Wells Road

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

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.

We reviewed recent notifications from the service. These give us information about the safety and wellbeing of people. We looked at how people using the service were being kept safe. This was because we had been sent a number of notifications about incidents or behaviours that challenge between people who live at the home. At our visit we were well assured that people were safe and properly supported when they showed certain behaviours that may challenge others.

We found people were protected from the risk of acquiring infections and there were systems being followed to keep the home clean. Personal protective equipment was readily available to staff and all staff were following the latest guidance.

The registered manager and staff showed they had a detailed knowledge of the people they supported. The team had developed trusting relationships, so that people felt safe receiving support. People were able to have privacy and independence with staff nearby if needed.

The registered manager worked closely with the local safeguarding team to reflect on the current practice within the service to ensure that lessons were learned and to make improvements where needed. Rating at last inspection: The last rating for this service was Good (7 March 2018).

Why we inspected

CQC have introduced targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. We found no evidence during this inspection that people were at risk of harm from these potential concerns in the notifications we read.

Please see the safe and well led section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wells Road on our website at www.cqc.org.uk. 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.

Wells Road Care Home is registered with us to support up to six people with complex learning disabilities and or mental health needs. At the time of our visit there were six people living there.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. This means people with learning disabilities and autism using the service can live life to their full potential.

There was a registered manager for the service. 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 told us they felt safe and staff knew how to protect people from the risk of harm and abuse in the home and when they were in the community. Risks that people may face were identified and then managed safely. Medicines were managed safely. People were able to look after their own medicines. This was with assistance from staff when needed.

People were involved in planning menus and their wishes in relation to meal choices were included in the options available. People were supported to eat and drink enough to stay healthy. People were supported to build up confidence in self budgeting and preparing and cooking their own meals.

Staff were properly supported to do their job effectively. This was because they were well supervised in their work. Staff were also being trained and updated. This meant they knew how to provide people with effective care.

People we met were positive in their views of the staff team and how they supported them. People felt well supported with their particular and often complex needs. People were treated with warmth and attentiveness from the staff that supported them at the home. We saw how staff spent plenty of time speaking with people they were supporting. There were also many positive and warm interactions between them. People looked relaxed with the staff when they wanted to speak with them.

People’s range of needs were assessed and their care was properly planned with their involvement if this was what they wanted. Care plans supported and set out for staff the care to be delivered. This was explained in detail in a way that properly met the needs of the person that the care plan was about. The staff team conveyed to us they had an up to date understanding and insight into the complex needs of the people they supported.

There were systems in place to protect people’s rights in the home. The staff followed the Mental Capacity Act 2005 if people lacked capacity to make informed decisions in their daily lives. The provider had completed an application under the Mental Capacity Act Deprivation of Liberty Safeguards for one person. This had been accepted and DoLS safeguards were in place for the person concerned.

The registered manager investigated and responded to people’s complaints, promptly and openly. They did this by ensuring they followed the provider’s complaints procedure.

People were supported to take part in activities and events that were meaningful to them in the home and the local community. Staff supported people to gain independence with a wide range of activities in the home and the community.

People who lived at the home felt supported by the registered manager. People also said they could approach and see the registered manager at any time if they wanted to speak with them.

The registered manager worked hard to learn from any mistakes and to make sure people were safe. The registered manager was open and transparent in their approach to running the home. They understood the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way when running social care or health service.

There were a number of quality monitoring systems and checks being carried out of the service. These were to monitor the care and service people received. Recent health and safety checks had identified the need for actions to be taken to keep the environment free from safety hazards. Health and safety audits showed that risks to people were identified and the actions needed to keep people safe were set out.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Every person who we spoke with told us they felt safe at the home and with the staff who assisted them there. Interactions between people who lived at the home and the staff were positive in tone. People approached the staff on duty for support and to talk with them .This showed that people felt safe in the company of the staff who supported them.

The environment was maintained to a clean hygienic standard. Staff were trained to understand how to minimise infection control risks in the home. They were also able to refer to suitable guidance on the subject when required.

There was a suitable process in place for reviewing and evaluating incidents and accidents which had occurred at the home. The manager had introduced a new recording system. There was also an online reporting system .We saw how both systems captured information after an incident. This included ones where people had shown behaviours that may have been challenging. A senior manager was also able to log in and read the online records. This was to ensure that suitable action had been taken after an incident or occurrence at the home.

Is the service effective?

Everyone we spoke with told us they were satisfied with the care and support that they received at Wells Road.

Staff were observed providing assistance in a calm and attentive approach. The staff spent time with people who needed one to one support. This was due to their particular complex needs that impacted on how they carried out their own personal care. Staff were heard prompting people with their needs in a discrete and respectful way.

Is the service caring?

Everyone we spoke with told us staff were “nice”. We saw how people who used the service were supported with their needs by staff. The staff were respectful and attentive in approach. Staff were also patient in manner when they assisted people who they needed regular prompting and reassurance about certain matters in their life.

The staff showed they understood how to support people with their complex needs. The staff we spoke with also had insight into the impact that peoples mental health needs and learning disabilities had in their daily life. For example they knew that one of their roles was to prompt and support people with their personal care.

Is the service responsive?

Care plans and risk assessments were detailed and informative. They clearly explained how to support people with their learning disability and their mental health needs. For example, we saw there was guidance information and clear strategies for staff to follow so that they safely responded to people when they needed additional support. The staff told us they followed these approaches when people’s mood and behaviours changed.

Staff told us they had been provided with suitable training so they were able to safely respond to potentially violent and aggressive incidents. The training enabled staff to use non-confrontational techniques. Staff were able to give us examples of times when they had responded to situations that may have been challenging with people who lived at the home.

Staff were supervised to ensure that their performance and development was properly monitored. If staff required additional support, for example after an incident or occurrence this was provided by the manager. The staff told us they felt properly supported when they had responded to behaviours that were particularly challenging.

Is the service well-led?

People who lived at the home felt well supported by the manager of the service. Everyone we spoke with was observed to have a close and trusting relationship with the manager. For example, one person wanted to talk to the manager about their plans for the day and we saw them asked the manager for their advice.

We saw that regular ‘house meetings’ were held at the home. The minutes we viewed showed people’s views were sought about the way the home was run. People who lived at the home also told us they were often asked by their key worker and the manager to give their views of the care and support they had received.

Each person had a number of individual plans which set out their needs and goals. The plans helped to ensure that staff were consistent in their approach and provided people with the support that had been agreed. This included support with medication; we found that suitable arrangements were being made for the management of people’s medication.

People who used the service said that they helped out with the domestic work. The home looked clean when we visited and we saw that there were procedures in place for infection control.

One person said that one of the best things about the home was “having a key worker”. This meant that they had a staff member assigned to them who they could talk to about their needs and how they were feeling. We were also told about meetings when people talked together about things that were important to them. We found that people’s complaints were being taken seriously and followed up.