This comprehensive inspection took place on 01 March 2017 and was unannounced. Maranello is a nine bed service for people with a learning disability and supports people to live within their community. On the day of our inspection there were seven people using the service. There was a second similar service located on the same site managed by the same provider.This inspection was to see if the provider had made the improvements required following an unannounced comprehensive inspection at this service on 03 February 2016. At the inspection in February 2016 we had found two breaches of legal requirements in relation to Regulation 15 and 18. Following the inspection, we received an action plan which set out what actions were to be taken to achieve compliance. The overall rating from the inspection in February 2016 was Requires Improvement.
At this inspection we found improvements had been made to meet the relevant requirements.
There was a manager in post at the time of the inspection. 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 living at the service required staff to provide support to manage their day-to-day care needs, as well as to manage their behaviour and reactions to their emotional experiences. staff had taken appropriate steps and reviewed people’s behaviour; and analysed what worked or not; and provided consistent responses when people’s needs changed to ensure that they continue to meet the individual’s needs.
Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards training and they and the registered manager understood the requirements of the Act. This meant they were working within the law to support people who may lack capacity to make their own decisions.
Most people had difficulty discussing complex issues and thinking about the future but a few were able to share their views about day-to-day life at the service. People indicated and told us they liked living at the service and that the staff were kind and helped them a lot.
We saw there were systems and processes in place to protect people from the risk of harm.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. All relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.
We found that staff worked to assist people to lead ordinary lives and looked at how to assist individuals to reach their full potential. People were supported to go out and about in the local community and routinely went out with staff.
Staff had received a range of training, which covered mandatory courses such as fire safety as well as condition specific training such as managing autism and other physical health needs. We found that the staff had the skills and knowledge to provide support to the people who lived at the service.
Relatives and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that consistent numbers of staff routinely provided support to people who used the service during the day and overnight.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We observed that staff had developed very positive relationships with the people who used the service. We saw that the staff effectively assisted people to manage their anxiety. Interactions between people and staff were warm and supportive. Staff were kind and respectful.
People made decisions about what they did throughout the day where they were able.
We saw that people had plenty to eat and that each individual’s preference was catered for and and staff had ensured that people’s nutritional needs were met. Staff monitored each person’s weight and took appropriate action if concerns arose.
We saw that people living at Maranello were supported to maintain good health and had access a range healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. Where able staff worked with people to create them.
We saw staff encouraged people to develop their daily living skills and supported them with their hobbies and leisure interests inside and outside of the home. During the visit we saw staff joined people doing creative work and identified activities people would enjoy doing.
We saw that the provider had a system in place for dealing with people’s concerns and complaints. Relatives we spoke with told us that they knew how to complain and did not have any concerns about the service.
The provider used a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager used them to critically review the service. This had enabled them to identify areas for improvement and make the necessary changes.