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Inspection carried out on 17 January 2019

During a routine inspection

This comprehensive inspection was carried out on 17 January 2019 and was unannounced.

Somerville is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Somerville is registered to provide support for up to seven people who require support with their mental health. At the time of our inspection seven people were living there.

The house is a large adapted domestic style dwelling situated in a busy area of Wallasey near to local amenities and transport. All of the bedrooms had en-suite bath or shower rooms.

The service has 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.

During our previous inspection of the service in December 2017 We had found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of Regulation 17. This was because systems and processes were ineffective at assessing monitoring and mitigating risks relating to the health, safety and welfare of people. We also found a breach of Regulation 18 of the Registration Regulations 2009.This was because the provider had not notified the commission without delay of an event that affected the health, safety and welfare of a person who used the service

The overall rating for the service was ‘requires improvement’. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; ‘Is the service safe?’ ‘Is the service effective? ‘Is the service caring? ‘Is the service responsive?’ and ‘Is the service well-led?’ To at least a rating of good.

At this inspection we identified that improvements had been made and the provider was no longer in breach of these regulations.

People living at Somerville told us that they liked living there. one person told us, “It’s very nice, staff are okay.” Another person told us, “It’s all right here, I like it.” The home had an ethos of promoting people’s independence and working alongside people to support them to increase their everyday living skills.

People were supported to occupy their time in ways they enjoyed and benefited from. At home people were supported and encouraged to be as independent as possible with everyday living skills such as cleaning and meal preparation. People attended a variety of clubs and classes in their local community, they also enjoyed regular holidays and days out. Whilst people were encouraged to go out and about independently staff were available to accompany people who needed their support.

People who were able to could go into their kitchen at any time and make a drink or meal with or without staff support. People told us they helped to plan meals and went food shopping if they chose to do so. An individual approach was taken to meals. This meant that some people ate different meals or prepared their own and budgets were adjusted accordingly. People who needed support at mealtimes or with their nutrition were provided with this.

Systems were in place for safeguarding people from the risk of abuse and reporting any concerns that arose. People felt safe living at Somerville and staff knew what action to take if they felt people were at risk of abuse. A system was in place for raising concerns or complaints and people felt confident to raise any concerns they had in the knowledge they would be listened to.

People’s medication was safely managed, stored and recorded. People told us they were happy for staff to look after their medication and they always received it on time. Staff provided peop

Inspection carried out on 4 December 2017

During a routine inspection

This inspection was carried out on 04 December 2017 and was unannounced. This was the first inspection of the home since it was registered in September 2016. It was carried out by an Adult Social Care (ASC) inspector.

Somerville is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Somerville is registered to provide support for up to seven people who require support with their mental health. At the time of our inspection seven people were living there, six of whom had lived together for many years.

The house is a large adapted domestic style dwelling situated in a busy area of Wallasey near to local amenities and transport. All of the bedrooms had en-suite bath or shower rooms.

The service has 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.

The people we spoke with all told us that they liked living at Somerville. Their comments included “much better conditions” (than where they had previously lived). “It’s quieter here, I like that.” “It’s lovely. Nice and modern. One of the nicest I have been in.”

We found breaches relating to governance of the service. Although a number of systems were in place for monitoring and improving the quality of the service provided these had not always been effective. Systems had failed to monitor the time it took to repair emergency lights, deal with hot radiators and ensure records were located in the correct place.

You can see what action we told the provider to take at the back of the full version of the report.

The people we spoke with who lived at Somerville were all very positive about living there and about how the support they received had improved their lives. With the support of staff people were learning to be more independent, look after their personal care, engage with their local community and plan for their future.

Procedures were in place for safeguarding vulnerable adults, supporting staff who report a concern and dealing with complaints. People told us that they felt safe living at Somerville and confident to raise any concerns they may have. Staff knew how to identify any potential safeguarding concerns and how to report them.

People told us that they liked and trusted staff who worked at Somerville. Sufficient staff worked at the home to provide people with the support they needed. Systems for recruiting new staff were robust enough to check they were suitable to work with people who may be vulnerable.

Staff had received training to provide them with the information they needed to support people safely and in line with current good practice. Training was on-going and planned to equip staff with skills to enhance the support they provided.

The management team knew people well and had built positive relationships with people. Staff felt supported whilst working at the home.

People’s medication was well managed and they received the support they needed. Staff knew about risks to people’s mental and physical health and had provided support to people in managing any health concerns they had. This had not always been clearly recorded within their care file.

People had been encouraged to make decisions and choices for themselves. When someone needed the protection of a Deprivation of Liberty Safeguard (DoLS) this had been applied for on their behalf. Restrictions to people’s freedom had been minimised and any impact on others living at the home had been considered and addressed.

A through assessment of people’s support needs and their choices had been carried out. Followi