The inspection took place on 19 July 2018 and was unannounced. This was the first inspection of the home since it registered with CQC in June 2017. 187 Nursery Road 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. 187 Nursery Road accommodates up to six people with learning disabilities and/or autism. There were five people living at the home at the time of our inspection.
The 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.
The home is managed by London Care Partnership Limited, a provider of housing and support to people with a variety of needs including autism, learning disabilities and mental health needs.
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 were safe because they lived in a well-maintained environment with enough staff available to provide the care they needed. The rota was planned to ensure there were sufficient staff to keep people safe and meet their needs. Additional staff were deployed if people’s needs changed or they required additional support.
Staff adopted a positive approach to risk-taking which enabled rather than restricted people. Staff understood any risks involved in people’s care and took steps to minimise them. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out appropriate pre-employment checks before staff started work to ensure they were suitable for their roles.
Medicines were managed safely. Accidents and incidents were recorded and reviewed to ensure any steps that could be taken to prevent a recurrence had been implemented. There were plans in place to ensure that people’s care would not be interrupted in the event of an emergency.
People’s care was provided by regular staff who knew their needs well and provided support in a consistent way. Staff had a comprehensive induction when they started work and access to the training they needed for their roles. They met regularly with their line managers for reflective practice meetings which provided opportunities to discuss their performance and any training needs.
People’s needs had been assessed before they moved to the home. Transitions between services were well-planned and managed, which had enabled people to settle in quickly and successfully. People were supported to exercise 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’s dietary needs were met and they were encouraged to choose what they ate whilst maintaining a healthy weight and diet. Staff supported people to stay healthy and to obtain treatment if they needed it. Staff were observant of any changes in people’s healthcare needs and responded promptly if they became unwell. People who had ongoing conditions were supported to see specialist healthcare professionals regularly.
Staff were kind and caring and had established positive relationships with the people they supported. Relatives told us staff worked hard to provide the support their family members needed. Staff treated people with respect and maintained their dignity. Relatives told us staff encouraged their family members to perform tasks with support, which maximised their independence. People were supported to maintain relationships with their friends and families. Staff kept people’s relatives up to date with important events and informed them promptly about any concerns.
People received care that was tailored to their individual needs. Staff consulted people and their relatives when planning people’s care and involved relevant professionals where necessary. People had opportunities to take part in activities they enjoyed. Staff encouraged and promoted people’s involvement in their local community.
There were appropriate procedures for managing complaints. Relatives told us the registered manager had responded positively to any issues they had raised.
Relatives, professionals and staff told us the home was well managed. Relatives said the registered manager was approachable and always made themselves available if they wished to discuss any aspect of their family member’s care.
Staff understood the provider’s values and demonstrated these values in their practice. There were clear expectations about the quality of care and support people had a right to expect. The provider was a person-focused organisation and the views of people who used services were listened to and acted upon. The provider welcomed feedback from people, relative and professionals and used this to improve the service.
Staff were well supported by the registered manager and had opportunities for professional development within the organisation. Staff felt valued for the work they did and told us their suggestions for improvements were encouraged. They told us the registered manager supported the team well and led by example in their approach to supporting people. The registered manager and team leaders had attended development coaching to improve their skills in supporting staff. The provider had effective systems of quality monitoring, which involved people who used services.
Staff shared important information about people’s needs effectively. Team meetings were used to ensure staff were providing people’s care in a consistent way that reflected best practice. Professionals provided positive feedback about the way in which staff worked with them to ensure people received good quality care that met their individual needs. Staff also had access to advice and guidance from specialist professionals employed by the provider, such as the Positive Behaviour Support Team.
The standard of record-keeping was good and personal information was kept confidential. The registered manager kept up to date with changes in legislation and best practice and had informed CQC about notifiable events when necessary.
Further information is in the detailed findings below.