Reevy Road Care Home

We found the following examples of good practice.

Visitors were tested on arrival or had to present a negative COVID-19 test which was completed just before they arrived at the service. There was signage to explain what everyone should do to ensure infection control measures were followed.

Alternative forms of maintaining social contact were used for friends and relatives who were unable to visit; for example: keeping in touch using video and telephone calls.

The service had effective processes in place so clothes were laundered safely.

PPE was situated throughout the building and staff were observed wearing appropriate PPE.

Staff received training around infection prevention and only worked in this service, to reduce the risk of transmission of the COVID-19 virus.

The service had an Infection Prevention and Control policy that was up to date and had been audited during the pandemic to reflect best practice.

Further information is in the detailed findings below.

People’s experience of using this service:

The service continued to be safe. People were protected by staff who knew them well and understood how to prevent avoidable harm. Risk assessments had been carried out and guidance given to staff to promote people’s well-being.

Pre-employment checks on staff were undertaken to see if they were suitable to work in the service. Once employed, staff were supported through an induction, training and supervision.

Systems were in place to manage people’s medicines safely. Staff had been trained on how to correctly administer medicines.

Relatives told us staff and the registered manager were responsive to any concerns they wished to raise about the service.

Staff were aware of people’s dietary needs. The menu gave people choices and met the needs of people of differing religious backgrounds. Staff treated people equally and respected their preferences.

The building was clean, tidy and free from odours. Adaptations had been made to the building which supported people’s free movement around the home.

Documentation was up to date and accurate. Staff worked in partnership with families and professionals from different backgrounds to seek information, advice and guidance on how to meet people’s needs..

Staff had developed end of life plans with people and their relatives if it was appropriate. However, they also respected people’s wishes not to discuss this sensitive issue.

We found people were treated with kindness. Staff and been trained in dignity and had certificates to say they had become dignity champions.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

The service continued to be well led by a registered manager who carried out a comprehensive review of the service when they came into post in October 2018. This led to an action being developed to make service improvements. Relatives and staff were complimentary about the registered manager and the changes they were making to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good. (Last report published October 2016).

Why we inspected: This was a scheduled inspection based on previous rating to check that this service remained Good.

Follow up: We will continue to monitor this service with partner agencies and through information sent to us by the provider. Our next inspection will be carried out in line with our inspection scheduling unless information of concern comes to light. Should concerns arise we may bring forward our next inspection.

The home had a manager, however they were not 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. The manager told us they had submitted their application to the Care quality Commission and was awaiting a date for their fit person interview.

Reevy Road provides care and accommodation for up to 24 people who have a learning disability. The home is situated in a residential area of Bradford. In addition to residential care the service provided support and encouragement to people to enable them to move onto supported living. There are three separate units within the service; however people are able to access all of the building if they choose. Bluebell unit can accommodate a maximum number of seven people with a view to moving on to supported / independent living. Rose unit can accommodate a maximum number of five people some of who have a behaviour that challenges and Lavender unit can accommodate a maximum number of 12 people who have a higher dependency of needs. At the time of the inspection there were total of 18 people who used the service.

Systems were in place to make sure people received their medicines safely. However, some improvements were needed. Staff had not had their competency assessed on a regular basis to administer medicines safely but the registered provider had already identified this failing and had plans to complete this by the end of 2016. Stock control needed to improve as the current system resulted in lots of wastage. Staff were ordering new medicines for people when some unused medicines could be carried over and used in the next month. The room where medicines were stored was not taken and recorded to make sure it was the right temperature in which to store medicines.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Staff were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

There were sufficient staff on duty to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. However, on the day of the inspection we identified that the upstairs windows did not have window restrictors in place. The manager took action on the day of the inspection to address this urgent matter and confirmed after the inspection that all upstairs windows had been restricted in the two days following the inspection.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Risk assessments had been personalised to each individual and covered areas such as moving and handling; behaviour that challenged; nutrition and hydration and choking. This enabled staff to have the guidance they needed to help people to remain safe.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards, which meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that staff had received supervision on a regular basis and an annual appraisal.

We saw that people were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional needs were met. People were weighed on a regular basis and received nutritional screening.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We saw that people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.

Assessments were undertaken to identify people’s care, health and support needs as well as any risks to people who used the service and others. Plans were in place to reduce the risks identified. Care plans were developed with people who used the service and relatives to identify how they wanted to be supported.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. Staff told us how they encouraged and supported people to access activities within the community.

The registered provider had a system in place for responding to people’s concerns and complaints. Relatives told us they knew how to complain and felt confident that staff would respond and take action to support them. People and relatives we spoke with did not raise any complaints or concerns about the service.

There were systems in place to monitor and improve the quality of the service provided. We saw there were a range of audits carried out by the manager with further checks from line management. A senior manager in the organisation visited the service on a regular basis to monitor the quality of the service. However, records of these visits were not available for inspection.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff we spoke with understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care.

People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities inside and outside the service regularly.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People knew how to make a complaint if they were unhappy. People told us they had never needed to make a complaint but if they did they thought complaints would be investigated and action taken as necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

The relatives we spoke with were all very complimentary of the care at the home. Their comments included; 'I would recommend it here, wonderful place', 'Fabulous, the key worker has been brilliant understanding our needs' and 'They are looked after so well here.'

The provider had appropriate systems in place to ensure valid consent was obtained from people before staff assisted with care.

We found people's needs were fully assessed so that appropriate care was planned and delivered.

We found the premises secure, of suitable design and layout and maintained.

Staff were provided with support to undertake their role effectively. This included a structured training programme and regular supervision and appraisals.

Systems were in place to regularly monitor and assess the quality of the service and ensure any risks to people's health, safety and welfare were identified and managed.

We spoke with two people that used the service and one person indicated that they enjoyed the activities at the home and the second person acknowledged that they liked living at the home.