Archived: FitzRoy Supported Living - Maidenhead

As part of this inspection we spoke with five people who use the service, three relatives, the registered manager, three members of staff and one professional who worked with the service. We reviewed records relating to the management of the home which included, six care plans, five staff personnel files, daily care records, risk assessments, audits, policies and procedures. We also spoke to the local authority Commissioners.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

Care plans gave guidance and instruction to staff on how to meet people's needs in a way which minimised risk for the individual. They ensured that staff had the information necessary to support people safely.

People's records showed they had access to routine and specialist health services. Directions from professionals were recorded accurately in the care plan and staff we spoke with knew how to access and follow them.

Records we looked at were accurate and fit for purpose. We saw they were stored securely and could not be accessed by unauthorised people. Staff personnel files contained appropriate pre-employment checks.

Medicines were managed appropriately. There were systems in place to order, store, record and dispose of medicines in a safe manner. People told us they were supported to take their medicines as they wished.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). We spoke with the manager with regard to the Supreme Court ruling which widened and clarified the definition of deprivation of liberty. They were aware of the ruling and had been in contact with the local authority DoLS team. At the time of the inspection two applications were being prepared.

Is the service effective?

People were supported to use a range of health care professionals including speech and language therapists, psychologists, audiologists and GPs.

Staff were observed supporting people in a friendly and patient manner and people appeared relaxed and happy in their homes.

Activities were planned individually and we saw how staff had worked with people who have limited verbal communication skills using photographs of activities and people participating in them.

Is the service caring?

Relatives we spoke with commented positively on the support their loved ones received. For example, one relative said: 'I'm thrilled with the care' receives.' We observed staff being polite and treating people with respect. People told us staff helped and supported them, for example: 'I get on with all the staff; they help me do what I need to do.

Is the service responsive?

People's needs had been assessed before they started using the service. People's needs were reviewed with them and their relatives as appropriate. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to meaningful activities and they had been supported to maintain relationships with their friends and relatives.

We spoke with relatives of people who use the service. They told us they could talk to staff if they were unhappy about something. They said they felt confident they would be listened to and action would be taken if necessary.

One professional we spoke with said: 'staff and managers always appear responsive and keen to provide the best service they can.'

Is the service well-led?

Quality assurance processes were in place. Staff told us they felt they could approach the senior staff for advice. They knew and understood their responsibilities and the importance of their role. Regular meetings were held to ensure all staff were up to date with changes to people's care and the expectations of the service. People and their relatives said they were consulted about their views and they had completed satisfaction questionnaires.

We saw people who use the service were involved in agreeing the level of support they received, and signed their consent to the support provided. One support worker told us 'We must ask people, and ensure they agree [to the support we provide]. We can't do anything without their consent. They make their own decisions.'

We saw people who use the service were provided with appropriate support, as their needs were assessed and reviewed regularly. The provider ensured risk assessments identified hazards and took measures to reduce possible harm. One relative said 'X loves it there. I've seen such improvements [in their abilities]'.

At our previous inspection on 6 March 2013 we found not all staff received supervision or appraisal. At this inspection we found the provider ensured staff had regular supervisions and an annual appraisal. One support worker told us 'I feel valued and listened to. Even if we're short-staffed or busy the manager has time for us.'

We saw the provider conducted regular quality assessments to ensure care and support was provided appropriately and safely. They sought feedback from people who use the service to ensure people were satisfied with the support they received.

The provider had a complaints procedure, which was shared with people who use the service in an appropriate format for them to use. We saw complaints had been addressed in accordance with the provider's procedure.

We saw that staff spoke to people with respect. The language used in care documents was person centred and written from the perspective of the person. There was widespread use of easy read documents throughout the service.

We looked at care records. We saw that a thorough assessment of need was completed. Each person had a two page profile, a person centred plan, and an essential lifestyle plan. These plans identified the person's strengths, needs, and aspirations.

All staff had received training in safeguarding of vulnerable adults. Staff we spoke with demonstrated a good understanding of different types of abuse. They were clear about how and when to report concerns in line with the local authority procedure.

There was an induction programme which completed during the first twelve weeks in post. This meant that staff understood their roles and had the skills to deliver good quality care. However we heard that supervision was not always regular and that support workers did not have appraisals. This meant that some staff might not have received support to do their job well.

The provider completed regular quality monitoring checks using a system based on care quality commission outcomes. This meant that the manager was able to monitor quality and identify areas for development.