Sheffield Crisis House

Sheffield Crisis House is a residential care home providing short term support to people experiencing a mental health crisis. Sheffield Crisis House is registered to provide accommodation for persons who require nursing or personal care. However, it is a condition of the registered provider's registration they must not provide nursing care. The service can provide support to up to 7 people. At the time of our inspection there were 3 people using the service.

People’s experience of the service and what we found:

People were safeguarded from the risk of abuse. People told us they felt safe during their short term stays at the service. Risks posed to people were assessed upon admission and mitigated. Environmental safety checks were regularly conducted to protect people from risks during a period of mental health crisis. However, radiator covers which protect people from the risks of burns, were not in place at the time of the inspection. The provider had recognised this, and plans were in place to ensure all radiators were safely covered.

People were supported by enough staff. Staff were recruited safely, and people and relatives told us staff were kind and caring. Where people were supported to take their medicines, this was safely managed. Staff were trained and understood their roles in relation to infection, prevention and control. The service was visibly clean and audit systems were in place to ensure staff adhered to and promoted appropriate infection control practices. The provider had systems in place to monitor accidents and incidents. Action was taken to mitigate future risks to people and learn lessons from them.

Care records were individualised and contained information about people's preferences and needs. Staff felt supported in their roles and told us morale was good within the team. Staff received regular supervisions and attended team meetings, to provide them with opportunities to raise concerns and make suggestions.

Overarching governance systems were in place to ensure the provider monitored the quality and safety of the service. The service had a welcoming and calm atmosphere. People and relatives told us the service was well led. Feedback was sought from people upon them leaving the service and used to improve the quality of care. There had been no formal complaints made at the time of our inspection, people and staff understood how to raise concerns if needed.

The registered manager understood their roles under duty of candour and made external reports to CQC and the local authority, where required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was Good (published 12 September 2018).

At our last inspection we recommended the provider updated fire safety records, reviewed staffing allocations and updated some care records. At this inspection we found the provider had taken action to improve in these areas.

Why we inspected

This inspection was prompted by the time since the last inspection at the service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Sheffield Crisis House on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The premises were clean. Staff completed enhanced cleaning of frequently touched surfaces.

Staff completed infection prevention and control (IPC) training and were observed to be wearing the correct personal protective equipment (PPE) and following best practice.

Staff were involved in regular COVID-19 testing and the provider made sure they were following the legal requirement for all staff and relevant visitors, such as health and social care professionals, to have had the COVID-19 vaccine.

The provider was facilitating visits for people living in the home in accordance with the current guidance.

Sheffield Crisis House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sheffield Crisis House is registered to provide accommodation for persons who require nursing or personal care. However, it is a condition of the registered provider’s registration they must not provide nursing care at Sheffield Crisis House. The service provides short-term accommodation for people experiencing a mental health crisis. Staff provide 24 hour emotional and practical support to assist people to resolve their crisis. The service has six beds and is located in a residential area of Sheffield. There is a bedroom on the ground floor of the property suitable for people with mobility difficulties. The remaining floors are accessed by stairs. At the time of the inspection there were four people living at the service.

There was a manager at the service who was registered with the CQC. 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 our last inspection 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. We have made four recommendations in our report, which means we expect the registered provider to consider our feedback and make improvements before the next inspection.

People living at the service told us they felt safe. Staff had completed safeguarding adults training and were aware of their responsibilities in protecting people from abuse. We saw systems in place to evacuate people safely in the event of an emergency. However, we identified people’s personal evacuation plans were not always being completed and therefore made a recommendation for the registered provider to prioritise completion of the same. On the day of the inspection we found there were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited. However, staff told us they sometimes felt rushed. We made a recommendation about the staffing arrangements at the service.

We found very clear evidence that people’s care and support was planned and reviewed with them and not for them. The people we spoke with told us the standard of care they received was good. We made two recommendations about the information recorded in people’s care records.

The service encouraged people to maintain a healthy diet and worked collaboratively with external health services to promote people's wellbeing and positive discharge outcomes. Staff told us they enjoyed working at the service and had received support, training and supervision to help them to carry out their support role effectively. 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 support this practice.

People said they were treated with respect and dignity, and staff supported them in a way which met their needs. People told us staff were caring and kind and as a result of the emotional support they had received they felt more confident. We saw the service promoted people’s independence by supporting people to manage their own routines, such as cooking, cleaning and washing. People who were as assessed safe to do so were supported to administer their own medication and had access to a lockable safe in their room. People were able to access their local community and the service provided regular opportunities for meaningful and stimulating social diversions, with an emphasis on improving people’s mental well-being.

Information about people's experience of Sheffield Crisis House was gained by speaking with three people staying at the service and by reviewing questionnaires about the quality of the service which had been completed by people following their stay. Information was also gained by speaking with the registered manager and with the two support workers on duty at the time of our inspection. We also reviewed a range of records.

Each person was positive about the support they received. One person described Sheffield Crisis House as, 'nice, friendly and relaxing.'

People said that they felt safe at the service. Each person commented that staff being available at all times had a positive impact upon their sense of safety. Our conversations with staff and our check of records demonstrated that the service were aware of, and followed local safeguarding procedures in order to safeguard people.

People were protected against the risks of unsafe or unsuitable premises. One person described the premises as, "safe and clean." We found that a number of daily and weekly checks were in place to ensure the safety of fixtures and fittings within the property.

Prior to the inspection we had contacted the service and asked for information about the steps taken following the incident to ensure safe care, treatment and support of people using the service. This information was provided within the required timescale and contributed to our inspection.

We found that people supported by the service at the time of our inspection were positive about the care and support they had received. Comments within completed surveys were also positive, one comment described the service as, "an amazing environment for recovery."

Whilst the provider demonstrated knowledge and awareness of safeguarding, local guidance and reporting procedures had not been followed to ensure that people who used the service were safeguarded from abuse. Observations of the premises and our review of risk assessments identified some areas of concern about the safety and suitability of certain fixtures and fittings within the service. There were effective systems to regularly assess and monitor the quality of service that people received.