Archived: Mr R Jeffries t/a Allan House Limited

Allan House is a residential care home providing personal care to seven people at the time of the inspection. The service can support up to nine people in one adapted building.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. Staff did not wear anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People were protected from the risk of potential abuse and told us they felt safe. There were enough staff to meet people’s needs and people received their medication. Lessons were learnt when things had gone wrong and people were protected from the risk of cross infection.

People had their needs assessed and were supported to eat and drink enough to maintain a balanced diet. Staff worked with other agencies and supported people to access healthcare services. Staff received training in order to support people effectively and the building was adapted to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by caring staff who knew them well and respected their privacy and promoted their dignity. People were supported to express their views around their care.

People received personalised support responsive to their needs. The provider was meeting people’s communication needs and had a complaints policy in place and people felt able to complain. People were supported to maintain relationships and partake in activities.

There was a positive culture, person centred culture with the service. The registered manager was aware of their roles and responsibilities. The provider engaged with people who used the service and worked in partnership with others

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Allan House is registered to provide accommodation and personal care for up to nine people. People who used the service predominately had a learning disability. At the time of our inspection there were nine people who used the service.

The service had 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 and associated Regulations about how the service is run.

People described staff as going 'the extra mile' when they provided care and support. People were treated with care, kindness and respect and staff promoted people's independence and right to privacy.

People were supported to establish and maintain friendships and relationships with people that were important to them. Staff had clear values and were dedicated to providing a high standard of care that was inclusive for people.

We found medicines were managed in a way that kept people safe from potential harm.

People were kept safe because staff understood how to recognise possible signs of abuse and the actions they needed to take if people were at risk of harm.

People’s risks were assessed in a way that kept them safe whilst promoting and enabling people to be as independent as possible.

We found that there were enough suitably qualified staff available to meet people’s needs in a timely manner. The registered manager made changes to staffing levels when people’s needs changed.

Staff were trained to carry out their role and the provider had safe recruitment procedures that ensured people were supported by suitable staff.

Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests where they are unable to do this for themselves.

People’s capacity to make specific decisions was in the process of being assessed and staff knew how to support people in a way that was in their best interests. We found that where people were able they consented to their care and treatment.

People were supported with their individual nutritional needs and staff supported people to maintain a healthy diet. People were able to access health services when needed with support from staff.

There was a strong focus on person centred care and people’s preferences in care were recorded throughout the care plans. People were supported to be involved in hobbies and interests that were important to them.

The provider had a complaints procedure that was available to people in a format that they understood. There was a system in place to investigate and respond to complaints received.

Staff told us that the registered manager was approachable. Staff understood the values of the service and were enthusiastic about their role and what their support meant for people.

People and staff were encouraged to provide feedback on the service provided. The registered manager had systems in place to assess and monitor the quality of the service provided.

We found that the provider had systems in place to gain consent for care and treatment from people who used the service. We spoke with staff who told us that they respected people's decisions and understood their responsibilities with regards to the Mental Capacity Act 2005.

We observed people who used the service being treated in a caring and respectful way. One person told us, 'I like the staff they are kind to me and they listen to me'. Another person told us, 'I feel happy here. I am treated well'. We saw records that showed care was planned and delivered in line with people's preferences. Staff we spoke with knew the needs of people who used the service and how they preferred care to be carried out.

We saw that the provider had systems in place that prevented the risk of cross infection. We saw staff used protective equipment during our inspection and staff we spoke with understood the importance of infection control.

The provider had enough staff to meet the needs of the people who used the service. Staff we spoke with told us that they took on extra work to cover sickness and holidays to ensure that people received consistent care.

The provider had effective systems in place to assess and monitor the quality of the service provided. We saw that the service was well led by the registered manager.

At this inspection we found that the provider had made improvements to their recruitment systems.

People were supported to have their health and personal care needs met. People were able to take part in activities they wanted to do.

People said they felt able to talk to staff about any concerns. One person said, "I go to staff if I have a problem". Systems were in place to make sure that staff knew about safeguarding issues.

People told us that they liked the staff and got on well with them. There was a system in place to check staff's suitability to work at the home and we saw that checks were in place. There was no formal system in place to assess and manage risks prior to the full employment checks being completed and in circumstances where there a CRB check showed previous concerns.

People told us that they knew how to raise any problems and that the care staff would try and sort them out.