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Inspection carried out on 22 August 2017

During a routine inspection

This inspection took place on 22 and 31 August 2017. The first day of our visit was unannounced.

The Helen Ley Care Centre provides nursing care for a maximum of 37 people. At the time of our visit there were 28 people living in the home and four people on respite care.

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.

This service was last inspected in March 2015 when we identified some concerns around the safe management of medicines. We returned in October 2015 and found improvements had been made. We gave this service an overall rating of good.

People felt safe living at The Helen Ley Care Centre because staff knew them well and how to care for them safely. There were enough nursing and care staff to provide effective care in a safe way. However, although staff tried to respond to people's requests in a timely manner, due to the high levels of dependency in the home, sometimes people had to wait for assistance.

Risks associated with people's care were identified and staff were knowledgeable about those risks and how to manage them. Staff completed training in safeguarding and understood their responsibility to report any concerns they had about people’s health or wellbeing.

People were confident their health needs were met and spoke positively of the multi-disciplinary approach and collaborative working with other healthcare professionals. Healthcare professionals shared their knowledge and provided training so staff could be responsive to people’s individual needs. People received their medicines when they needed them and as prescribed.

The provider had effective systems to ensure care staff received training and support that equipped them with the necessary skills and competency to meet people’s complex care needs. Nursing staff received training to ensure they followed best practice and their clinical skills remained up to date.

Staff demonstrated a good working knowledge of their responsibilities under the Mental Capacity Act 2005. People told us they made their own decisions about their day-to-day care and support, and said staff respected their right to decide.

People spoke about the caring attitude of staff in very positive terms, especially the emotional support they received from staff when they were feeling low or anxious. There was a very friendly and inclusive atmosphere within the home with people engaging with each other and staff in a relaxed and comfortable manner. Staff supported people to maintain their dignity and respected their privacy and confidentiality.

Staff worked closely with the dietician and speech and language therapy team to ensure they knew about people’s nutritional preferences, allergies and special dietary requirements. Meal times were a social occasion and people were able to choose what they wanted to eat.

Before people moved to the home, there was a multi-disciplinary assessment to ensure the service could meet each person’s individual and specific needs. Staff provided appropriate care and were responsive to changes in people’s needs. However, inconsistent completion of records did not always evidence that people had received the care as set out in their care plan.

Staff told us they enjoyed working at the home and were motivated to provide people with high quality care. They spoke highly of the registered manager and the support they received, especially at challenging times.

People and their relatives had the opportunity to be involved in decisions about their care and the running of the service. They were invited to care reviews and meetings and encouraged to complete quality assurance questionnaires. People and their family members knew how to mak

Inspection carried out on 2 October 2015

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

The Helen Ley Care Centre provides respite and full time nursing care for up to 35 people with neurological conditions. At the time of our inspection there were 26 people receiving care at the home.

We previously carried out an unannounced comprehensive inspection of this service on 3 and 6 March 2015, at which a breach of the legal requirements was found. This was because medicines were not safely managed in the home.

As a result of the breach of the legal requirements and the impact this had on people who lived at The Helen Ley Care Centre, we rated the key question of ‘Safe’ as ‘Requires improvement’. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘The Helen Ley Care Centre’ on our website at www.cqc.ork.uk.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breach.

We undertook a focused inspection on the 2 October 2015 to check that they had followed their plan and to confirm they now met the legal requirements. At this inspection we found the requirements had been met.

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 and associated Regulations about how the service is run.

Appropriate arrangements were undertaken to manage the risks associated with the unsafe use and management of medicines.

Inspection carried out on 3 and 6 March 2015

During a routine inspection

This inspection took place on 3 and 6 March 2015. It was an unannounced inspection.

The Helen Ley Care Centre provides respite and full time nursing care to people with neurological conditions. The home has 25 beds, of which eight are available for respite care. At the time of our visit 20 people were living at the home.

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.

The home provided a safe environment for people to live. The home and equipment was well maintained and staff knew how to use specialist equipment safely. Staff also knew they had responsibilities to keep people safe and told us they would report any concerns about people’s safety or poor practice to the manager. People told us they felt safe in the home.

Good practice around the management of medicines was not consistently followed to ensure medicines were stored and handled safely.

Staffing levels kept people safe but staff were not always able to respond immediately if people wanted assistance to get up or go to bed at the same time. The provider had responded to concerns about delays by recruiting an extra member of staff to work in the evening.

Staff received regular training to meet the needs of people effectively. Training was also provided to support staff in meeting the specific needs of people who lived at the home.

A variety of healthcare professionals visited the home on a regular basis to meet people’s physical and mental healthcare needs. People had the benefit of in-house therapy services to maintain and improve their health.

Staff responded to people’s needs in a caring and kindly manner. There was a relaxed atmosphere in the home and people and their visitors socialised in communal areas. People were supported to make choices and develop skills so they could maintain a level of independence.

A variety of activities were provided and people were encouraged and supported to involve themselves in planning the activities programme. People told us they would have no hesitation to raise concerns and were confident they would be responded to appropriately.

There was a structured management team in place. However, the registered manager found it difficult to complete all their managerial tasks as they also provided some of the clinical care in the home. The provider was actively recruiting senior staff so the registered manager could concentrate on the managerial or clinical aspects of their role.

Staff told us the registered manager was approachable and supportive and they felt confident to make suggestions about how the service could be improved. Both staff and the people who lived in the home were enthusiastic about ensuring the quality of service provided at the home was maintained.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 1 October 2013

During a routine inspection

During our visit we met with most of the 24 people who used the service and spoke with eight of them about the service they received. We also spoke with two visiting family members.

Some people had complex care needs, which meant they might have had difficulty telling us what it was like to live at Helen Ley Care Centre. We therefore also gathered evidence of people's experience of the service by observing the care they received from staff.

People we spoke with told us they were satisfied with the service they received. One person told us, “I feel safe and happy here.” Another person said, “They think of everything I need.”

People told us that staff treated them with respect and promoted their privacy. People said staff knocked on their door and sought their permission before entering the room and assisting with personal care. One person told us, “Staff treat you with the greatest of respect.”

We observed that staff were familiar with the needs of people who used the service. They were able to interpret the non-verbal prompts or body language some people used to express their wishes.

Sufficient staff were available with appropriate experience and skills to meet the needs of people who used the service.