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Inspection Summary


Overall summary & rating

Good

Updated 25 January 2018

This inspection took place on 13 December 2017 and was unannounced.

65A Newtown provides care and support for three people who have autistic spectrum disorder and is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

“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.” Registering the Right Support CQC policy.

A registered manager was 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.

There were people that used non-verbal language. While their communication plans stated they used pictures and object of reference to communicate, their care plans and information was not in their preferred method. For example pictures. The registered manager said equipment was now available to provide information in picture format.

Quality assurance systems were in place and where shortfalls were identified action plans were developed to meet the set standards. While audits had identified people’s views were not formally gathered action had not been taken to introduced on how to gain feedback about the service. processes.

We observed the people at the service accepted staff support and approached staff for attention. The staff we spoke with said they had attended safeguarding training. They knew how to identify abuse and the procedures for reporting their concerns.

Risk assessments were in place for people with medical conditions such as epilepsy and for people that showed anxiety through verbal and physical aggression. Action plans gave staff guidance on the actions to take to ensure people were protected from harm and were able to take risks safely. Staff were aware of the actions needed to minimise risks to people.

Incident and accidents reports were completed and analysed for patterns and trends.

Staff told us there was some lone working but mainly two staff were on duty. The rota showed that two staff were on duty during the day and at night there was one waking staff. The registered manager said two staff were mainly on duty to allow for people to go out during the day and evening.

Medicines were audited which included the stocks held and medicines ordered. We saw medicine administration records (MAR) were signed to indicate medicines administered. Some people were prescribed ‘as and when required’ (PRN) medicines for pain and to reduce agitation. We saw for one person the medicine care plan stated that the person may not tell staff when they were in pain and staff needed to look for changes in behaviour as the person may be in pain. The member of staff took immediate action and included how staff were to identify the person was in pain into the support plan.

Staff told us the training was good. There was mandatory training which staff we spoke with said they had attended. One to one supervision was with the line manager. The member of staff on duty had not had regular supervision although the line manager had made attempts to organise them. The registered manager said this was to be addressed. Discussions with the member of staff were to take place.

Staff knew the day to day decisions people were able to make. We saw people’s capacity to make decisions about their care and treatment was assessed. Where people lacked capacity best interest decisions were taken.

The pe

Inspection areas

Safe

Good

Updated 25 January 2018

The service was consistently safe.

Medicine systems were safe.

Risks were identified and action plans were developed on minimising the risk. Members of staff were knowledgeable on actions necessary to reduce risks.

There were sufficient staff to support people and we observed that staff were visible and available to people.

Staff knew the types of abuse and their responsibilities to report any concern.

Effective

Good

Updated 25 January 2018

The service was effective.

Staff enabled people to make choices. People’s capacity to make complex decisions was assessed and best interest decisions were taken with the person and their relatives where appropriate.

The staff had the skills and knowledge needed to meet the changing needs of people.

People’s dietary requirements were catered for.

Caring

Good

Updated 25 January 2018

The service was caring

People were treated with kindness and with compassion. We saw positive interactions between staff and people using the service. Staff knew people’s needs well and how to reassure them when they became distressed.

People’s rights were respected and staff explained how these were observed.

Responsive

Requires improvement

Updated 25 January 2018

The service was not fully responsive

Care plans were person centred. The care observed was consistent with the care plan guidance. Care plans were not in picture format for people that used this method of communication.

People had access to community and in-house activities. People were supported to maintain contact with relatives.

Complaints procedures were in picture and words format.

Well-led

Good

Updated 25 January 2018

The service was well led.

Quality assurance systems were in place which enabled the service to continuously improve. However, the views of people were not gathered and used to improve services.

Staff were aware of the values of the organisation. They said the team worked well together