Archived: Room 29

Updated 27 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection site visit activity started on 23 January and ended on 24 January 2018. It included visits to one house, two flats and the central office. We visited the office location on the morning of 23 and all day on 24 January to see the manager and office staff; and to review care records, policies and procedures.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The provider was given 48 hours’ notice. This was so that we could be sure the manager or senior person in charge was available when we visited and that consent could be sought from people to a home visit from the inspector. The inspection was carried out by a single inspector.

Before the inspection we reviewed all the information we held about the service. This included notifications the home had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We also contact local commissioners who had experience of the service.

We had received a Provider Information Return (PIR) from the service. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with five people who used the service and five staff. We had telephone conversations with three relatives.

We spoke with the registered manager and a team manager. We reviewed five people’s care files, policies, risk assessments, health and safety records, consent to care and treatment, quality audits and the 2018 satisfaction survey results. We looked at four staff files, the recruitment process, complaints, training, supervision and appraisal records.

We visited one supported living location and observed care being delivered to people.

We asked the team manager to send us information after the visit. This included policies and the staff training record. The house agreed to submit this by Thursday 25 January 2018 and did so.

Updated 27 February 2018

The inspection took place on 23 January and was announced. The inspection continued on 24 January 2018 and was again announced.

Room 29 provides personal care to adults with a learning disability, physical disabilities, mental health needs or sensory impairment. At the time of the inspection the service was delivering personal care to 12 people.

This service provides care and support to people living in 1 ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service also provides personal care to people living in their own houses and flats in the community.

Not everyone using Room 29 receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

Regular supervisions were not recorded. Staff told us that they felt supported and used protected office time to share any issues or seek further support from managers. We were told that supervisions would be formerly recorded and regularly take place.

Recruitment was carried out safely. Checks were undertaken on staff suitability before they began working with people.

People’s needs were assessed and reflected choices and preferences which in turn ensured that people were supported to achieve outcomes. The service had worked closely with people to ensure that additional specific personalised goals were set.

People’s independence was promoted through the effective use of equipment and technology. This enabled people to access areas of their home, community and complete personal care tasks independently.

People were supported by staff who received regular training specific to their needs. Staff told us that they felt supported and able to fulfil their roles.

Personalised care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had a care file which also included outcomes and guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.

People and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training. People were provided with information about how to keep safe and told us staff explained risks to them.

Effective positive behaviour support plans had been completed and were up to date. These gave staff clear guidance on how best to support people which had led to positive outcomes.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. People being supported by the service all had capacity and consent had been sought by the service to deliver care and treatment.

Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines. Medicine Administration Records reviewed showed no gaps. In addition people were assessed and supported to manage their own medicines where appropriate. There was an infection control policy in place and regular cleaning took place in locations to prevent and control the risk of infection.

People were supported with shopping, cooking and preparation of meals in their home. The training record showed that staff had attended food hygiene training.

People told us that staff were caring. During home visits we observed positive interactions between staff and people. This showed us that people felt comfortable with staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes, interests and communication needs. Information was available in various easy read and pictorial formats. This meant that people were supported by staff who knew them well.

People, staff and relatives were encouraged to feedback. We reviewed the findings from quality feedback questionnaires which had been sent to people and noted that they contained mainly positive feedback.

There was an active system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints in place. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.

Staff had a good understanding of their roles and responsibilities. Information was shared with staff so that they had a good understanding of what was expected from them.

People, relatives and staff felt that the service was well led. The management team encouraged an open working environment. People and staff alike were valued and worked within an organisation which ensured a positive culture was well established and inclusive. The management had good relationships with people and delivered support hours to them.

The service was aware of their responsibilities under the Health and Social Care Act 2008, Duty of Candour, that is, their duty to be honest and open about any accident or incident that had caused, or placed a person at risk of harm. They also understood their reporting responsibilities to CQC and other regulatory bodies and provided information in a timely way.

Quality monitoring visits and audits were completed by the management team. These audits covered areas such as environment, medicines, paperwork and practice. Actions were identified and recorded as complete once achieved.

The service worked effectively in partnership with key organisations including, local authority, safeguarding and commissioners.