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Reports


Inspection carried out on 10 October 2017

During a routine inspection

Trevelyan Road is a residential home for four men with mental health needs.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

There was a new manager at the service who was had submitted an application to become registered. 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 that staff were caring. There was a relaxed atmosphere at the home and the interaction between people and care workers was friendly. Some care workers acted as key workers to people which helped to develop caring relationships.

People were supported to live independent lives. They helped staff when they prepared meals and took an active role in doing chores around the home such as their laundry or tidying up.

People are 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. People were able to take part in a number of activities and community events such as football and gardening and attended workshops throughout the week.

People had their healthcare needs met by the provider, appropriate referrals were made when necessary to healthcare professionals. People received their medicines on time from trained staff.

There were enough staff on shift to meet people’s needs, where people needed one to one support in the community this was arranged. Staff received regular mandatory training every two years and regular supervision.

Individual risk assessments and care plans were in place for each person. Steps that needed to be taken to manage risk were documented and followed by staff. Steps for staff to take to support people in meeting their recorded outcomes were met. This helped to ensure people had appropriate care and support.

There was an open culture in the home, with people able to come into the office and speak to staff. Regular meetings were held for both people using the service and staff.

Inspection carried out on 28 July 2015

During a routine inspection

We carried out an unannounced comprehensive inspection of this service on 1 and 3 December 2014. We identified a number of breaches in the regulations relating to care and welfare of people using the service, supporting staff, complaints, assessing and monitoring the quality of service and notification of incidents.

Following this visit, we asked the provider to send us an action plan by 27 March 2015 describing the actions they were going to take to meet the legal requirements and what they intended to achieve by their actions. We received the provider’s action plan on 30 March 2015.

Due to the significant number of breaches we found during our previous visit, we undertook another full comprehensive inspection on 28 July 2015 to check that the provider had followed their plan of action and to confirm they now met legal requirements. This inspection was unannounced.

During our inspection on 28 July 2015 we noted improvements had been made in relation to the shortfalls that had been previously identified. People’s care plans and risk assessments had been reviewed, although we found that key worker meetings were not always recorded. The provider had arranged additional training for staff which enabled them to carry out their roles more effectively. People’s complaints were explored and action had been taken where concerns had been raised. Improvements had been made in the way that quality monitoring was carried out.

Trevelyan Road provides accommodation and support for up to four males with a history of mental health needs. It is situated in a residential area of Tooting with good access to local shops and transport links. The home is arranged over three floors with a lounge, kitchen/dining area, toilet and a bedroom on the ground floor, two bedrooms and a bathroom on the first floor and one bedroom on the third floor. There is an accessible garden to the rear of the property. There were three people using the service at the time of our inspection.

There was a registered manager at the service. 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 using the service told us they liked living at the home and that staff looked after them. They said that they were satisfied with all aspects of their care and had no complaints. They received their medicines on time and liked the food at the home. People were encouraged to lead independent lives and to improve their daily living skills such as shopping for food, carrying out household chores and helping staff in preparing meals. They were able to maintain family relationships. People said that they were happy with the activities that were available to them.

Staff told us they had recently attended training which meant they were able to support people with mental health needs more effectively. They were able to give their views on the running of the service by making suggestions through regular supervision sessions and team meetings. They demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and their responsibilities in relation to abiding by the principles of the Act.

Care plans had been amended which meant that staff had the information they needed to enable them to support people more effectively. People’s progress towards their identified goals was monitored through care plans reviews. However, formal recording of one to one key worker sessions did not always take place.

Quality monitoring at the service had been improved. The director carried out regular visits which helped to ensure that improvements were sustained. Feedback from healthcare professionals was sought and more thorough audits were completed.

We made a recommendation in relation to record keeping.

Inspection carried out on 1/12/2014 and 3/12/2014

During an inspection to make sure that the improvements required had been made

This inspection took place on 1 and 3 December 2014 and was unannounced. The service met the regulations we inspected at the last inspection which took place on 21 November 2013.

Trevelyan Road provides accommodation and support for up to four males with a history of mental health needs. It is situated in a residential area of Tooting with good access to local shops and transport links.

There was a registered manager at the service. 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.

The home is arranged over three floors with a lounge, kitchen/dining area, toilet and a bedroom on the ground floor, two bedrooms and a bathroom on the first floor and one bedroom on the third floor. There is an accessible garden to the rear of the property.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 during this inspection. We found that the provider was not meeting some of the requirements of the law in relation to meeting people’s individual care needs, supporting staff, how complaints and concerns were handled and how they monitored the quality of service provided. You can see what action we told the provider to take at the back of the full version of the report.

Care plans for people using the service were not always effective in capturing the required information and supporting people to achieve positive outcomes. People’s individual support needs were not being recorded in a way that was easy to follow which meant that people were at risk of not always receiving support that met their needs.

Although staff had attended some training, there was no evidence of training that had been delivered to staff in relation to supporting people with mental health needs and in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Although meetings were held with people using the service, we saw that concerns raised were not always followed up or assigned to staff to look into. Therefore the provider did not ensure that people’s concerns were followed up.

The provider did not have an effective way of monitoring the quality of service provided to people, either through formal feedback methods or through quality assurance audits. We identified shortfalls in reporting significant events to the Care Quality Commission (CQC) as required.

There was an open door culture at the service. We observed people coming into the manager’s office throughout our inspection wanting to speak with him. Staff told us that the manager was very supportive and easy to talk to.

People told us they enjoyed living at the home and that staff treated them with respect. We saw that there was a friendly relaxed atmosphere at the home with people and staff spending time in the lounge together. People told us they felt safe living at the home.

People were able to go out during the day by themselves or with staff. Some people were restricted from leaving the home at certain times or without a support worker. Where this was done the decision to restrict them had been taken lawfully and in their interests.

Staff administered medicines safely. Although staff recorded and completed medicine administration record (MAR) charts correctly, we saw in some instances that appropriate action was not always taken when people refused their medicines. We have made a recommendation to the provider about this.

People told us they felt supported by staff and that there were enough staff members to meet their needs. Staff told us they were content working at the home and felt that they received good training to help them meet people’s needs.

People had access to healthcare services and received on-going healthcare support, for example, through their GP. Referrals were made to other professionals if the need arose. People met with their psychiatrist and their mental health needs were reviewed by their psychiatrist and the community mental health and learning disability team.

People told us they enjoyed the food at the home and had no concerns. People were encouraged to help staff in preparing meals, so that they could become more independent. During our inspection, we saw that people were given choice and independence in aspects of their daily living such as activities and household chores.

Inspection carried out on 21 November 2013

During a routine inspection

Our inspection on the 21 November 2013 found that staff and people who used the service lived and worked together in a homely setting.

We looked at the care plans of people who used the service and found that information was completed and up to date. We looked at peoples nutritional needs and found that a variety of meals were planned and changes were made to suit peoples individual tastes . We looked to see if people were protected against the risk of abuse and they were.

People using the service that we spoke with told us “staff are doing well for us” and “I’m moving soon to a one bedroom flat”.

We looked to see if staff were supported to do their jobs. Staff we spoke with told us, “we get plenty of training” and “you’re well supported here”

Inspection carried out on 10 January 2013

During a routine inspection

We spoke to four people who use the service, three staff members and the manager during this unannounced visit to Trevelyan Road.

One person told us 'I'm very comfortable with my living arrangements here' and another individual said 'I'm satisfied with the support here'. Each individual said that staff treated them with dignity and respect and said that they were able to make their views known.

Comments from people who use the service about the staff who supported them included 'the staff are good here', 'we all talk and interact' and 'the staff are very good to me'.