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Nimrod House Supported Living Good

Inspection Summary


Overall summary & rating

Good

Updated 20 November 2018

The inspection took place on the 5 October 2018 and was announced.

At our last inspection on 29 August 2017 the service received an overall rating of 'Requires Improvement'. We identified four breaches of the regulations relating to safe care and treatment, fit and proper persons employed, staffing and good governance.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Responsive and Well- Led to at least good. At this inspection we found the provider had made the necessary improvements to meet the standards required of them.

Nimrod House provides care and support to people living in a supported living setting. Each person’s flat had a living area, separate bathroom and kitchen. People live in their own flats so they can live as independently as possible. People's care and housing are provided under separate contractual agreements. The Care Quality Commission does not regulate the premises used for supported living; this inspection looked at people’s personal care and support.

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 had risk assessments in place and now clearly stated how to mitigate against risk. Staff supported people to take risks in a safe way so that their freedoms were respected. Relatives told us their family members were kept safe at the service by staff.

Staff understood the different types of abuse and how to report abuse if they suspected it. Staff also knew when to whistleblow if they witnessed poor practice.

Staff were recruited safely and relevant checks were performed to check for suitability before staff could work with people at the service.

People’s medicines were managed safely and the registered manager regularly checked staff competency in medicine administration to ensure safe practice.

The risk of infection was minimised as staff were provided with personal protective equipment and they kept people’s living areas clean and tidy.

People’s needs were assessed before they began to use the service and people were involved in the care planning process along with their relatives and health professionals. People’s care plans were person centred and people were given the opportunity to speak with their key worker each month to discuss their care.

Staff received mandatory training and specialist training in Autism and diabetes, specifically related to the people they supported which ensured they received good care from staff who understood their health needs. Staff were supported by management and received regular supervision and an annual appraisal where appropriate.

People were offered choices and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) Where needed the registered manager had made appropriate applications to the Court of Protection where people’s liberty was being deprived.

People’s dietary and food preferences were now clearly recorded, people were supported to eat and drink well. People were supported to access health services to maintain good health.

People were supported by staff who were kind and patient. We observed people laughing and dancing with their key worker. People’s privacy and dignity was respected. People were supported to explore personal relationships.

People took part in a number of activities of their choice and records showed people suggested new activities they wanted to try.

The registered manager had an open-door policy and staff felt well supported by management and other staff at the service.

The registered manager had a variety of monitoring tools they used to check the quality

Inspection areas

Safe

Good

Updated 20 November 2018

The service was now safe.

Risk assessments had improved and provided clear details on how to mitigate risk.

The service now carried out safe recruitment practices before new staff began to work with people.

Staff knew how to identify abuse and how to respond to an allegation of abuse.

People�s medicine was managed safely and the risk of infection was minimised due to use of personal protective equipment.

Effective

Good

Updated 20 November 2018

The service was now effective.

Relatives thought staff were good at their job and supported their family member well.

Staff now received effective training in specialist areas to support people at the service. People were offered choices and staff understood the principles of the MCA.

People were supported to maintain good health and were taken to health appointments by staff.

People�s dietary needs and food preferences were clearly documented. People were supported to eat healthily and stay hydrated.

Caring

Good

Updated 20 November 2018

The service remains caring.

Responsive

Good

Updated 20 November 2018

The service was now responsive.

Care plans were detailed and more person centred. The service used more pictures to support the care planning process and involve people in their care. People�s preferences were recorded clearly.

People were encouraged to choose and take part in a number of activities.

People were supported to make complaints and relatives complaints were recorded and responded to in line with the service�s policy.

Well-led

Good

Updated 20 November 2018

The service was now well- led.

People were comfortable around the manager. Staff and relatives could approach the manager and felt they did a good job.

Quality systems were in place to monitor the service and to make improvements.

Best practice was shared amongst staff and they felt they were always supported to improve the quality of care.

Feedback on the service was requested from people, their relatives and external stakeholders.