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69 Chartridge Lane Requires improvement

Reports


Inspection carried out on 3 February 2020

During a routine inspection

About the service

69 Chartridge lane is a residential care home providing personal care up to six people with mental health and/or learning disabilities and autistic spectrum disorder.

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.

Six people were using the service at the time of our visit. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing 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 told us they felt safe living in the service. Risks had been identified but action had not always been taken quickly to address and minimise the risk. We were concerned the staffing levels for night time were insufficient. We have made a recommendation about responding to the findings of risk assessments in a timely way.

Care documents were not always up to date or accurate, the registered manager had been away from the service for six months in 2019, a new manager was in post during this time. When the new manager left the service, the registered manager returned. They told us since their return some records had gone missing. Records were not always explicit in their detail, this meant it was difficult for the registered manager or others reviewing the information to get a clear picture of what care had been provided.

Improvements had been made to the storage and administration of medicines since our last inspection in 2017. At this visit we found the storage, administration and records related to medicines were safe.

Staff understood and practiced good infection control. Staff had received training in safeguarding people. Staff understood their responsibilities in protecting people from abuse. Safe recruitment processes were in place to ensure people were protected as far as possible from being cared for by unsuitable staff.

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.

Staff received support, training, supervision and appraisal in order they could provide care to a high standard. Care plans identified people’s food and drink preferences. Specialist professionals and agencies were involved in care provision where required, People were supported to healthcare appointments when needed.

The building was well maintained. People were able to personalise their own rooms with their chosen decorations and accessories.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. From our observations and through discussions with staff, we ascertained care was person centred and focussed on people’s needs rather than the needs of the service. People were treated in a respectful and caring way by staff. Staff c

Inspection carried out on 5 May 2017

During a routine inspection

This inspection took place on 5 and 9 May 2017. It was an unannounced visit to the service.

We previously inspected the service on 13 and 19 April 2016. The service was not meeting some of the requirements of the regulations at that time. This was in relation to staff recruitment practice, keeping the statement of purpose up to date and records of medicine administration. We asked the provider to make improvements to people’s care. They sent us an action plan which outlined the changes they would make. During this inspection we found improvements had been made in each of these areas.

69 Chartridge Lane provides support for up to six adults with learning disabilities. It was full at the time of our visit.

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 2008 and associated Regulations about how the service is run.

We received positive feedback about the service. A relative told us “I am very happy” with all aspects of care that (name of person) receives at Chartridge.” Another relative said “We would definitely say that the home is providing safe, effective and compassionate care.” A third relative commented “I’m more than happy with the care.” They added “When I go to visit it’s like their home.” A healthcare professional had provided positive feedback to the home, saying “The residents are always well supported. The home is clean and tidy. The staff are always welcoming and helpful. My overall impression is that it is a warm and happy place, it is truly a home.”

We found there were enough staff to meet people’s needs and to support them to access the community. Staff had been recruited using effective procedures to protect people from the risk of harm. They were supported through supervision, staff meetings and a wide range of training. Staff understood their responsibilities to protect people from the risk of harm. They said they would report any concerns to the registered manager or provider.

Each person had a care plan which outlined the support they required. Risk assessments had been written to identify any potential areas where people may be injured or harm. Measures were then put in place to reduce those risks. Staff supported people to attend healthcare appointments to keep healthy and well.

We looked at medicines practice. We noticed medicines cabinets had been moved since the previous inspection and were no longer affixed to a wall; instead they were free standing within a lockable stationery cupboard. We advised the registered manager this arrangement may not be secure. We also noticed some medicines were stored in a plastic crate at the bottom of the stationery cupboard. Action was taken whilst we were at the home to improve arrangements. After the inspection, we were sent photographic evidence of the cabinets now secured to the wall.

We also found staff had not noticed a medicine had expired and had continued to use it three months after the manufacturer’s expiry date. The registered manager addressed this straight away. However, systems within the home and staff who administered medicines had not noticed this medicine was out of date.

