015. At that inspection we found the service not safe, effective, responsive or well-led. The overall rating was ‘requires improvement’. At this inspection we found all breaches of compliance had been addressed. The management of the service had improved and the service was fully compliant with the Regulations.

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.

Two people living at 49 Regents Park had limited verbal communication skills and were unable to answer detailed questions about the service, although they appeared happy and relaxed. One person told us “I like living here.” We spoke with two relatives during and after the inspection who told us they were entirely happy with the care people received. Comments included “I am happy they are in safe hands. The staff at the moment are excellent” and “They look after all of them really well. They are happy.” They also told us the staff went “above and beyond” their duties by showing care and support for the whole family. The relatives were involved and consulted in all aspects of the service and told us “It feels like we are all part of an extended family.”

The provider had introduced new monitoring systems since the last inspection to ensure the home ran smoothly and to identify where improvements were needed by the provider. While we saw many examples of improvements to the service, for example the care plans were regularly reviewed and up to date, we also found some areas that needed to be improved such as their recruitment procedures. The provider and registered manager took prompt action to address these during the inspection as soon as the issues were brought to their attention. The provider also began to adjust their monitoring and quality improvement systems to ensure that in future they are pro-active in identifying and addressing all issues promptly.

On the whole, safe procedures had been followed when recruiting new staff. Checks and references had been carried out by the provider before new staff began working with people. The manager and provider gave assurances that where checks highlighted the possibility that applicants may not be entirely suitable, they took a range of actions to monitor and support new staff. However, these actions were not evidenced by clear risk assessments.

Medicines were stored and administered safely.

Staff rotas showed there were sufficient staff on duty each day to meet the needs of the people living there. This was confirmed by staff and relatives we spoke with. Staff received training, supervision and support to enable them to effectively support each person’s mental and physical health needs. New staff received thorough induction training before they began working with people. All staff received ongoing training on topics covering all aspects of their jobs.

Staff showed caring and understanding of each person’s individual needs. People were treated with kindness and respect. Staff had an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS provides a process by which a person can be deprived of their liberty when they do not have the capacity to make certain decisions and there is no other way to look after the person safely. Applications had been submitted for people living in the home and were waiting for assessment by the local authority. Staff understood the importance of seeking consent before carrying out care tasks. We saw staff offering choices and seeking consent before carrying out any tasks for each person.

People had been involved and consulted in drawing up and agreeing a plan of their support needs as far as they were able. Their care plans were comprehensive, well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were regularly reviewed and updated. The care plans and daily notes provided evidence to show that people were supported to maintain good health.

On weekdays two people attended a day centre where they were able to participate in activities including cooking, gardening, arts and crafts and animal care. They also went out on shopping trips and outings. One person had chosen not to attend the day centre and therefore they received individual support from staff to do whatever they wanted to do each day, such as going for walks, shopping trips and visits to their family.

The home was well maintained, clean, warm and comfortable.

11 and 20 May and 2 June 2015

During a routine inspection

The inspection took place on 11 and 20 May and 2 June 2015. The first two visits were unannounced. During weekdays the people attended a day centre; therefore we visited in the evenings so that we could meet them and find out about the support they received. On the third day we visited the providers’ main office where records such as staff files were held.

49 Regents Park is registered to provide accommodation with personal care for up to four people who have learning disabilities and/or physical disabilities. The property is a large terraced house and the adjacent property, 47 Regents Park, is also a registered care home run by the same provider. Although separately registered the two properties were closely linked and shared the same staff team.

At the time of this inspection there were four people living at 49 Regents Park. The property was divided into two separate units. In the basement there was a self-contained flat for one person, and on the ground and first floors there was accommodation for three people. Each unit was independently staffed, although staff said they frequently worked in 47 Regents Park or in other services run by the provider.

There was a registered manager in post who also managed two other care homes in the Exeter area. 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.

Where people were subject to restrictions, Deprivation of Liberty Safeguards (DOLS) applications had recently been submitted. The provider and registered manager had recently been made aware of changes in legislation by members of the local authority safeguarding team. This meant the provider and registered manager were not fully up-to-date with current legislation or good practice guidance.

People were offered a range of main meals although these were not always home cooked and did not fully meet people's dietary needs. People were not always offered a pudding course. Some puddings and 'extras' such as jellies, cakes and Angel Delight had been purchased by people from their own money. One person was restricted from having extra food such as biscuits when they requested.This meant people were not offered a full choice of foods to suit their individual preferences.

Staff rotas showed there were sufficient staff to support people when they were at home. During weekdays three people attended a day centre that is not regulated by the Commission and therefore we did not look at staffing levels while people were at the day centre. During our visits to the home we saw people received support from staff when they needed it. However, following the inspection we received information that indicated staffing levels sometimes fell below the levels shown in the staff rotas. This information has been passed to the local authority safeguarding team for further investigation.

