61 Track Road

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service was delivered in line with these values.

People’s experience of using this service:

¿ People told us they felt safe at Track Road. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse had taken place. Safe recruitment and selection processes were in place.

¿ Risk assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Staff were trained and competent to administer medicines.

¿ Staff felt supported with an induction and role specific training, which ensured they had the knowledge and skills to support the people who lived at the home. People were supported to eat a balanced diet, and meals were planned around their tastes and preferences.

¿ People received a good level of support to lead fulfilling lives and achieve their aspirations. They were supported to maintain good health and had access to healthcare professionals and services.

¿ 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 supported this practice. Evidence of best interest discussions, where required, was not always available. The registered manager sent us evidence these were completed following our inspection.

¿ Staff were caring and supported people in a way that maintained their dignity, privacy, independence and diverse needs.

¿ People experienced person centred care and engaged in social and leisure activities which they chose.

¿ The registered provider had good systems of governance in place to drive improvements to the quality of the service.

¿ Further information is in the detailed findings below.

Rating at last inspection: At the last inspection the service was rated good and remained good at this inspection (last report published 19 August 2016).

Why we inspected: This was a planned comprehensive inspection which took place on 27 February 2019 and was announced.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We last inspected the service in January 2014 and found that it was not in breach of any regulations at that time.

61 Track Road is a four bedroomed house in a residential area. The house accommodates up to four people with autism and/or learning disabilities. There is a lounge, dining room and kitchen and each person had their own individualised room. There were four people living in the home at the time of the inspection.

The home had a registered manager in place. 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.

At the time of our inspection the registered manager was also manager at two of the registered provider’s other services in the area.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns without fear of recrimination. The registered provider had up to date safeguarding and whistle blowing policies in place and information on how to report any concerns was displayed within the service.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work. The checks included obtaining references from previous employers to ensure that staff were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced and checked such as fire equipment and electrical safety. The records showed that the temperature of the water as it left the boiler was not reaching the minimum recommended and this was being investigated by the registered provider.

Staff received appropriate training and demonstrated that they had the skills and knowledge to provide support to the people they cared for. Staff also received regular supervisions and annual appraisals.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

The records we viewed showed us that people had appropriate access to health care professionals such as dentists and opticians.

We saw that people were provided with a choice of healthy food and drinks to help ensure their nutritional needs were met. People were involved in the menu planning and shopping and staff demonstrated a good knowledge of people’s dietary preferences.

During our inspection we saw people engaged with staff in a positive way. From our observations it was clear that staff knew the people who lived at the service well and we saw that they responded to their care needs accordingly.

We observed that people were encouraged to be independent and to participate in activities that were meaningful to them. People were supported to go out into the local community on a day to day basis and also went on holidays of their choice.

We looked at support plans and found that they were written in a person centred way and included information about the goals people were hoping to achieve.

The registered provider and registered manager had systems in place for monitoring and assessing the service. Action plans were produced to address any issues identified during the quality assurance process and any necessary changes were implemented.

We spoke with staff who told us they felt supported and that the registered manager was always available and approachable. The registered manager also felt suitably supported by the registered provider. Throughout our visit we saw that people who used the service and staff were comfortable and relaxed with the registered manager and each other. Staff were observed to be caring and respected people’s privacy and dignity. There was a relaxed atmosphere and we saw staff interacted with each other and people who used the service in a very friendly and respectful manner.

We used a number of different methods to help us understand the experiences of the people who used the service, because the people who used the service had complex needs.

Care records had information on people's daily routine. They described what time people liked to get up, what they liked to eat and drink, and how they liked to spend their days.

People's needs were assessed and care and treatment was planned in line with their individual care plan.

Records were well laid out, easy to follow, legible and comprehensive. Each record contained information on a development and support plan which had long and short term goals. We saw that people had daily and monthly objectives and that these had been reviewed and were up to date.

Care plans reflected a person centred approach and covered areas such as personal care, mobility, communication, medication and challenging behaviour.

We saw that the home had policies and procedures in place to safeguard people from abuse.

We saw from training records that all of the staff had received training in safeguarding and were able to demonstrate a clear understanding of the learning.

We looked at two staff records which showed that staff were up to date and had received training across areas such as infection control, safeguarding vulnerable adults, medication, food hygiene and equality and diversity.

We asked how the provider monitored the quality of the care delivered. We spent time observing the care and interaction between staff and people who use the service. We spoke with staff and the manager about the care and wellbeing of people who use the service. We also gathered evidence of people's experiences of the service by reviewing care records and quality assurance documentation.