Mr & Mrs A H Akbarally

Mr and Mrs Akbarally is a residential care home for people with learning disabilities. The home can accommodate up to three people. At the time of the inspection there were two people living at the home. People at the home had a range of learning disabilities.

People’s experience of using this service:

People told us this service was a cosy family home and that is exactly what we saw. The size of this service meant that staff were engaged with people all day alongside the two managers who knew them very well. Even though the people and staff had been at this service together for at least seven years, the work was still ongoing to ensure that care standards were maintained. Relatives felt comforted to know their family were safely looked after by kind and caring people.

The management team ensured that they worked in line with ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion to ensure that people with learning disabilities can live as ordinary a life as any citizen. The size of service met current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.

People’s needs were consistently met and assessed to enable improvements and progress in their lives. Risks to people were assessed and managed to balance people’s safety and right to lead a non-restricted life. There were enough well trained staff to ensure people were supported safely at all times.

People, relatives and staff were engaged via meetings so that everyone could contribute to the development of the service. There was a credible strategy in place with plans for improvements at the service. This was being implemented by the registered manager who was pro-active in considering how the service could be improved.

People received person centred care that supported them to take part in activities they enjoyed. People knew how to complain and were confident in approaching the managers.

Rating at last inspection:

Good (Published October 2016)

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

Mr & Mrs A H Akbarally provide accommodation and support for a maximum of three adults with a learning disability. At the time of this inspection there were three people living at the home. People had varied communication needs and abilities. However all were able to hold conversations to varying degree. People who lived at the home required differing levels of support from staff based on their individual needs; however, all needed emotional support and help to access the community in which they lived.

During our inspection the registered manager was present. 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.

Robust recruitment procedures were not always followed to ensure staff were safe to work with people. We have made a recommendation about this in the main body of our report.

Medicines were managed safely and staff training in this area included observations of their practice to ensure medicines were given appropriately and with consideration for the person concerned. Written guidance about some ‘as and when’ medicines was not in place to help inform staff how to give this safely. We have made a recommendation about this in the main body of our report.

Checks on the environment and equipment had been completed to ensure it was safe for people to use. But remedial action was not always taken promptly. We have made a recommendation about this in the main body of our report.

Quality assurance audits and checks were completed that helped ensure quality standards were maintained and legislation complied with. Quality assurance processes included obtaining and acting on the views of people in order that their views could be used to drive improvements at the home. Although checks had been completed they had not always ensured changes were made when needed. We have made a recommendation about this in the main body of our report.

People appeared very happy and at ease in the presence of staff. Staff were aware of their responsibilities in relation to protecting people from harm and abuse.

People were supported to take control of their lives in a safe way. Risks were identified and managed that supported this. Systems were in place for responding to incidents and accidents that happened within the home in order that actions were taken to reduce, where possible reoccurrence.

Staff were available for people when they needed support in the home and in the community. Staff told us that they had enough time to support people in a safe and timely way. Staff were sufficiently skilled and experienced to care and support people to have a good quality of life. Training was provided during induction and then on an ongoing basis.

People consented to the care they received and were supported to understand their rights. Capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise. The home followed the requirements of the Mental Capacity Act 2005 and was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were supported to access healthcare services and to maintain good health.

People were routinely involved in the review of their care packages and regular meetings took place that helped people to express their views. People played an active role in planning their meals and had enough to eat and drink throughout the day.

Positive, caring relationships had been developed with people. Staff knew what people could do for themselves and areas where support was needed. Staff appeared very dedicated and committed.

People received personalised care that was responsive to their needs. Activities were offered both within and outside of the home and people were supported to increase their independent living skills. People were also supported to maintain contact with people who were important to them.

Staff understood the importance of supporting people to raise concerns. Information of what to do in the event of needing to make a complaint was available to people.

People spoke highly of the registered manager. Staff were motivated and told us that management of the home was good. The registered manager was aware of the attitudes, values and behaviours of staff.

Whilst we were at the home we were also able to speak with a health care professional, they told use that that they had only recently started to visited the home, and that they had no concerns. We spent time observing how staff interacted and supported people, we saw staff treating people in a sensitive, respectful and professional manner.

We looked around the building which was clean, comfortably furnished and free from unpleasant odours. One person was happy to show us their room. Their bedrooms were personalised with photographs, books, TV's and pictures. On display in the kitchen dining area was the individuals programme for of activities for the week. We saw that the people living at Northcroft Road spent most of the week attending day centres so were out during the day. The people we spoke with told us they 'liked this home it's cosy' and that it was 'very nice here'.

We looked at the plans of care the service had produced in respect of each of the people who used the service, and the records identifying the outcomes people who used the service experienced. Within these records we saw evidence of people who used the service, and their representatives being involved on a regular basis.

Staff were aware of the need to not promise confidentiality when allegations of abuse were shared with them. Staff training records showed that all staff received training in safeguarding. Induction records showed that new staff were given information about safeguarding from an early stage.

Staffing numbers were flexible so people could enjoy activities in the home and in the local community. There were satisfactory numbers of staff to support people in the way they needed.Staff responded quickly and sensitively to any care needs and interacted well with people.

We saw that systems were in place for quality assurance. There were frequent formal audits of the home and monitoring checks by managers. These were recorded and any issues raised were acted on.