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We are carrying out a review of quality at Fell Close. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 16 February 2017

During a routine inspection

This inspection took place on 16 February 2017 and was announced.

At our last inspection on 24 November 2014 we rated the service ‘Good’. We found the service remained 'Good' at this inspection.

Fell close is registered to provide long-term accommodation to four adults who have a learning disability and/or a physical disability. The service is situated in Newby, on the outskirts of Scarborough. There is limited car parking available to the front of the service and disabled access into the building. People have access to a garden area to the rear of the building and a selection of communal spaces within the service. These included a dining area and a lounge. Both floors of the service have communal bathrooms and toilet facilities. The bedrooms are all single occupancy. At the time of this inspection, four people were using the service.

The registered provider is required to have a registered manager, but at the time of our inspection the manager in post was not registered with the Care Quality Commission (CQC). For this report, we have referred to this person as ‘the manager’ throughout the text. 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.

We found that the care staff had a good knowledge of how to keep people safe from harm and the staff had been employed following robust recruitment and selection processes. We found that the management of medication was safely carried out.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

People that used the service were cared for and supported by qualified and competent staff that were regularly supervised. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing. People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on.

People were able to see their families when they wanted to. There were no restrictions on when people could visit the service. We saw that staff were caring and people were happy with the care they received. People had access to community facilities and most participated in the activities provided in the service.

We observed good interactions between people who lived in the service and staff on the day of the inspection. We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People’s comments and niggles/grumbles were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that the manager met with people on a regular basis to discuss their care and any concerns they might have. This meant people were consulted about their care and treatment and were able to make their own choices and decisions.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever p

Inspection carried out on 26 November 2014

During a routine inspection

This inspection was carried out on 26 November 2014 and was unannounced.

Fell Close is owned by The Wilf Ward Family Trust. The home is registered to provide care for up to four people with physical or learning disabilities. It is situated in Newby, just outside Scarborough. There was a registered manager at the time of our inspection but they were on long term sick leave and an interim manager was in place. 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.

We found that this service was safe and people told us that they felt safe living in the home. Staff were recruited safely and checks were made before staff were employed to ensure that they were considered suitable people to work with people who used the service.

There was sufficient staff with appropriate skills and knowledge on duty to meet the needs of the people who used the service. Staff received supervision from more senior staff which enabled them to discuss any matters pertinent to their work and to develop personally. This was done regularly. There was a full training programme in place and staff reported that they were able to access appropriate mandatory and additional training.

The staff spoke kindly to people and treated them with respect which was reflected in the very good relationships between staff and people who used the service we observed during our inspection.

Staff were able to explain how they would safeguard people and if necessary how they would report any incidents that may have caused people harm. We saw that staff had received training in safeguarding vulnerable adults. This meant that staff awareness around safeguarding was good and if any situation arose where someone was at risk of harm staff would know what to do. We found medicines were managed appropriately ensuring that people received their medication safely.

The interim manager was aware of how to follow the principles of the Mental Capacity Act 2005 and applications had been made in respect of people being deprived of their liberty where required.

The environment required some improvement and updating to ensure that it was appropriately equipped for people using the service. The building was fully accessible. The environment included alterations to ensure anyone with mobility needs could navigate easily around the building. Activities were based on the individual person and were designed to provide meaningful and enjoyable occupation and development of independent living skills. Bedrooms were personalised and people had personal items in place. The rooms were decorated according to each individual person’s choices. These required some updating and maintenance.

There was a robust and effective quality assurance system in place which helped in the development of the service and making changes and improvements. This included monitoring and auditing at various levels.

Inspection carried out on 20 December 2013

During a routine inspection

At the time of our visit four people resided in the home. They told us that the staff were ‘ok’ and ‘caring’. They told us that they went out regularly and one person said “I went to York last week to the railway museum. I went on the train”. Another person said “I like going to McDonalds”.

We saw that people were encouraged to make day to day decisions for themselves. They were supported to make appropriate decisions when they were not able to do this for themselves. People's individual lifestyles were promoted.

The care plans were comprehensive and included pictorial information about their wishes and aspirations as well as the help and support they needed. Staff had a good knowledge of the dietary requirements of people who used the service and provided appropriate support.

We saw that staff had received training in the safeguarding of vulnerable adults and they understood their responsibilities in relation to keeping people safe.

We saw that medication was managed safely and people received their medication in line with the prescriber's instructions.

Staff received training to ensure they had the skills necessary to meet the needs of each person. Staff also received support through supervision and appraisals.

The manager told us about a range of health and safety audits which were carried out by the provider. For example, the provider carried out regular maintenance checks, portable appliance tests, fire checks and hot water temperature checks. Equipment used within the service was also regularly serviced. This helped to keep people safe.

Inspection carried out on 7 January 2013

During a routine inspection

We saw that people had a care plan that informed staff how they wanted to be supported. Staff were observed offering people choices and giving them time to make a decision. Staff told us they had completed training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DOLs). Staff told us that they had this training each year and this ensured they remained up to date with any changes in the law or recognised practices.

We saw that care plans contained an individual daily diary that covered what activities they had done, who had visited and what they had eaten during the day. Information held in the care files indicated that people who used the service accessed other health and social care professionals. These included specialist learning disability services, dietician, dentist, optician and their doctor.

People who used the service had their own rooms and could access the gardens and other communal areas. Where people required equipment appropriate to their needs it was serviced at intervals recommended by the manufacturer. Staff told us that they were trained in the use of each piece of equipment.

We saw the staff rota's for the home. The staffing levels provided were seen to be appropriate for the level of individual needs. We saw a copy of the complaints policy. It provided clear guidance on what to do if someone had a complaint. There were also clear guidelines of how the organisation would respond to any complaints received.