9 December 2014
During a routine inspection
Our inspection visit was unannounced and took place on 9 December 2014.
This service is registered as Supported Living Service but is known as Mansfield View.
Mansfield View is a supported living service for 16 adults who have learning difficulties. Support is provided in six bungalows and one upstairs flat. The bungalows are arranged around a small courtyard area. Support is provided by a team of on-site staff who provide 24 hour support, seven days per week. Staff provide the support people need within their own homes and also support people to access resources and opportunities within the community. The provider has an on-site office.
We visited three of the properties at Mansfield View during our inspection. We spoke with three people who lived at the service and also undertook some informal observations. These observations enabled us to see how staff interacted with people and see how care was provided. This was because some people had communication difficulties and were not always able to verbally communicate their experience of the service to us.
During our inspection visit we spoke with the acting manager, a team leader, four support workers and the registered manager. The registered manager oversaw the operation of Mansfield View and some of the provider’s other services also visited during our inspection. 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.
The service was last inspected by the Care Quality Commission (CQC) in February 2014 in response to concerns raised with us. Mansfield View were non-compliant with two of the three regulations inspected at this time. These related to staff training and supervision and people’s records. The service were compliant with the regulation relating to the care and welfare needs of people living at the service.
Following our previous inspection, the provider sent us an action plan to inform us of the changes they were going to make. During this inspection we checked that improvements had been made with regard to the areas we were previously concerned about.
We found that records were now in place to document staff training and staff received regular supervision as well as an annual appraisal. People’s support plans had been re-written and now included clear information and risk assessments to support staff to safely support people. Support plans also contained information about people’s preferences, dislikes and the people who were important to them.
We found that there were sufficient staff to meet people’s needs and keep people safe. Conversations with staff, the acting manager and the registered manager demonstrated that they were aware of local safeguarding procedures and had the necessary knowledge to ensure that vulnerable adults were safeguarded from abuse.
Mansfield View provided 24 hour support, seven days per week in people’s own homes. In addition to the checks undertaken by the landlord in relation to the safety of the premises, the provider also undertook a number of checks relating to safety aspects of the properties, for example, checks of water temperatures and fire safety checks. During our inspection we found that weekly fire checks had not consistently been taking place since August 2014. The lack of regular fire safety checks meant that people, staff and visitors could not be assured that the fire safety system in place was effective and fully operational. The registered manager had identified this shortfall during one of their monitoring visits and had asked the acting manager and staff to address this. They agreed to ensure that weekly fire checks were undertaken.
Our review of the training matrix together and our conversations with staff identified that some key training courses relating to the needs of people with learning difficulties had not been undertaken by all the staff working at the service. For example, a number of staff working at the service had not received training about supporting people with behaviours which may challenge. Additionally, staff had not received training about epilepsy and dementia. The registered manager and the acting manager agreed to provide training in the above areas.
People were involved in a range of day to day decisions and we noted that the staff adapted their communication to meet the needs of the person they were supporting. Staff and the registered manager were up to date with current guidance to support people to make decisions. Any restrictions placed up on people were made in people’s best interest using appropriate safeguards.
Mansfield View effectively met, responded and recorded any changes in people’s healthcare needs. Staff were aware of people’s differing nutritional needs and were able to explain how they safely assisted people to eat and drink. Our lunchtime observations confirmed that people received appropriate nutrition and assistance to eat and drink.
People were positive about the staff at Mansfield View. For example, one person said, “The staff are kind to me.” We saw lots of positive interactions between people and staff throughout our inspection. Staff had a clear understanding of how people expressed their needs. Staff responded to people’s needs and the way in which they communicated discomfort or distress in a timely way. People’s support plans contained comprehensive, person centred information about people’s individual health and support needs.
Mansfield View were proactive in supporting people to access meaningful activities to meet their differing needs and interests. A member of staff spent a day each week sourcing activities for people. This also involved ordering pieces of equipment to meet people’s individual needs. For example, projectors had been ordered to project calming images on to the walls of the rooms of people who had hearing impairments. People’s support plans provided information about the meaningful activities people enjoyed to do, such as painting and knitting.
People spoken with during our inspection had no complaints. An advocacy service was in place to support people to raise any issues and/or make a complaint. People’s support pans contained information about how to make a complaint and the support they may require to do so.
Staff were positive about the acting manager and the way in which she, and the team leaders led the service. A system was in place to continually audit the quality of care provided at Mansfield View. We saw that this incorporated a range of weekly and monthly audits relating to all areas of the service.