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Inspection Summary


Overall summary & rating

Good

Updated 3 November 2016

This inspection took place on 20 September 2016 and was announced. We also made phone calls to staff, people and their relatives on 26, 27, 28, 29 and 30 September 2016.

We last inspected this service in September 2015. At that inspection we found the provider was not meeting all the regulations. We found suitable arrangements were not in place to support staff through the provision of training, supervision and appraisal, consent to care and treatment had not been obtained from people, recruitment checks were not robust enough and systems in place to monitor and improve the quality of the service were not effective. An action plan was received from the provider which stated they would meet the legal requirements by 20 January 2016. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

18 Portland Terrace is registered to provide personal care to people in their own homes. 18 Portland Terrace has two key parts; Care and Share Associates (CASA) and LIFE. CASA provides care at home services for people in Newcastle including palliative and end of life care. LIFE is an Independent Supported Living (ISL) service for people with learning disabilities, which operates across Newcastle and North Tyneside. At the time of this inspection, 18 Portland Terrace was providing care to approximately 300 people. Of these people, approximately 50 people were being supported by LIFE.

The service had a registered manager. 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 a 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 kept safe from harm. Staff completed safeguarding training as part of their induction and this was refreshed on an annual basis. Staff were aware of the different types of abuse people might experience and of their responsibility for recognising and reporting signs of abuse. People told us they felt safe.

Possible risks to the health and safety of people using the service and the staff members who supported them were assessed. Where risks were identified, care plans were created to provide advice and guidance to staff members on how to safely support the person whilst also taking into account the person’s wishes and rights.

We found improvements had been made to the systems for the recruitment of new staff members. Checks were completed to establish whether potential staff members had criminal records, to determine their right to work in the UK and references were sought to verify the information supplied on their application forms. Recruitment files were reviewed by senior staff members to ensure potential staff members were suitable before they were allowed to work with people.

People were assisted to take their medicines safely by staff who had been appropriately trained. Medication Administration Records (MARs) were returned to the office on a regular basis and checked by senior staff members to ensure people were receiving their medicines as prescribed.

Staff were given the appropriate training and support they required to work effectively. Staff spoke highly of the training they received and the provider encouraged and supported staff to undertake additional qualifications relevant to their roles.

People’s rights were respected and protected. Care staff were aware of the importance of offering people choice and respecting their wishes. Information was provided in people’s care records of any assistance people required to make informed choices about their care. The service was in the process of introducing new documentation which provided addition direction to staff where there were concerns about a person’s capacity to make decisions about their care and treatment.

Care workers were described as kind and caring and people were very positive about the care and support they received from the service. External healthcare professionals told us staff were knowledgeable about the people they supported and acted on advice and guidance.

People using the service received care and treatment that was appropriate to their needs. People and their relatives were encouraged to be involved in their care planning and were consulted on a regular basis about their care and treatment. Spot checks and observations were completed to ensure staff were providing people with appropriate care and support. People’s care plans were reviewed and updated on a regular basis, including following a change in their needs.

Information about the provider’s complaints policy and procedure was made available to people and their relatives. Complaints were investigated thoroughly and written responses provided to complainants about the outcome of their complaints. Action was taken to improve the service in response to complaints and comments from people, their relatives and staff.

People and staff told us the service was well managed. There was a clear management structure in place and staff told us they knew who to contact if they required assistance or advice. Staff and people felt able to raise issues of concerns and that these would be dealt with appropriately. External professionals we spoke with were complimentary about the service.

Improvements had been made to the system for checking the quality of the service although we found the records kept of actions taken were not always clear. We also found the registered manager did not always have a comprehensive oversight of the service due to the delegation of a number of roles and responsibilities. We made a recommendation in relation to this.

Inspection areas

Safe

Good

Updated 3 November 2016

The service was safe.

Staff received safeguarding training and were aware of the signs and symptoms people being abused may display and of their responsibility for reporting any concerns promptly. Records were maintained of safeguarding concerns including actions undertaken by the service to protect people from harm.

Risks to people were assessed and appropriate measures taken to either minimise or mitigate these risks whilst also taking into consideration people’s choice.

Improvements had been made to the systems for checking the suitability of new staff members. Checks were performed by senior staff members to ensure new staff members were suitable for the role before they were signed off to work with people.

People were assisted to take their medicines safely.

Effective

Good

Updated 3 November 2016

The service was effective.

Staff received appropriate levels of training and support and were encouraged and supported to undertake additional qualifications relevant to their roles.

The service worked within the principles of the Mental Capacity Act (MCA) 2005 to protect people’s rights. New care documentation had been introduced to assist staff in determining whether people required support to assist them in making informed decisions about their care and treatment.

People were supported to maintain good health and have access to other healthcare services.

Caring

Good

Updated 3 November 2016

The service was caring. People spoke highly of the caring nature of the staff who supported them.

People were treated as individuals and encouraged to be as independent as possible. The service encouraged people using the service to make choices about their daily lives.

People’s privacy and dignity were respected

Responsive

Good

Updated 3 November 2016

The service was responsive.

People spoke highly of the service they received and felt it was responsive to their needs. People were regularly asked for their views and opinions of the service and the care they received.

People's needs were monitored and reviewed on an on-going basis and where changes were required to people’s package of care, these were made promptly.

Information was provided to people about the provider’s complaints policy and procedure. Complaints were taken seriously and investigated thoroughly. Complainants were informed of the outcome of their complaints in writing.

Well-led

Requires improvement

Updated 3 November 2016

The service was not consistently well-led. Although there were systems in place to monitor and develop the effectiveness of the service we found improvements could be made to the documentation which detailed the action taken to improve the service. We also found through delegating roles and responsibilities to the three care managers the registered manager did not always have oversight of the service in all areas.

People and staff were complimentary about the management of the service. People and their relatives felt able to approach management staff with concerns or issues and that action would be taken to address these. Staff told us they felt supported in their roles and were able to access support when they required it.