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Archived: 136 Warminster Road - SHSC Respite Service Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 19 May 2016

During a routine inspection

The inspection took place on 19 May 2016 and was unannounced. The home was previously inspected in November 2014 when we found two breaches of Regulations. These were regarding the safe management of medicines and shortfalls in care records. Following that inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. This inspection was undertaken to check that they had followed their plan, and to confirm that they now met all of the legal requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link

for '136 Warminster Road' on our website at www.cqc.org.uk'

At this inspection we found improvements had been made and the provider had addressed both breaches found at the last inspection.

Warminster Road provides short stay respite accommodation for up to five adults with learning difficulties. Three beds are located within the main building, which is shared with the local council. The remaining two beds are located in a neighbouring on-site property known as 136a Warminster Road, which is a detached house.

The service did not have a registered manager in post at the time of our inspection, but an acting manager had recently been appointed. They told us they were hoping to submit their application to be the registered manager shortly. 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 and associated Regulations about how the service is run.

We were unable to speak with people using the service as they were either away from the service or we were unable to communicate with them in a meaningful way. Therefore, we observed how staff supported people and following the inspection visit we contacted three relatives to gain their opinion of the service provided. All the people we spoke with said they were very happy with the care provision.

We saw there were systems and processes in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding vulnerable people and were able to explain the procedures to follow should an allegation of abuse be made.

There were enough skilled and experienced staff on duty to meet people’s needs and enable them to follow their interests.

The company’s recruitment system helped the employer make safer recruitment decisions when employing staff. We found new staff had received a structured induction and essential training at the beginning of their employment. This had been followed by refresher and specialist training to update and develop their knowledge and skills.

People received their medications in a safe and timely way from staff who had been trained to carry out this role.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding and knowledge of this subject and people who used the service had been assessed to determine if a DoLS application was required.

People were fully involved in choosing what they wanted to eat and drink. We found people were also involved in shopping and preparing meals.

Care files reflected people’s needs and preferences, as well as any risks associated with their care. These provided staff with detailed guidance about how to support people and keep them as safe as possible. Care plans and risk assessments had been reviewed and updated each time the person returned to the home to ensure there were no changes in their needs. We saw staff enabled people to follow their preferred interests and routines, such as attending a day centre, and be as independent as possible.

The provider had a complaints policy to guide people on how to raise concerns. There was a structu

Inspection carried out on 13,14 & 17 November 2014

During a routine inspection

An unannounced inspection visit to Warminster Road took place on 13 November 2014.

Warminster Road provides short stay respite accommodation for adults with learning difficulties. The service has five registered beds. Two beds are located in ‘136a Warminster Road’ which is a detached house. The remaining three beds are located within ‘House 3’ which is within a shared, on-site, neighbouring property.

The service was last inspected by the Care Quality Commission (CQC) in February 2014 and was found to be meeting regulations relating to consent to care and treatment, care and welfare of people who use services, staffing, assessing and monitoring the quality of service provision and complaints.

As well as speaking with each person using the service, we also undertook a number of informal observations in order to see how staff interacted with people and see how care was provided. This was because some people accessing the service had communication difficulties and were not always able to verbally communicate their experience of the service to us. We also telephoned the relatives of four people on 14 and 17 November 2014 in order to gain their views about the service.

During our inspection visit we spoke with the team leader and with the registered manager. 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. We spoke with four support workers by telephone on 14 November 2014.

Our inspection identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report

Our check of medication records identified that medicines were not always safely managed and recorded. This meant that people accessing the service may not be protected against the risks associated with the unsafe management of medication.

Our review care plans highlighted some gaps and inconsistencies about records at Warminster Road. Our findings made it difficult to establish whether some plans were current and accurately reflected people’s needs. Whilst there was no evidence to suggest that these shortfalls had negatively impacted upon people, the lack of information, review and recording within some key documents meant that people may not be protected against the risks of receiving inappropriate care and treatment.

Whilst detailed checks took place in relation to health and safety and the premises, we identified that audits relating to key areas of practice did not take place. For example, the shortfalls identified during our inspection in relation to medicines and records had not been identified or highlighted by an internal auditing system.

Observations throughout our inspection demonstrated that people were supported safely by staff who knew their individual needs and preferences. Conversations with staff and our observations showed us that staff offered and involved people in a range of day to day decisions and adapted the way they communicated to meet the needs of the person they were supporting. People were treated with dignity and respect throughout our inspection and staff were aware of people’s differing cultural and religious needs.

Relatives we contacted following our inspection were confident that their family members were safe when staying at Warminster Road. Our conversations with staff and our review of records demonstrated that staff identified safeguarding issues and followed local procedures in order to safeguard people. Appropriate systems were in place to safeguard and manage people‘s finances.

Staff were appropriately vetted to ensure they were suitable to work with vulnerable adults before starting work. There were enough staff to safely meet people’s needs in a timely manner. Staff had appropriate qualifications, knowledge and skills to perform their roles and there were systems and opportunities for staff to develop their skills and discuss good practice.

People were appropriately supported to make decisions in accordance with the Mental Capacity Act, 2005 (MCA). Whilst the manager had an understanding of the MCA and Deprivation of Liberty Safeguards (DoLS), some members of staff could not consistently demonstrate an understanding of these pieces of legislation and how they applied in practice.

Our observations of a meal time and our review of records evidenced that people’s nutritional needs were met. People’s physical health needs were monitored and referrals were made when needed to health professionals. Staff also supported people to attend and access health and medical appointments when needed.

People were supported to maintain contact with their family members and to access existing day time and evening activities during respite stays at Warminster Road. The service had an open and transparent culture that actively encouraged feedback from people who used the service, their relatives and staff.

Inspection carried out on 23 January 2014

During a routine inspection

We found there were effective processes in place to ensure people�s consent to treatment and capacity to make decisions had been adequately managed.

We found people�s care and welfare needs had been met. We talked with two family members of people who used the service by telephone during our inspection visit. Family members we did speak with told us they were happy with the quality of care their relatives received at the service. Some comments captured included, �Good staff up there,� �Can�t fault it � its lovely,� �Staff are smashing with them,� �Happy with care [son] gets,� and �Staff are wonderful.�

We found people�s needs had been met by sufficient numbers of appropriate staff.

We found there were effective systems to regularly assess and monitor the quality of service that patients received.

We found there was a complaints process in place.