The Care Quality Commission
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Archived: St Lukes

Overall: Good read more about inspection ratings

Flats 1-5, 26 St Lukes Close, Cannock, Staffordshire, WS11 1BB 07407 731243

Provided and run by:
Turning Point

All Inspections

28 March 2018

During a routine inspection

We inspected this service on 7 March 2018. St Lukes provides care and support for five people living in a 'supported living' setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The people who live at St Lukes have learning disabilities and 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. At the time of the inspection, there were two people living there.

At our last inspection on 2 March 2016, we rated the service 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 ongoing 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.

People continued to receive safe care. Staff had a good understanding of what constituted abuse and knew what actions to take if they had any concerns about people’s safety? Risks associated with people’s care were assessed and managed. Incidents and accidents were investigated thoroughly to ensure lessons were learnt and improvements made to minimise the risk of reoccurrence. There were systems in place to ensure people were protected by the prevention and control of infection. People received their medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines. There were sufficient, suitably recruited staff to meet people’s needs.

People continued to be cared for effectively. People were supported to enjoy their meals and their dietary needs and preferences were met. Staff were supported and trained to ensure people received care and support in line with best practice. People were supported to access healthcare professionals to help maintain their day to day health needs. The home was adapted and decorated to meet people’s individual needs and preferences. 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 the service supported this practice.

The care people received remained good. Staff had formed positive, caring relationships with people. People’s privacy and dignity was promoted at all times.

The service remained responsive. People received personalised care that met their individual needs. Staff understood people’s diverse needs and supported people to follow their interests and engage in activities they enjoyed. People and their relatives were able to raise any concerns or complaints and were confident these would be acted on.

The service remained well led. Staff felt supported and valued by the management team. There were suitable systems in place to continuously assess, monitor and improve the quality and safety of the service. The provider encouraged people, their relatives and staff to give feedback on how the service could be improved to make improvements where needed.

Further information is in the detailed findings below.

2 March 2016

During a routine inspection

We inspected this service on 2 March 2016. This was an announced inspection and we telephoned 48 hours’ prior to our inspection in order to arrange to meet with people who use the service. At our last inspection in November 2014, the service was rated as good overall. However, we asked the provider to make improvements to ensure people were involved in reviewing their care and support. We also asked the provider to improve the systems they used to gather feedback on the quality of the service, including the recording of complaints.

St Luke’s Court is a supported living scheme that providers care and support to five people with a learning disability. On the day of the inspection, there were five people living at the service.

There was a registered manager at the service. 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 understood their responsibilities to keep people safe from the risk of abuse. There were systems and processes in place to protect people from the risk of harm. Staff received the training and support they needed to meet people’s individual needs and an induction programme was in place to support new staff to understand their role. There were enough staff to meet people’s needs and checks were made to confirm staff were suitable to work in a care environment. People received their medicines as prescribed.

Staff had caring relationships with people and respected their privacy and dignity. Staff welcomed people’s visitors to ensure their important relationships were maintained. People’s dietary needs and preferences were met and they were supported to access other health professionals to maintain good health.

People were supported to make their own decisions as much as possible, but where they lacked the capacity to do so, decisions were made in their best interests. People were supported to take part in activities both inside and outside of the home.

There was an open and inclusive atmosphere at the service. People and their relatives were supported to raise concerns and complaints. Arrangements were in place to gather people’s feedback to make improvements to the service where needed. The registered manager carried out checks to ensure people received a good service. Staff felt valued and supported by the registered manager and provider.

27 November 2014

During a routine inspection

This inspection took place on the 27 November 2014 and was unannounced.

St Lukes Court is a supported living scheme that provides care and support to five people with a learning disability.

The service requires a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager was in the process of registering with us (CQC).

At our previous inspection we found that there were insufficient staff to keep people safe. We found that people’s care plans were not always followed and this meant that people did not always receive the care they required. We had found the provider did not have effective quality monitoring systems in place. At this inspection we found staffing numbers had been increased, care was being delivered which met people’s assessed needs and the provider’s quality monitoring systems had been effective.

People who used the service were unable to tell us if the care they received was good. The relatives we spoke with had a mixture of views about the care their relative received.

The provider had systems in place to keep people safe. The manager and staff knew what constituted abuse and reported any incidents of suspected abuse appropriately.

Staff were assessed as competent before administering any medication. Records showed that people had their medication at the prescribed times.

Staff were well trained and supported to fulfil their role. The provider had robust recruitment process in place. Arrangements were in place to ensure that newly employed staff received an induction and opportunities for training. Records also showed that staff received regular supervision.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs) and to report on what we find. The Deprivation of Liberty Safeguards are for people who cannot make a decision about the way they are being treated or cared for and where other people are having to make this decision for them. The manager told us that they had raised several DoLS referrals with the local authority.

