• Care Home
  • Care home

Archived: High Street

Overall: Good read more about inspection ratings

2 High Street, Macclesfield, Cheshire, SK11 8BU (01625) 50066

Provided and run by:
East Cheshire Housing Consortium Limited

All Inspections

21/01/2015

During a routine inspection

This inspection took place on 21January 2015 and was unannounced. At our last inspection in August 2014 the service was meeting the regulations inspected.

The home has a registered manager with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

High Street care home is owned and managed by East Cheshire Housing Consortium [ECHC]. The home is based in Crewe, Cheshire and provides care and support for adults who have mental health needs. Six people can be accommodated in the property. ECHC is a charitable organisation that provides care and support to people who experience mental health issues. The main office is also situated in Crewe.

We found the staff had clear understanding of supporting people when they lacked capacity, including the requirements of the Deprivation of Liberty Safeguards and in the implementation of best interest decisions and capacity assessments.

We found care plans to be detailed regarding the personal care and clinical needs for people living at High Street and they fully focused on the individual person. Staff had a good understanding and knowledge of people’s individual care needs. Social support was well recorded within care plans to help determine individualised needs to include work and recreational activity.

We observed how staff interacted with people living at the home. They were respectful to people and interacted with them in a positive manner displaying clear knowledge and understanding of people’s hobbies, interests and communication systems.

We asked about complaints and the support worker showed us that the complaints file was empty and that no formal complaints had been made about the home. However people living at the home and their relatives told us they were confident that they could raise their opinions and discuss any issues with staff.

The service operated safe staff recruitment and ensured that all staff employed were suitable to work with vulnerable people. Safe recruitment checks were carried out prior to employment. Personnel files showed good evidence that recruitment procedures were robust to enable the management of the home to have adequate information before employing staff.

Various audits at the service were carried out by the registered manager and registered provider to help ensure that adequate standards were maintained throughout the service. They had evaluated these audits and created action plans for improvement in areas such as: supervision of staff, training needs for staff and staffing levels were under review including staffing levels needed at meal times. People living at the home, their relatives and staff were positive about the service and how it was managed

3 July 2014

During a routine inspection

We undertook an inspection of High Street on 03 July 2014.

During the inspection we spoke with the provider, the administrator and the staff member on duty in the home. We also spoke with three of the people who lived in the home.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people, the staff supporting them and from looking at records.

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

Is the service safe?

We looked at the safeguarding policy and the whistle blowing policy. They were available in the office used by the staff. The staff member we spoke to was aware of the policies and how to access them. There was also a copy of the local authority safeguarding procedure. The staff member described to us a number of issues where the staff had developed strategies to manage concerns to minimize the risk of abusive incidents occurring.

We spoke with staff and asked about their understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and what they would do if a person was not able to give their consent. The staff member was clear about the processes that would need to take place to support the person safely.

Is the service effective?

We spoke to three people who lived in the home. They told us that they were very happy with the support they received and the staff who provided it. People's needs were assessed and care and treatment was planned and delivered in line with their individual support plan. We looked in some detail at the care and support provided to three people who lived in the home.

These records included the person's support plan, risk assessments, and records about the support they had received from professional people outside of the home. We found the information in people's support plans was detailed and they clearly reflected people's individual wishes and choices. Support plans also included detailed pieces of information and guidance about particular aspects of people's care. We saw that some people had very clear wishes about how they wanted staff to support them in particular situations. We saw that this was documented and that staff were aware.

Is the service caring?

We spoke to three people who lived in the home. They all told us that they liked living at the home and staff assisted them in the way they wanted. Comments included; "staff were very nice and very helpful" and "Staff help me with appointments." They told us they were informed and consulted on changes to their care and treatment. One person told us how they were involved in their care and were supported to do their own shopping and to go out on visits to places they liked.

From our discussions with staff and our observations it was evident that staff knew people well and were providing support based on people's individual needs and choices. Staff were able to tell us about how they communicated with people living in the home and they were able to describe people's skills, needs, likes, dislikes and lifestyle choices.

Is the service responsive?

We saw that risks were very clearly identified and that risk management plans were discussed and agreed with the individual person. We saw that staff had drawn up an action plan in conjunction with the person to agree how the staff would support them during difficult periods. We saw that other health professionals had also been part of these discussions. We saw that the home worked very closely with a variety of health professionals including social workers and community psychiatric nurses.

Upon reviewing records we noted that the provider had not always notified CQC of notifiable incidents. For example, we highlighted that we had not been notified of an incident when the police had been called to deal with a situation of concern. Failure to inform the Care Quality Commission of a notifiable incident is an offence under the Care Quality Commission (Registration) Regulations 2009 and may place the welfare of vulnerable people at risk. We discussed our concerns with the provider and they told us they would take immediate action to ensure that future incidents were correctly reported.

Is the service well led?

We looked at the training records and saw that all staff were receiving regular training. We also noted that training had been planned and booked for the coming year to ensure that all mandatory updates were completed and staff had been informed of the dates they need to attend in advance. We saw that specific training was provided for staff in order to meet the needs of the people they were supporting such as dealing with deliberate self harm, dual diagnosis and violence and aggression.

We were told by the administrator that senior support workers were also provided with clinical supervision every two months by a health care professional outside of the organisation to enable them to seek confidential support. We also spoke with one support worker who told us that the provider and registered manager had arranged for them to receive clinical supervision outside of the organisation, as they recognised that this staff member was supporting a person who used the service through a very stressful period. The staff member told us that they felt supported in their role and the demands of their job were recognised by the management team.