Archived: NAS Community Services (Croydon)

At our last inspection on 28 and 30 October 2014 we found that, although the provider was meeting our regulations, the service required improvement because some records relating to the running of the service could not be located promptly when we requested them. At this inspection we found that the provider’s administration and record keeping systems had significantly improved. The registered manager provided us with records promptly when we requested them.

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 using the service and relatives told us the service was safe and that staff treated them well. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work and there were sufficient staff on duty to meet people’s needs. Risks to people were assessed and support plans and risk assessments provided clear information and guidance for staff on how to meet people’s needs. Medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed training specific to the needs of the people they supported and they received regular supervision and annual appraisals of their work performance. People were provided with sufficient amounts of food and drink to meet their needs, and they had access to a GP and other health care professionals when they needed them. The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and acted according to this legislation.

People were supported to be as independent as possible and their privacy and dignity was respected. People were provided with appropriate information about the service. This ensured they were aware of the standard of care they should expect.

People and their relatives, where appropriate, had been involved in planning for their care and support needs. Their needs were assessed, and support plans and risk assessments included detailed information and guidance for staff about how their needs should be met. People told us there were plenty of activities for them to partake in. Meetings were held where people could express their views and opinions about how the service was run. The service had a complaints procedure in place. People and their relatives said they were confident their complaints would be listened to and action taken if necessary.

The provider recognised the importance of regularly monitoring the quality of the service provided to people. They took account of the views of people using the service and their relatives through annual surveys. Staff said they enjoyed working at the service and they received good support from the registered manager and senior managers. There was an out of hours on call system in operation that ensured management support and advice was always available when staff needed it.

We found that some people or their relatives were involved in making decisions about their care and treatment. We found that everyone at the home had a person centred plan with relevant risk assessments and action plans in place. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We found that staff were supported through induction, training and supervision to deliver appropriate care. The provider had systems in place to assess and monitor the quality of the service.

People told us they were not always involved in decision making and believed they should be involved more. We found that although the provider sometimes invited family members for 'circle meetings', people and their families were not always involved in making some decisions such as the support they received around their personal care.

People told us they were happy with the activities provided at the day centre. We found that people who use the service attended daily activity centres which promoted their independence and community involvement.

People told us they felt safe. We found that although there was a safeguarding alert within the past twelve month, the provider had taken appropriate steps in securing the safety of people who use the service.

We found that the provider was supporting staff with supervisions, team meetings, and annual appraisals. However staff training was not regularly updated. We also found that the provider had not taken the necessary action to assess and monitor the quality of the service being provided.