Archived: Uxbridge Road

¿ Uxbridge Road is a supported living service that provides 24-hour care and support to nine adults with learning disabilities, complex needs and mental health needs. A team of care staff supported people during the day and there were two staff on shift during the night.

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

People’s experience of using this service:

¿ Some aspects of the service did not consistently promote people’s safety. Reasonable actions were not always taken promptly to mitigate risks to people’s safety and well-being when ensuring the care and the management of the use of equipment that was used as part of that care was safe.

because risk assessments were not always updated and reviewed to mitigate risks associated with the environment and equipment they used.

¿ Some sections of people’s care and risk management plans were not always kept up to date. However, staff knew how to support people to reduce the risks to their safety.

¿ Some records of the medicines being stored for two people were not always accurately maintained. The registered manager investigated and addressed these matters promptly.

¿ The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways. People's care and support was person-centred, proactive and coordinated. Support focused on promoting people’s choice and control in how their needs were met. Support and interventions were provided in the least restrictive ways. People were supported to have meaningful opportunities and activities. Staff supported people to access mainstream services and specialist health and social care support.

¿ Staff were aware of people's individual needs and preferences and used their knowledge to deliver person centred care. People and their relatives felt that staff cared and treated them with respect and dignity. Staff were very responsive to people’s needs at any given moment.

¿ Staff could perform their roles effectively as they received training, induction, supervision and support to do so.

¿ Staff supported people to manage behaviours that may challenge others in line with best practice.

¿ The registered manager worked in partnership with health and care professionals and the local community. Relatives, staff and other adult social care professionals told us that the service was managed well.

¿ At the time of the inspection both the halls and stairwells in the main house were being re-decorated. Substantial work was also taking place to refurbish the kitchen in the main house.

Rating at last inspection:

¿ We rated the service “good” at our last inspection. We published our last report on 27 July 2016.

Why we inspected:

¿ This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

¿ We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. We may inspect sooner if we receive any concerning information.

Uxbridge Road is a supported living service providing various levels of personal care support to nine adults who have a range of needs, including learning disabilities, mental health needs and physical needs. There is a main house where seven people lived and an annexe in the garden where two people lived. People lived in individual flats (which comprised a bedroom and en-suite facilities) and there were shared communal areas, for example the kitchen and living room which people could use. People had a tenancy agreement and rented their accommodation. The support hours varied from a few hours per day to one to one support during the whole day. This was dependant on people’s individual needs. The service was staffed 24 hours a day. There were eight people using the service at the time of the inspection as one person was in hospital.

The registered manager had left in February 2016 and the deputy manager, now the acting manager, was in the process of applying to become the 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.

Individual risk management plans were in place and staff were aware of the content and this informed their practice to enable them to support people appropriately. Those records that required clarifying were reviewed and updated during the inspection.

Improvements were being made to the monitoring of the service. Audits were recorded and included the various areas relevant to the service, such as checking staff recruitment information and the details in people’s care records.

People using the service told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm.

People told us that they were involved in their assessment of their needs and were encouraged to be involved in decisions about their care to ensure they received the support the way they liked.

People’s individuality and diversity was taken into account. People were supported to access their local community, take part in social and recreational and activities of their choice. People were supported to build and maintain social relationships so they led fulfilling lives and there were sufficient numbers of staff working to enable them to help people achieve this.

The Mental Capacity Act (2005) had been appropriately applied and the best interest decision making process followed to ensure decisions about people’s care were made collectively by more than one person.

Recruitment and selection procedures were in place and checks had been undertaken before staff began work.

Staff told us that they had access to training and were supported by the acting manager to undertake their role.

Arrangements were in place for the management of medicines and staff had been trained and assessed as competent in medicines administration.

People had access to the relevant health care services when needed to ensure their healthcare needs were met.

People’s views and complaints were listened to, addressed in a timely manner and used to improve the service.

The acting manager made them self available to people who used the service and the staff team. Staff were positive about the management in the service.

The detailed evidence supporting our summary can be read in 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. When the service had identified that someone was at risk, for example of misusing their medications, then they had put strategies in place to minimise those risks.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. The service asked their staff members to complete mandatory training courses which covered the skills needed to carry out the job. New members of staff were carefully checked in terms of their suitability for the role. For example, the service followed-up on references, required photographic identification, and carried out Disclosure and Barring Service (DBS) checks.

Is the service effective?

We found that the service involved people in decisions about their care through the use of key worker meetings. Members of staff could describe strategies for obtaining verbal consent prior to providing personal care. They respected people's wishes if they refused the offer of care.

People's needs had been assessed and suitable support plans were in place. These had not always been regularly reviewed. The manager was aware of this issue and showed us the plans already put in place to promote more accurate record keeping.

Is the service caring?

Care staff knew what was required and were following each person's support plan. People told us that they were happy living at the service. One person said "I like living here. I am independent. I am staying here for good." Another person told us "I am still enjoying it here." Someone else said "It's all right here."

We also spoke with relatives of people who were using the service. They told us the new manager had had a positive impact on the type of care being provided. One relative told us "There is a new manager in charge and she has put some good things in place. Staff morale is much better. My [relative] seems to be happier and I have noticed a change in him."

Is the service responsive?

We examined how the service responded to complaints and concerns as well as what actions they took. We looked at responses to any adverse incidents involving people who used the service. We saw that the service responded to these issues by carrying out investigations and then took actions to resolve any problems.

Is the service well led?

The provider had effective systems to regularly assess and monitor the quality of service that people received. The service had carried out a survey with the people using the service, their relatives and relevant health care professionals about the quality of the care they had received. The manager had worked on a development plan and was taking action when they identified any areas of poor performance. Members of staff were invited to attend meetings where they could raise concerns and the quality of care being provided was discussed.

People expressed their views and were involved in making decisions about their care and treatment. One relative said 'I am always informed about changes to my relative's care, decisions are never made without my involvement.'

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People's needs had been identified and care plans developed to meet their needs.

People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were not always cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff had received induction training when they commenced employment with the service, however they had not received adequate supervision to ensure they could meet the needs of people using the service.

The provider had a system to regularly assess and monitor the quality of service that people receive.