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

The building was well maintained and complied with gas and electrical safety standards. Regular fire safety checks and drills were carried out. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

The provider checked the quality of care at the service through visits and audits. Required records were maintained by staff. Most records were kept sec

Inspection carried out on 13 April 2016

During a routine inspection

This inspection took place on 13 and 19 April 2016. It was an unannounced visit to the service.

We previously inspected the service on 13 February 2014. The service was meeting the requirements of the regulations at that time.

69 Chartridge Lane provides support for up to six adults with learning disabilities. It was full at the time of our visit.

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 2008 and associated Regulations about how the service is run.

We received positive feedback about the service. Comments from people included “Staff have been absolutely tremendous,” “It’s superb here,” and “Staff support me when I need help.” A relative described the service as “It’s like a family home.”

There were safeguarding procedures and training on abuse to provide staff with the skills and knowledge to recognise and respond to safeguarding concerns. Risk was managed well at the service to enable people be as independent as possible. Written risk assessments had been prepared to reduce the likelihood of injury or harm to people during the provision of their care.

People’s medicines were not consistently managed safely as records of medicines administration were not always accurate. Staff supported people to attend healthcare appointments to keep healthy and well.

Staff received appropriate support through a structured induction, regular supervision and staff meetings. We saw there were sufficient staff to meet people’s needs. We found staff had not always been recruited effectively to make sure they had the right skills and experience to support people safely.

Care plans had been written, to document people’s needs and their preferences for how they wished to be supported. These had been kept up to date to reflect changes in people’s needs. The service listened to people’s views and involved them or their relatives in decision-making. People were supported to take part in a wide range of social activities.

There had not been any complaints about the service. People knew how to raise any concerns and were relaxed when speaking with staff and the registered manager.

The building was well maintained and complied with gas and electrical safety standards. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

The provider regularly checked the quality of people’s care through visits and audits. There were clear visions and values for how the service should operate and staff promoted these. Records were generally maintained to a good standard and staff had access to policies and procedures to guide their practice.

We have recommended the service follows good practice in relation to staff training before people are admitted to the home.

We found breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to recruitment practice and maintenance of accurate medicines records. We also found a breach of the Care Quality Commission (Registration) Regulations 2009 as the home had not updated its statement of purpose. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 13 February 2014

During a routine inspection

We found that the home understood consent and gave people as many choices as they could. They recognised when people could not fully understand things and make safe decisions. They made sure that people were supported to be as independent as they could be, as safely as possible.

We saw that people were well cared for and treated with respect and dignity. People told us or indicated that they liked living in the home.

We found that people were prescribed medication by their doctor which was given to them safely and at the correct times. We saw that the medicines in the home were stored properly, in locked cabinets in locked rooms or cupboards.

We found that there were enough properly trained staff to meet people�s individual needs. People told us or indicated that staff were good and one person told us that �� my staff are lovely��.

We found that the home had ways of looking at the care they offered so that they could make sure they maintained and improved it. We saw that they listened to the views of the people who lived in the home.

We saw that the home took health and safety seriously and kept people as safe as possible.

Inspection carried out on 27 February 2013

During a routine inspection

The home was clean and bright, and had a welcoming atmosphere, appropriate to the age group of the people who used the service. There were three people living there. We heard that people had access to a good variety of social activities and partial employments within their local and wider communities, for example, helping at a food bank, attending church and going to Riding for the Disabled on a regular basis.

We saw that all staff had attended safeguarding of vulnerable adults training, and were able to clearly describe different types of potential abuse. The staff told us they would immediately inform their manager if they had any such concerns, and were confident it would be quickly and appropriately addressed. The home had access to an Advocacy service, although none of the people who live there had used it.

There were effective recruitment and selection processes in place. Appropriate checks were undertaken before staff began work and this protected vulnerable adults who use the service.

We noted staff had received appropriate professional development and had access to regular supervision. This demonstrated a commitment to improving the high level of care given to people at 69 Chartridge Lane.

Inspection carried out on 19 October 2011

During a routine inspection

A carer (relative) of a person using the service described it as �Excellent�. The person told us that the home had a warm and happy atmosphere. The care was very good and the person using the service (a member of their family) had settled in well, was happy and did something different every day.