Gleneagle House

Sophia Maria House is registered to provide accommodation for up to seven women who require support with their mental health needs. At the time of the inspection there were seven people living at the service.

This inspection took place on 20 November 2018 and was unannounced.

At the last inspection, carried out on 21 June 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

Staff followed the provider’s procedures to support people to stay safe from abuse and from any incidents and accidents occurring. Staff carried out pre-employment checks before they started working with people to ensure their suitability for the role. Some people told us there was not enough staff to support them during the day, but we found that staffing levels were regularly assessed to meet people’s care and support needs.

Comprehensive risk assessments were in place to protect people from potential risks in the community. However, there were no risk assessments for people who smoked, some medicines protocols were not provided for staff and information was missing on the actions staff had to take to support people to leave the building safely in an event of fire. The registered manager took immediate action to address these concerns and updated records to ensure people’s safety.

Where people required support to prepare their meals or attend to their health needs, staff provided them with appropriate assistance.

Mental Capacity Act (2005) principles were followed by staff to support people in the decision-making process.

Systems were in place to review and monitor staff’s developmental needs. Staff completed training relevant to their role to ensure they had the required knowledge and skills to support people effectively. Although staff were aware of people’s mental health needs, they were not provided with a mental health awareness training. This was addressed by the registered manager in a timely manner after the inspection.

Staff were caring towards people’s support needs and helped people to make decisions related to their daily lives. People were encouraged to be as independent as possible and make choices about their everyday activities. Staff provided support that was respectful towards people’s care needs and privacy. People had assistance to maintain their relationships where necessary.

People were involved in planning their care and staff had access to information on how people wanted to be supported. People’s care needs were assessed and recorded appropriately to ensure consistent care provision. People provided feedback about the services they received.

People, health professionals and the staff members we spoke to felt that the service was well led which ensured good care for people. Systems were in place to support and motivate staff in their role and to encourage them to take responsibility for the care provision. Quality assurance processes were used to monitor staff’s performance and to review care records making sure they reflected people’s changing needs.

At the last inspection on 30 July 2014, the service was meeting the regulations we inspected.

The service has 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider had a safeguarding policy in place which gave staff guidance on how to protect people from harm and abuse. Staff demonstrated their awareness of the signs of abuse and the registered manager knew how to raise an allegation of abuse with the local authority safeguarding team.

Staff identified risks to people and these were managed. Staff developed risk management plans that gave guidance to staff on how to manage the identified risks and reduce their recurrence.

The service had sufficient numbers of staff available to meet people’s support needs. The staff rota showed that there was sufficient staff on duty during the day, evening and night shifts to support people. The level of staff was flexible to meet the needs of people to attend appointments or events outside of the service.

The management and administration of people’s medicines were safe. People received their medicines as prescribed and staff ensured people received the appropriate support with managing their medicines as needed. Staff ensured people’s medicines were re-ordered on a regular basis so these did not run out. There were systems in place for the safe administration, storage, and disposal of people’s medicines.

Staff had access to regular training and reflected on their working practices. The registered manager supported staff to undertake training which was relevant to their role and improved their knowledge in how to care for people effectively. Staff were supported by senior staff with regular supervision and appraisal to support them to identify their training and professional development needs.

People were supported to give their consent to care and support they received. People signed their care records to demonstrate that they understood their care arrangements in place for them. Staff were aware of their role and responsibilities in providing support to people within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were able to make choices on the meals they received. People were encouraged to prepare their own breakfasts if able and to support staff in the preparation of the lunch or evening meals. People made choices of the meals they wanted and they were able to make changes to this if they required. People had meals that met their health, nutritional needs and their preferences.

People’s health care needs were met by health professionals when required. Staff sought professional health care advice for people as and when needed to support people to maintain their health and well being. Staff demonstrated that they knew people well because they knew people’s personal histories. This helped staff to understand people’s likes and dislikes and involve them in making decisions about how they wanted to receive care and support.

People and their relatives contributed and were involved in planning their care. Care and support needs were person centred and people were cared for in a way that met their choices. Staff showed people kindness and compassion when speaking and when delivering care to them. Care and support delivered to people demonstrated staff valued them and respected their dignity and privacy.

People had the opportunity to participate in both in house activities and community based activities if they chose. Staff promoted and encouraged people’s independence and supported them to maintain relationships with friends, relatives and people that mattered to them.

The registered provider had systems in place that people or their relative was able to make a complaint. People were aware of the process of how to make a complaint about the care they received or if they were unhappy with any aspect of the service. People received a copy of the provider’s complaint policy and were confident that staff would deal with their complaint appropriately.

The service supported staff to be involved in the development of the service. Staff had the opportunity to discuss their opinions, share their ideas and views to develop the service. The registered manager informed the Care Quality Commission of notifiable incidents, which occurred at the service. The provider had systems in place that monitored, and reviewed the service to improve the quality of care to people. Staff completed regular checks of the service to ensure people were cared for in a safe environment.

The registered provider completed regular checks on the service to ensure it was of good quality. The registered manager developed a plan of action and shared these with the staff with details of associated actions points. Staff implemented service improvement plans to help develop the service and to ensure people received effective quality of care.

The service worked in partnership with local health and social services departments. The registered manager and staff developed relationships with commissioning teams outside of their local area because people had their care co-ordinated by different local authorities.

People were supported to maintain their independence and access the community. People were encouraged to undertake activities of daily living for themselves, with staff available for support if required.

Each person using the service had a care plan tailored to their support needs. The care plans addressed any support required regarding their mental health, physical health, social and financial needs.

People using the service told us they felt safe. People were protected from the risk of abuse and staff demonstrated knowledge in recognising potential signs of abuse.

There were effective recruitment and selection processes, and required checks had been undertaken before staff started work.

Staff regularly obtained the views of people using the service to monitor the quality of service provision. There were monitoring checks undertaken regarding record keeping, care delivery and health and safety aspects of the service.