22 February 2016
During a routine inspection
The service is a care home for up to nine adults and teenagers with learning disabilities who also experience mental health difficulties and may behave in a way that is challenging to others. When we inspected, there were four adults living there and a further person was in hospital.
The service 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.
People felt safe. They were supported by staff who understood their responsibilities as regards safeguarding adults. Staff felt well supported and were confident that the registered manager would take any concern they reported seriously.
People were treated with compassion and kindness by staff who were getting to know them and who prioritised their needs.
People received care and support to address their individual needs. Their independence was encouraged as much as possible and they were supported to take part in activities at home and out in the community.
At times people became upset, anxious or emotional, or behaved in a way that was challenging for others to cope with. Risks this presented had been assessed and positive behaviour support plans had been developed. These plans were detailed, specific to the person, and emphasised that the least restrictive possible measures should be taken.
Whilst there were enough skilled staff on duty to meet people’s needs, it was difficult for staff to attend to all aspects of their roles within their paid shifts. Because staff spent much of their time allocated to one-to-one support, they had little time to attend to non-contact tasks such as writing notes.
We identified two breaches of the Regulations.
There was a risk that people’s rights would not be protected because staff did not always follow the requirements of the MCA relating to the deprivation of liberty safeguards. A person had been stopped from leaving the home against their will yet this deprivation of liberty had not been authorised as required by the Mental Capacity Act 2005.
People’s consent to care, including restrictions that were in place to keep them safe, had not always been recorded. Where people had not given consent, there was no record of mental capacity assessments and best interests decisions in line with the Mental Capacity Act 2005.
You can see what action we told the provider to take at the back of the full version of the report.
We recommended the provider reviews their arrangements for training staff in similar new services in mental health to ensure staff have the skills they need when people start using the service. It had been over two months from when the home opened before all staff had received training in mental health and the skills needed to deal with behaviour that challenges others.
We also recommended that the provider keeps their staffing levels under review so that they can continue to ensure people’s safety and meet their needs.