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Inspection carried out on 19 March 2019

During a routine inspection

About the service: Anahita Recovery Centre is a care home that provides supported accommodation for up to 24 to people who have mental health needs. At the time of the inspection 22 people were using the service.

People’s experience of using this service:

¿ People said they felt safe. There were safeguarding policies and procedures in place and staff had a clear understanding of these procedures.

¿ Appropriate recruitment checks took place before staff started work and there was enough staff available to meet people’s care and support needs.

¿ Risks to people had been assessed and reviewed regularly to ensure people’s needs were safely met.

¿ People were receiving their medicines as prescribed by health care professionals.

¿ The service had procedures in place to reduce the risk of the spread of infections.

¿ Assessments of people’s care and support needs were carried out before they started using the service.

¿ Staff had received training and support relevant to people’s needs.

¿ People were encouraged to cook for themselves and they were supported to maintain a balanced diet.

¿ 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 support this practice.

¿ People said staff treated them in a caring and respectful manner.

¿ People had been consulted about their care and support needs.

¿ People were supported to participate in activities that met their needs.

¿ No one using the service required support with end of life care, however there were procedures in place to make sure people had access to this type of care if it was required.

¿ The service had a complaints procedure in place. People told us they knew how to make a complaint if they were unhappy with the service.

¿ The provider had effective systems in place to assess and monitor the quality of the service.

¿ The service worked in partnership with health and social care providers to plan and deliver an effective service.

¿ The provider took people views into account through satisfaction surveys and residents’ meetings. Feedback from the surveys and meetings was used to improve on the service.

¿ Staff enjoyed working at the service and said they received good support from the registered manager and deputy manager.

Rating at last inspection: Good. (Report was published on 18 October 2016).

Why we inspected: This was a planned inspection based on previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 21 September 2016

During a routine inspection

This inspection was carried out on 21 September 2016 and was unannounced. At our last inspection on 23 June 2014, we found the provider was meeting the regulations in relation to outcomes we inspected.

Anahita Recovery Centre provides supported accommodation for up to 24 people who have mental health needs. There were 22 people living at the centre at the time of this inspection.

The centre had a registered manager in post. The registered manager was also the registered provider. 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 registered manager told us they were leaving at the end of September 2016 and advised us that the provider had appointed a new manager to run the centre. The provider told us the new manager would apply to the CQC to become the registered manager for the centre.

Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work. Risks to people were assessed and support plans and risk assessments provided clear information and guidance for staff on how to support people to meet their needs. People’s medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed training specific to the needs of the people they supported and they received regular supervision and annual appraisals of their work performance. People were provided with sufficient amounts of food and drink to meet their needs. People had access to a GP and other health care professionals when they needed them. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and acted according to this legislation.

People were provided with appropriate information about the centre. This ensured they were aware of the standard of care they should expect. People had been involved in planning for their care needs. People were aware of the complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

The provider recognised the importance of regularly monitoring the quality of the service provided to people. They sought the views of people using the service at residents meetings and where people had made suggestions they had been listened to and acted upon. Staff said they enjoyed working at the centre and they received good support from the registered manager. There was an out of hours on call system in operation that ensured management support and advice was always available when staff needed it.

Inspection carried out on 23 June 2014

During a routine inspection

We gathered evidence against the outcomes we inspected to help answer our five key questions. 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 using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. One person said “Staff supports me to take my medication and remind me when I need to attend appointments. This helps me to keep safe and well.” Another person said “I get help from staff to get my medication from the Doctors, this helps me to keep well.”

There was an out of hours on call system in operation to ensure that management support and advice for staff was always available.

We saw that the fire alarm system was checked on a weekly basis and fire equipment had been checked by engineers. We also saw that a landlord’s gas safety check and portable appliance testing had been carried out by engineers in June 2013.

Is the service effective?

We found that people’s health and care needs were assessed with them, and they were involved in planning their care.

People's care plans described their mental health and physical health needs and provided guidelines for staff on how to best support them. We saw that risk assessments had been completed for example on medication, physical health and mental health relapse. Care plans and risk assessments had been kept under regular review and people were supported to attend medical appointments and meetings with mental health professionals.

Is the service caring?

We observed positive interactions between staff and people using the service during the course of our visit.

We asked people using the service about support they received from staff with their care needs. One person said: “I have a care plan and a key worker. They talk to me about what I need” Another person said “My key worker talks to me about my care needs. We talk about my room, my benefits and my emotions. I get to see my consultants and social workers when I need to”.

There were two small kitchens with kettles, toasters, fridges and microwaves where people could make breakfast, tea and coffee and have snacks throughout the day and night. We also saw fresh fruit was available in the communal area. We saw that people using the services were able to discuss the food provided at the centre and regular residents meetings. We also saw that care files included information about people’s dietary needs and a record of their food likes and dislikes.

Is the service responsive?

There were regular residents meetings where people using the service were able to express their views and opinions about the home. Where people had made suggestions they had been listened to and acted upon. For example, one person wanted to cook meals for themselves, the meeting minutes recorded that arrangements had been agreed for this to happen.

Two people using the service said they knew how to make a complaint if they needed to. They said they had raised concerns with the registered manager in the past and these had resolved promptly and appropriately to their satisfaction. We saw the homes record of complaints including details of how these had been investigated and resolved.

The Royal Borough of Greenwich commissions some services at the centre. We received a copy of a report from the Commissioning Quality Team’s visit carried out at the centre in February 2014. A number of recommendations for improvements were made. We contacted the commissioning officer; they told us there were no current or new concerns regarding this service. They said the centre had addressed all of the recommendations in their report.

Is the service well-led?

We found there were effective systems in place to regularly assess and monitor the quality of service that people received.

Staff told us they enjoyed working at the centre. They said they were up to date with their training and that they received regular supervision and an annual appraisal. One member of staff said “I enjoy working here, there is a very strong team, we support each other and we get good support from the manager and the provider.” Another member of staff said “We work really well as a team. The whole team goes in the same direction to meet the people’s needs.”

Inspection carried out on 3 January 2014

During a routine inspection

We spoke with five people who used the service about their experiences of living at the centre. People told us that they felt better since they moved into the centre. One person said "I am happy here", another said "I am getting most of the support I need". People told us they were happy with the support they received from staff which included help with cooking and cleaning, and support in the community if required. Each person said that sometimes they felt bored when they were at the centre and they would like more activities. People also told us that most of the time they felt safe living at the home, except some who on occasions felt anxious when other people were disruptive.

We found people were involved in planning and reviewing their support needs and objectives, and their independence was promoted. People were also able to make choices and we found these were respected where possible. We found people's care and support needs were assessed, and their care was planned and delivered in line with their needs and objectives. People's mental health was risk assessed and influenced how their support was planned. We found appropriate procedures in place for safeguarding vulnerable adults and staff knew how to report any concerns. The provider supported people through an induction and regular supervision, however improvements were required to staff training. The provider had quality assurance processes in place which were proportionate to the service.