Wardley Street

Wardley Street is a short-stay and/or emergency respite care service providing personal care and support to up to 7 people at any one time. This includes 5 short stay and 2 emergency beds. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 4 people staying at the respite service which accommodates people in 1 adapted building. Approximately 40 people and their families extensively use this respite service. People staying there may also have additional care needs associated with mental health, mobility, communication, or sensory impairment.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

People using this respite service all spoke positively about the standard of care and support provided at Wardley Street. A relative told us, “My [family member] loves to stay at Wardley Street. The staff are all so supportive there.” Another relative added, “It’s a wonderful service my daughter receives there. She always looks forward to going.”

Right Support

People received a service that was safe for them to live in and for staff to work. The quality of the service was regularly reviewed, and appropriate changes made to improve people’s care and support if required. This was in a way that suited people best. The home had well-established working partnerships that promoted people’s participation and reduced the danger of social isolation.

Right Care

Staff were recruited safely and appropriately trained. There were enough staff to support people to live in a safe way, whilst enjoying their lives. Risks to people and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. Staff were suitably trained manage people’s medicines safely.

Right culture

The home’s culture was positive, open, and honest, with leadership and management that was clearly identifiable and transparent. Staff were aware of and followed the provider’s clearly defined vision and values. Staff knew their responsibilities, accountability and were happy to take responsibility and report any concerns they may have.

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 August 2017).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good rated service to people.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Wardley Street 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 service was facilitating visits in accordance with current government infection prevention and control (IPC) guidance. People could visit the respite service providing they followed the provider’s strict COVID-19 guidelines. This included arranging visits in advance to minimise visitor numbers and showing proof they had tested negative for COVID-19 on the day of their prearranged visit.

Information about the services’ COVID-19, IPC, PPE and visitor procedure’s had been sent to everyone who regularly stayed at the service and their families. This information was also available in easy to read pictorial version’s to ensure people with communication needs could easily access this essential guidance.

People visiting the service and staff who worked there were all required to wear personal protective equipment (PPE) when in the building in accordance with current IPC guidance. The service had adequate supplies of PPE that met current demand and foreseen outbreaks.

Staff had received ongoing in-house and externally sourced eLearning and in-person IPC and PPE training throughout the pandemic.

The services’ area manager demonstrated a good understanding of the principles of isolation and knew which external authorities to go to for advice should there be a COVID-19 outbreak at the respite unit.

The service participated in a ‘whole home’ COVID-19 testing program. This ensured anyone about to stay, work or visit the service would need to show evidence they had tested negative for COVID-19 that day before they would be allowed to enter the premises. Staff confirmed they were tested daily for COVID-19. The provider knew how to apply for COVID-19 home testing kits and had adequate supplies.

The service was meeting current requirements to ensure non-exempt staff working at the service and any visiting health and social care professionals were all fully vaccinated against COVID-19. People using the service were strongly encouraged to be vaccinated against COVID-19 in accordance with current government guidance.

The premises looked clean. The frequency high touch surfaces, such as s light switches, grab rails and door handles, were cleaned had been increased during the pandemic. Staff confirmed they were expected to continuously clean these surfaces at least twice a day.

The provider operated effective monitoring systems to check staff complied with best IPC practices and were fully vaccinated against COVID-19. For example, managers routinely carried out unannounced inspections of the service to randomly spot check staff were wearing PPE correctly and the premises was being kept hygienically clean. Managers appropriately maintained up to date records of weekly PPE and monthly IPC audits they conducted at the service.

The provider had put adequate measures in place to mitigate the risks associated with COVID-19 related staff pressures. The service currently had its full complement of care staff and did not rely on temporary agency staff. To reduce the spread of COVID-19 staff were not currently permitted to transfer between the providers other adult social services in the area.

We were assured that this service met good infection prevention and control guidelines.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

There was a new manager at the service who had submitted an application to become registered. 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.

Relatives praised the caring attitude of staff. They said their family member enjoyed going to stay at the service and they were satisfied they were well looked after whilst they were there. They said the service kept them regularly updated about any changes during the stay. We received similar comments from health and social care professionals. Care workers were aware of people’s preferences, their likes and dislikes and how they liked to spend their day.

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. People were supported to live independent lives and continued to enjoy the activities they participated in whilst at home during their respite stay at the service. People were encouraged to help staff with daily chores such as their laundry or help prepare meals if they wanted to.

People continued to be supported to take their medicines on time, staff completed medicine administration record (MAR) charts when they administered medicines to people. People’s healthcare needs were met by the provider, referrals were made when required and specialist support plans were in place to support people for health conditions such as epilepsy. People were supported in relation to their eating and drinking support needs.

Staff told us they felt supported and worked well together as a team. New staff received a thorough induction in the minimum accepted standards expected of care workers and also into the values and behaviours expected of them. Staff received regular training, supervision and appraisal.

The provider carried out an assessment of people’s needs and their risks before they came to use the service. This meant that the provider had appropriate information to support people. Individual care plans were in place for each person. Care plans included a personal information and contact sheet, support plans, professional guidance and end of stay reports. End of stay reports included social and recreational activities that took place, if there were any health concerns, behavioural issues and night reports. This was given to carers when people went back home.

Care plans were person-centred. A person centred profile was available giving information about how best to support people, their qualities and important things to them. People’s communication, cultural and spiritual support needs were included in care plans.

People were given information about their care and support in a format that was easy to understand. Pictures of staff were on display in the entrance to the service, menus were available in a pictorial format and cupboards were labelled with their contents.

There was an open culture within the service with an emphasis on support and transparency. Quality assurance and governance systems were effective and used to drive continuous improvement. Debriefs were held demonstrating the providers commitment to on-going learning.

The service enabled and encouraged open communication with people who use the service, those that matter to them, staff and other stakeholders. The service worked in partnership with key organisations, including the local authority to support care provision.