The Care Quality Commission
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Archived: 47 Regents Park

Overall: Good read more about inspection ratings

47 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 and 22 April 2016. The inspection was carried out by one inspector.

The service provides accommodation and personal care for up to four adults with learning disabilities. The accommodation is arranged with three bedrooms, lounge dining room, kitchen and bathroom in the main house and a self-contained flat in the basement for one person. On the day of this inspection there were four people living there.

The service was last inspected on 11 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.

The people living at 47 Regents Park had limited verbal communication skills and were unable to answer questions about the service. Therefore we relied on our observations of their interaction with three care workers during our visit. People were relaxed and smiling and appeared comfortable in all interactions. Two relatives told us they were entirely satisfied with the care people received and felt people were safe. Comments included “I have always been very pleased with the care she has received” and “There is support for the whole family. If I have a problem I can call someone and I am confident it will get sorted.”

The provider had introduced new monitoring systems since the last inspection to ensure the home ran smoothly and to identify where improvements were needed. We saw many examples of improvements to the service, such as care plans, and staff training. We also found some areas that needed to be improved, such as the quality monitoring process and staff recruitment checks. The provider and registered manager took prompt action to address these when during the inspection as soon as the issues were brought to their attention. The quality monitoring systems needed further adjustment to ensure the provider is pro-active in identifying and addressing all issues promptly.

People who used the service, staff, relatives and professionals told us the service was well-managed. Comments included “In my experience the home is well run, and I believe the staff provide an excellent and caring service.”

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.

People were supported by sufficient numbers of staff to meet their needs fully. In the last year the range of training for staff had increased significantly. Staff had received training on topics relevant to the needs of the people living there, including autism, epilepsy and sign language. The increased level of skills had resulted in positive benefits for people living in the home. For example, people who used sign language were able to communicate more easily with staff. Staff told us they were well supported and supervised.

Medicines were stored and administered safely.

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. 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. 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 people attended a day centre where they participated in a variety of social activities including cooking, gardening, arts and crafts and animal care. They also went out on shopping trips and outings.

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.

47 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, 49 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 47 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 49 Regents Park or other services operated 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.

The registered manager was not aware of the requirement to notify the Care Quality Commission of any incidents or accidents although they told us no serious incidents had occurred since the last inspection. This meant there was a risk serious accidents or incidents may not be adequately investigated by external agencies and professionals who have a legal responsibility to ensure people’s safety and well-being.

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 they had not kept up with changes in legislation designed to protect people’s rights.

People were offered a range of cooked main meals, although these were not always home cooked. People were not always offered a pudding course although fresh fruit was always readily available if people wanted. Records showed each person had purchased items from their own income such as jellies, cakes and Angel Delight which they were given as a pudding course after some meals. This meant people were not offered a full choice of foods to suit their individual preferences.

During our visits to the home staffing levels were sufficient to ensure 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.

People were supported by staff who 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 and reduce risks

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. We found breeches 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

14 October 2013

During a routine inspection

47 Regents Park is a residential care home which provides care and support for up to four younger people with a learning disability. We talked with the people who currently lived at the home, three staff working in the home, the manager and the organisations training provider.

We looked at the care records of the people living in the home saw how they were provided with information which enabled them to be involved in the way they lived. Many documents were provided in an 'easy read' format which met people's needs. The staff working in the home respected people's privacy and treated them with dignity and respect.

People's care and welfare was supported by staff who had a clear understanding of people's needs. One person told us, 'I like it here', and 'I do things I like to do'. The care records we looked at were detailed with each person having an individual care plan which explained their needs.

Staff had received training in a range of subjects related to people with learning disabilities; this ensured people were supported safely. People's living environment was clean, hygienic and safe; measures were in place to ensure people's safety outside the home where they were involved in community based activities.

Records were well maintained and regularly reviewed. Files were stored securely and records relating to the management of the home were routinely reviewed and updated.

20 December 2012

During a routine inspection

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

There were two people living in the home at the time of our inspection. Both were seen to be able to move freely about the home and were comfortable in each others company as well as with the staff who supported them.

We found that the provider had suitable arrangements in place to gain people's consent to care and treatment and saw that people agreed to the support offered to them.

We saw that people received safe and appropriate support that met their needs. The staff demonstrated a good knowledge of people's individual needs. We saw that staff had effective skills to manage the changing moods of people in the living in home.

People's nutritional needs were met by the service and their allergies or intolerances were accounted for. Their medication was safely managed and administered by a trained and knowledgeable staff group.

The provider had effective systems in place to routinely audit and monitor the services it provided to reduce the risks to people using the service.

28, 29 March 2011

During an inspection in response to concerns

The two people who lived at 47 Regents Park had little or no verbal communication. They have lived with Regents Park Ltd for many years, and first lived with them as young children in a property registered as a children's home. During our visits to this home and to the day centre we saw people were relaxed and cheerful, and were occupied in a range of different activities. We were shown how each person has been supported by the staff team to make choices about every aspect of their daily lives.

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. We talked to one care worker during our evening visit to the home, and also to the team leader, and they were enthusiastic about their work and were able to demonstrate a very good understanding of each person's care needs, their personality, and the things they enjoyed doing.