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Inspection Summary


Overall summary & rating

Good

Updated 29 June 2018

This inspection took place on 23 and 30 May 2018 and was announced. We gave the provider 48 hours’ notice as the service is a home for adults with mental health needs who are often out during the day. This was their first inspection since the provider registered with us in December 2016.

Forward Support Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Forward Support Limited can provide support to up to ten people with mental health conditions who may also have a forensic history. At the time of our inspection eight people were living in the home. Forward Support Limited is a large house with large communal areas and a separate games room in the garden. Each person had their own bedroom with en-suite bathroom facilities.

There was 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.

People told us they felt safe living in the home. Staff were knowledgeable about safeguarding adults and records showed appropriate action was taken when people were identified as being at risk of abuse and avoidable harm. Risks faced by people living in the home were clearly identified, particularly with regard to the risks of mental health relapse, with clear measures in place to mitigate and escalate these risks. When incidents occurred, the service took effective action to ensure lessons were learnt and improvements made. People told us there were enough staff available to ensure their needs were met. Staff knew about the risks of people’s medicines and records showed they were supported to take medicines as prescribed. During the inspection the provider completed medicines care plans to ensure medicines practice was in line with best practice guidance.

People were involved in comprehensive needs assessments and completed a gradual transition to moving to the home. Care plans did not always reflect the detailed knowledge of staff about how to provide support to people. This was addressed by the service during the inspection. Records showed staff supported people to work collaboratively with other organisations and healthcare services involved in their care and treatment. Staff received the training and supervision they needed to perform their roles. People told us they were supported to eat and drink in line with their personal and cultural needs and preferences. Everyone living in the home had capacity to consent to their care and treatment. Some people were subject to restrictions due to the nature of their needs and staff supported them to understand and comply with these conditions.

People told us they had developed trusting relationship with staff. Staff demonstrated they understood the need to provide emotional support and were able to identify how people expressed their emotional needs. People were supported to practice their religious faith where they wished to do so. The service had taken steps to ensure that people felt safe to disclose their sexual and gender identity. Staff demonstrated how they treated people with respect and we saw staff always communicated with people in a polite and respectful manner.

The home operated a key-working system where each person had a named member of staff who led on ensuring they received the right support. People met with their keyworkers regularly and staff regularly reviewed and updated people’s care plans. Records showed any changes were escalated promptly and effectively with other agencies involved in providing care and treatment. People knew how to make complaints. There was c

Inspection areas

Safe

Good

Updated 29 June 2018

The service was safe. People were protected from avoidable harm and abuse. Staff were knowledgeable about safeguarding adults processes.

There were clear systems in place to manage and monitor risks faced by people living in the home.

People told us there were enough staff on duty. We saw people didn't have to wait to be supported by staff who were visible and available.

People were supported to take their medicines by staff. The service took action during the inspection to ensure this was managed in a safe way.

The home was clean and well maintained.

Staff responded to incidents in an appropriate and timely manner to ensure lessons were learnt.

Effective

Good

Updated 29 June 2018

The service was effective. People were involved in their needs assessments and the service worked with previous placements to ensure people had a smooth transition to the home.

The service took action during the inspection to ensure care plans reflected the knowledge of staff about how to provide support to people.

Staff received the training and support they needed to perform their roles.

People told us they were supported to have meals that reflected their personal and cultural preferences.

External professionals told us and records confirmed the service worked collaboratively with other organisations to ensure people's needs were met.

People told us they were supported to access healthcare services and follow the advice of healthcare professionals.

The service worked within the principles of the Mental Capacity Act 2005. People were supported to understand and comply with conditions of their placements.

Caring

Good

Updated 29 June 2018

The service was caring. People had developed positive and trusting relationships with staff who identified and responded appropriately to their emotional needs.

People were supported to practice their religious faith if they wished to do so.

The service had taken steps to ensure people felt safe to disclose their sexual and gender identity.

People told us they felt staff respected them and staff demonstrated they understood the importance of treating people respectfully.

Responsive

Good

Updated 29 June 2018

The service was responsive. People met with their keyworkers regularly where they contributed to reviews and updates to their care.

Staff completed regular monitoring to ensure people continued to receive the support they needed.

People knew how to make complaints and there was a clear process for responding to complaints.

The service had systems in place to ensure they could provide appropriate end of life care if this was needed.

Well-led

Requires improvement

Updated 29 June 2018

The service was not always well-led. The audit systems in place had not identified missing paperwork or issues with the quality of the information within care files. The registered manager took action during the inspection to address these concerns.

There was a vision and values base to the service which was available to people living in the home. This focussed on the rights and responsibilities of people receiving services.

People, staff and external professionals spoke highly of the registered manager who ensured effective joint working with external partners.

Regular meetings and surveys gave people, relatives and staff the opportunity to be engaged in service development.