Staff knew how to protect people from the risk of abuse. They had received training on safeguarding adults and knew who to contact if they suspected abuse may have occurred. Systems were in place to ensure people’s cash or savings were managed safely. This meant people were protected from financial abuse.

Staff recruitment, supervision and training records showed staff had been carefully recruited by obtaining references and carrying out checks on their suitability before they were offered employment. Information provided by the registered manager showed staff received training on relevant health and safety topics, but only four staff out of a total staff team of 18 had received training on autism, challenging behaviour, or epilepsy. Information received after the inspection indicated that some shifts had been staffed by new and inexperienced staff who may not have the skills or knowledge to help them support people effectively. This information has been passed to the local authority safeguarding team for further investigation.

Staff received regular supervision and support. Staff meetings were held regularly. Staff said they worked well together as a team.

Each person attended a day centre every weekday operated by the provider where they were offered a range of activities they could participate in. This service is not regulated by the Care Quality Commission and therefore we did not check the services or care provided to people while they attended the day centre. In the evenings and weekends they were able to choose to go out, for example to a local pub, walks in the area or the cinema, or stay at home and do activities of their choice.

Medicines were stored and administered safely, although procedures for discarding medication when no longer safe to use were not fully effective. Staff had received adequate training on safe administration of medicines.

People were supported to maintain good health. However, risks to people’s health and welfare had not been assessed and reviewed regularly. Staff were given guidance and training on how to recognise risks and reduce the risk of occurrence.

People had not been fully consulted or involved in drawing up and reviewing their care plans. The care plans had not been regularly reviewed or updated and some information was out of date. This meant staff did not have access to up to date information about people at all times.

During our visits we saw staff interacting with people who lived there in a caring and empathic manner. Staff understood each person’s individual communication methods. People were offered choices.

There were systems in place to monitor the daily routines in the home. Daily reports on all aspects of the support given to each person were completed by staff. The reports were returned to the provider’s head office each month to be checked by the provider and manager. However, the registered manager did not regularly work in the home and there was a risk some poor practice or ineffective routines were not picked up or addressed. There was also a risk that incidents and accidents may not be reported to the Care Quality Commission correctly.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations (2014).You can see what action we told the provider to take at the back of the full version of the report.

11 October 2013

During a routine inspection

There were three people living in the home at the time of our inspection. All three people were relaxed in the company of each other and with the staff who supported them. One person had the ability to tell us about their experiences whilst the other two had limited verbal communication; however their expressions and noises indicated how they felt. We observed that all three responded positively to the interactions with staff and the smiles and comments they made showed they were happy with the care they received.

The people using the service had their privacy and dignity respected and were provided with appropriate amounts of information about themselves, the care and support they received and about the activities they undertook.

People's care and support was delivered as described in their detailed care plans by care workers who demonstrated a good knowledge of the needs, preferences and wished of the people they supported. The environment was clean and tidy with a homely appearance which reflected the preferences of the people who lived there.

The provider had ensured staff had access to appropriate training and they were supported to develop their knowledge and skills to provide appropriate levels of car to people using the service.

Records about people using the service were detailed and up to date with evidence of routine reviews. Records relating to the management of the home were up to date ensuring people had a safe environment in which to live.

14 December 2012

During a routine inspection

49 Regents Park is a residential care home which provides care and support for three younger people with a learning disability. We talked with all the people who lived at the home, two staff working in the home, the manager and the provider. We looked at the care records of all people living in the home and the records of two staff.

There were three people living in the home at the time of our inspection. People appeared comfortable whether in the lounge or in other communal areas of the home. We saw that staff had a good knowledge of the needs of people. Staff were observed to address people by their preferred names and were polite and respectful at all times. They checked that people were happy to do things such as assisting with personal care before supporting them.

We saw that people were safe in the home and their care and welfare were managed in accordance with their care plans. Staff were knowledgeable about the needs of people and the abilities they had. They were appropriately skilled and received regular support and development.

We found that medication was generally well managed by staff who had a good knowledge of people's medication and what conditions it was for.

There were appropriate systems in place to routinely monitor the quality of service provided and the environment it was provided from.

29 March and 4 April 2011

During an inspection in response to concerns

The people who live at 49 Regents Park talked about some of the things they enjoy doing and the place they like to go. We saw staff supporting them to do a range of activities including going out for walks, or attending the day centre. People were relaxed and cheerful, and described some of the choices they had make, including the things they had purchased in local shops and the things they had chosen to eat that day. People wore attractive and fashionable clothing and accessories, and told us how they enjoyed choosing what they wanted to wear every day.

We saw care workers talking to people in a calm and friendly manner. If people did not want to participate in an activity staff respected their wishes.