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The Apuldram Centre

Overall: Good read more about inspection ratings

Common Farm, Appledram Lane South, Chichester, West Sussex, PO20 7PE (01243) 783370

Provided and run by:
The Apuldram Centre

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Background to this inspection

Updated 18 April 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.

This was a comprehensive inspection completed on the 8 March 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that they would be in. The inspection was completed by one inspector.

Before our inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since their registration. A notification is information about important events, which the service is required to send us by law.

We reviewed the information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we met with six people who used the service, including people who lived in their own home. We spoke to two relatives for their views on the service. We spoke with three staff during the inspection and the registered manager and provider.

We looked at four records which related to people individual care needs. We viewed three staff recruitment files, training evidence and records associated with the management of the service. This included policies and procedures, people and staff feedback, and the complaints process.

Overall inspection

Good

Updated 18 April 2018

The Apuldram Centre is a supported living service and domiciliary service that provides care and support to adults of all ages in their own homes. The service provides help with people's personal care needs in Chichester and the surrounding areas. This includes people who may have a learning or physical disability as well as people living with sensory impairment.

The Apuldram Centre provides care and support to people living in a 'supported living' setting, so that they can live 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 supports some people on a 24 hour basis and others who may require support with personal care needs at specific times of the day and/or night. At the time of this inspection, ten people received support with their personal care needs from the agency.

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 service had a registered manager in post. 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.

At the last inspection, the service was rated Requires Improvement. At this inspection we found the service was now rated Good.

Why the service is rated Good.

The service was now safe. At the inspection in September 2015, we found the provider was in breach of a Regulation associated with the safe management of medicines. We asked the provider to take action to ensure medicines procedures were safe and to send us an action plan of how and when this was being addressed, which they completed. At the inspection in October 2016 we found some improvements had been made to the safe management of medicines, but we also found the provider had not taken sufficient action to ensure medicines were safely managed at all times. The report highlighted that people were supported with their medicines, but records of medicine stocks were unclear and did not match the quantities we checked. At this inspection we found that the provider had followed their action plan and that steps had been taken to ensure the breach was met.

People’s medicines were now managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received medicines training and understood the importance of safe administration and management of medicines.

The PIR states; “Apuldram is committed to keeping the people who it supports, staff and volunteers safe. Our policies and procedures set out the way in which we work.”

The service was now well-led. At our inspection in October 2016 it recorded that at the time of our inspection there was no registered manager in post. It also highlighted that quality and safety of the service was audited but this had not always identified shortcomings in the safe management of medicines as required in the last report. At this inspection we found there was now a registered manager in post and the breach concerning medicine quality checks had now been met.

The provider had systems in place to monitor, assess and improve the service. There was an open culture, and people, relatives and staff said they found access to the office and management team welcoming and easy. Staff were positive and happy in their jobs. There was a clear organisational structure in place.

People able to, when asked, told us the service they received was safe. People felt safe with the staff who supported them. Family members gave positive feedback about the staff, the safety of people and how staff related to their loved ones.

There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. There were adequate numbers of staff available to meet people's needs in a timely manner.

People were protected as staff had completed safeguarding training and staff had a good knowledge of what constituted abuse and how to report any concerns. Where staff supported people to manage their finances, amounts of money spent on the person's behalf were carefully recorded and balances maintained and checked.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff monitored people's health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

People's human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA). People's nutritional needs were met because staff followed people's support plans to make sure people were eating and drinking enough, and potential risks were known. People were supported to access health care professionals to maintain their health and wellbeing.

People were enabled and supported to lead fulfilling, independent and active lives. People were supported to reach their goals and ambitions. 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.

Risks associated with people's care and living environment were effectively managed to ensure their freedom was promoted. People were supported by consistent staff to help meet their needs. People's independence was encouraged and staff helped people feel valued by engaging in everyday tasks where they were able, for example helping prepare meals.

People continued to receive a service that was caring. Staff demonstrated kindness and compassion for people through their conversations and interactions. If people found it difficult to communicate or express themselves, staff showed patience and understanding.

People received information in a format suitable for their individual needs. Throughout the inspection we saw evidence of how the provider and staff understood and promoted people's rights as equals regardless of their disabilities, backgrounds or beliefs.

The service was responsive to people's needs and people were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation. People were supported to access the local community.

People could make a complaint and were confident action would be taken to address their concerns. The manager and provider treated complaints as an opportunity to learn and improve.

Staff adapted their communication methods dependent upon people’s needs, for example using simple questions and information for people with cognitive difficulties and information about the service was available in larger print for those people with visual impairments.