10th October 2015
During a routine inspection
This was an announced inspection that took place on Saturday 10th October 2015.
Roper Street is part of the Croftlands Trust which provides care homes and personal care support throughout Cumbria. This service provides support to people in both Copeland and Allerdale. Most of the support provided is to people who have enduring mental health problems. Some people live in tenancies near to the office and have support from staff on an on-going basis. Other people who use the service have less intensive support in their own homes.
At this visit only four people were in receipt of personal care support but other people had housing, social and psychological support. We only looked at the support provided to people in receipt of personal care.
The home had a registered manager. 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.
Staff understood how to protect vulnerable people from harm and abuse. Staff were trained in this and in matters of equality and diversity. Staff told us that they could report any issues in confidence to the registered manager or the provider.
The service had a suitable emergency plan in place that had been recently updated. Accidents and incidents were managed appropriately.
We judged that staffing levels were appropriate to provide people with suitable levels of care and support.
Recruitment was managed appropriately. New team members had suitable background checks before they started to work in the service.
The organisation had a disciplinary process which was used when there were any issues of poor practice.
The staff in the project understood how to manage infection control and told us they had access to equipment and cleaning materials when necessary.
Medicines management in the service needed some improvement. The registered manager was aware of some issues and was dealing with gaps in the management processes.
This meant that the service was in breach of Regulation 12 (2) (g) because some elements of medicines management could have been unsafe for people in the service.
Staff received suitable training on all the issues that the organisation deemed to be necessary to keep people safe and well cared for. Staff told us they did e-learning and attended external training courses.
We saw evidence to show that staff received both formal and informal supervision. We also saw records of annual appraisals.
Staff showed a good understanding of mental health legislation. They received training that gave them knowledge of mental health issues.
The team did not use restraint in the service but had contingency plans to deal with any episodes of mental ill health. People were, where appropriate, asked for consent for all interventions. Staff understood that they should always use the least restrictive interventions where people needed support.
Staff helped some people to shop and make meals. They encouraged people to eat healthily.
The office was in a secure building and there was accommodation for staff who slept-in overnight. The service had suitable telephone and IT systems.
We saw caring and sensitive interactions between staff and people who used the service. Staff were patient and showed a good understanding of the distress that mental ill health might cause.
People had ready access to advocacy. Staff were careful to ensure people had privacy and confidentiality maintained. Independence was promoted in all the support given.
Assessment and care planning were of a good standard. People told us that they were involved in all aspects of their recovery planning as well as their day-to-day needs.
People were encouraged to go out and to participate in community activities.
There had been no formal complaints or concerns. The organisation had suitable policies and procedures about this.
The service had a suitably qualified and experienced registered manager. The organisation was in the process of reviewing matters of governance in all their services. The proposed changes would help rationalise the management structure and allow the services to work more effectively.
This service had good, routine quality monitoring systems in place. Records were of a good standard.
We had evidence to show that the team worked well with local GPs and members of the mental health teams in the area.
You can see what action we have told the provider to take at the back of the full report.