The inspection took place on8,10 and 15December 2015 and was unannounced.
No.18 provides accommodation and care across two houses, to three adults with a learning disability. On the day of the inspection three people were using the service.
The service had 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.
No. 18 is part of Bowden Derra Park, a complex of residential accommodation. The registered manager was also responsible for the other Bowden Derra Park services. No. 18 had a deputy manager who oversaw the day to day running of the service.
People and staff were relaxed throughout our inspection. There was a calm, friendly and homely atmosphere. People’s records were personalised and were being updated to reflect people's needs more accurately and how they wanted them to be met. There were sufficient staff to meet people’s needs.
Staff responded quickly to people’s changing needs. Relatives were involved in reviewing people's needs and how they would like to be supported and the service planned to involve people more fully also.
People’s preferences were identified and respected. Staff put people at the heart of their work; they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed and staff focused on people rather than on tasks.
Staff received a comprehensive induction programme and were trained to carry out their roles effectively. Staff were knowledgeable about the people they were supporting and had an in-depth appreciation of how to respect people’s individual needs around their privacy and dignity. People’s risks were managed well and monitored.
People were supported to take part in a range of activities which reflected their interests. However, staff, relatives and a healthcare professional we spoke with felt people could be supported to do more activities at home and in the local community based on their needs and interests.
People’s medicines were managed safely. People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers, learning disability nurses and occupational therapists.
All staff had undertaken training on safeguarding vulnerable adults from abuse and demonstrated a good knowledge of how to identify and report any concerns. Staff described what action they would take to protect people from harm. Staff felt confident any incidents or allegations would be fully investigated.
People were protected by safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.
Relatives and friends were made to feel welcome and people were supported to maintain relationships with those who mattered to them. People and those who mattered to them knew how to raise concerns and make complaints. Complaints had been recorded, investigated and the outcome fed back to the complainant.
Staff understood their role with regards to the Mental Capacity Act (MCA) (2005) and the associated Deprivation of Liberty Safeguards (DoLs). The MCA aims to empower and protect people who may not be able to make some decisions for themselves. DoLS are used to protect the rights of people who lack the ability to make certain decisions for themselves and make sure that their freedom is not inappropriately restricted.
There were effective quality assurance systems in place. The registered manager followed a monthly and annual cycle of quality assurance activities. Staff described the management as supportive and approachable.