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Archived: St Michael's Support & Care Requires improvement

This service was previously registered at a different address - see old profile

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 March 2016

We carried out an inspection of St Michaels Support & Care on 10 and 11 February 2016. This was an announced inspection where we gave the provider 48 hours’ notice because we needed to ensure someone would be available to speak with us.

St Michaels Support & Care provides services to adults with learning disabilities and mental health needs. People who used the service previously lived in hospital, long term residential care or had moved away from their home for the first time. The service supports people in supported living accommodation. At the time of our inspection there were 34 people who received personal care from the service based across five supported living units. During this inspection we visited the office the service operates from and two supported living units. One specialised in provision for people with a learning disability and the other specialised in mental health provision.

We last inspected the service on 7 and 17 April 2014 and found the provider was meeting the required standards at that time.

The service had a registered manager 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.

Most of the risk assessments were recorded and plans were in place to minimise risks. We found risk assessments for two people were not reviewed and updated following a serious safeguarding incident to ensure people were protected at all times.

We did not see evidence that regular and recent fire tests had been carried out at the service to ensure people were safe during an emergency. Staff confirmed recent fire tests had not been carried out but were able to tell us what to do in the event of an emergency. Staff had been trained in fire safety. Checks had been made in gas safety, electrical hardwiring and portable appliance to ensure the premises was safe.

Supervision for the supported living service that provided support to people with learning disabilities was not consistent and regular one to one meetings were not being carried out. Staff had not received annual appraisals. The team leader and registered manager told us this had not been carried out. Supervisions were being carried out in the supported living unit that supported people with mental health needs.

Due to risks to their safety, most people living at the supported living unit that supported people with learning disabilities, were not allowed to go outside without staff or relative accompanying them. Appropriate Deprivation of Liberty safeguards had not been applied for. The registered manager and the team leader told us that people lacked capacity. However, we did not see capacity assessments were carried out to ascertain if people had capacity to make decisions. We were informed that all people living at the service will be assessed in accordance to the Mental Capacity principles.

Spot checks were not routinely documented and there was no information on how often staff had received spot checks. Keeping detailed records of spot checks is important to keep track of the number of checks undertaken and help identify areas of improvements or best practise that could be used in staff supervision and appraisals.

There were appropriate systems in place to monitor the service. Regular audits were undertaken; however, these did not identify the shortfalls we found during the inspection.

Staff and resident meetings were not held regularly at the supported living unit that supported people with learning disabilities. The last staff meeting was held on June 2015 and we did not see evidence of residents meetings being held since May 2015. Staff and resident meetings were regularly carried out in the supported living unit that supported people with mental health needs.

Pe

Inspection areas

Safe

Requires improvement

Updated 25 March 2016

Some aspects of the service were not safe.

Some risk assessments were not updated to reflect people’s current circumstances.

Medicines were stored and administered on time.

Recruitment procedures were in place to ensure staff members were fit to undertake their roles and there were sufficient numbers of staff available to meet people's needs.

Staff members were trained in safeguarding and knew how to identify abuse and the correct procedure to follow to report abuse.

Effective

Requires improvement

Updated 25 March 2016

Some aspects of the service were not effective.

Supervisions was not consistent and appraisals were not carried out with staff at the support living service that supported people with learning disabilities. People’s rights were not being consistently upheld in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Staff members were trained and had the skills and knowledge to meet people’s needs.

People had access to healthcare and were supported with food when required.

Caring

Good

Updated 25 March 2016

The service was caring.

There were positive relationships between staff and people using the service. Staff treated people with respect and dignity.

People had privacy and staff encouraged independence.

Staff had a good knowledge and understanding of people’s background and preferences.

Responsive

Good

Updated 25 March 2016

The service was responsive.

Care plans included people's care and support needs. Care planning and reviews involved people in decision-making.

People participated in activities such as going to theme parks and bowling.

There was a complaint system in place. People knew how to make a complaint and staff were able to tell us how they would respond to complaints.

Well-led

Requires improvement

Updated 25 March 2016

Some aspects of the service were not well-led.

Staff and resident meetings were not carried out regularly for one of the supported living services we visited.

Systems were not in place to carry out regular spot checks and comprehensively record and communicate its findings.

There were appropriate systems in place to monitor the service. Regular audits were undertaken; however, these did not identify the shortfalls we found.

Staff told us that the team leaders were supportive and approachable.