People’s health care needs were met through close monitoring and with support from external agencies. When people’s needs changed this was quickly noticed and the relevant support was gained.

When people had specific nutritional needs these were met by competently trained staff.

The provider supported people to be as independent as they were able and to maintain and make friendships.

Care was planned and personalised. Records, observations and discussions with staff demonstrated that people using the service were at the centre of the care being delivered. Regular reviews took place to ensure that where people’s preferences had changed this was identified, however we could not see how the person themselves or their representative had been involved.

The provider told us that they had responded to people’s complaints and concerns in line with the complaints procedure, however there was no clear audit trail of complaints raised and the outcome.

Staff told us that the new manager was approachable and supportive. Quality monitoring systems were in place to ensure continuous improvements were identified and made.

10 April 2014

During a routine inspection

We visited St Lukes on a planned scheduled inspection. We had informed the service the day before of our planned visit to ensure someone would be available to facilitate the inspection. We spoke with staff supporting people who used the service, relatives, social care professionals, looked at records and observed people's care. At our previous inspections in August and November 2013 we had concerns that people's care and welfare needs were met and records that supported staff to care for people were not appropriately completed. We looked to see if improvements had been made.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is it Safe?

The service had a safeguarding policy. Staff we spoke with had received training and knew how to keep people safe.

We observed and we were told that there were times when there were insufficient staff to meet the care and welfare needs of people who used the service. This meant that people were not always receiving safe appropriate care. A relative told us: 'I do worry that my relative is not safe when I'm not there'.

Is it Responsive?

Records showed that people who used the service or their representatives had been involved in the planning of their care.

We saw that when a person lacked capacity to make decisions for themselves, the relevant people had been involved in supporting the person.

Is it Effective?

We saw that people had an assessment of their care and support needs. The assessments highlighted the need for specialist equipment and specific health care interventions. We could not always see that people's specific health interventions had been met by staff.

People had access to a range of health care professionals who visited them in their homes. We saw that generally health care appointments were kept but there had been occasions that the service had not ensured people had attended their appointment.

People who used the service accessed the community supported by staff. Two relatives told us that they were concerned that resources that were available were not always utilised effectively due to lack of staff.

Is it Caring?

We observed staff spoke to people with dignity and respect. Staff showed patience and encouragement. People looked well cared for and dressed appropriately in their individual style.

Staff we spoke with were kind and respectful about the people they supported. We were told people got together at the weekend for group activities which they enjoyed.

Is it Well Led?

The service did not have a registered manager. The manager in place told us they were leaving. We saw that the current manager had made improvements to the records kept within the service.

The service had a quality assurance system to monitor and improve the service.

We saw that action had been taken to make some improvements identified at our previous inspections but we still had concerns that there were insufficient staff to meet the care and welfare needs of people who used the service.

25, 26 November 2013

During an inspection looking at part of the service

This was a visit to check whether the provider had taken action to address issues identified at the last inspection. We spoke with managers, support staff and relatives. We spent some time observing care provided to people. In this report the name of a registered manager appears. They were not in post at the time of the inspection but their name appears because they were on our register at the time.

Relatives were satisfied with their relative's care and hoped that improvements recently made would continue.

At the previous inspection care was not always provided in the way described in people's plans of care. At this inspection the provider had addressed the issues we had previously raised but we saw there were other areas of care that people did not receive.

When we visited last time agency staff did not have the necessary checks and training to provide people with a satisfactory standard of care. On this inspection we saw that the provider had put in a procedure to check agency staff were suitable to work at the service. The provider did not have records for agency staff that had worked at the service for some time. Agency staff confirmed they were trained by the provider to undertake their role but there were no records to confirm this.

Permanent staff that worked at the service had the training required to provide people's care. Training records were not kept up to date to confirm that this training had been provided.

30 July and 1 August 2013

During a routine inspection

This was a scheduled inspection. We told the manager we were visiting one day in advance. This was to make sure that people were available to speak with us.

We were unable to speak with people that received a service. Relatives we spoke with were pleased with the service and felt that their relative's needs were being met.

Systems were in place to gain the views of people that received a service. Information was available to help staff to understand people's specialist communication needs.

The service completed comprehensive assessments and plans of care were personalised to give staff the information to provide people with safe care. People were supported to have their health care needs met. Records did not always confirm that some parts of people's care were provided.

People received the hours of care they had been assessed as needing to meet their needs. However due to nature of the service some people's care was disrupted when staff needed to provide additional care to other people.

The service provided a range of training but not all staff had received all the training needed to provide people with care safely. Systems were in place to support staff but not all staff had received individual supervision.

The way the service recruited agency staff was not ensuring they were suitable to work at the service.

Systems were in place to review and monitor the quality of care people received.