This inspection was carried out on 29 and 30 September 2015 and was unannounced.
Yoakley House is part of complex of accommodation provided by Michael Yoakley’s charity, the complex also includes 47 almshouse cottages and bungalows. Yoakley House provides accommodation for up to 31 older people who need support with their personal care. Staff employed by the service also provide personal care for up three people living in the almshouse cottages or bungalows.
The service is a single story purpose built property, with 31 single bedrooms with en-suite facilities. Yoakley House provides permanent residential care services for up to 26 people, pre-booked respite for up to three people at a time and emergency short term care for a maximum of two people referred by their GP. There were 28 people living at Yoakley House at the time of our inspection. Three people living in the almshouse cottages were receiving a personal care service.
The registered provider, Michael Yoakley's Charity is a registered charity and a committee of trustees oversees the running of the service. A registered manager was working at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The manager and deputy manager provided strong leadership to the staff and had oversight of all areas of the service. Staff were motivated and felt supported by the management team. The staff team had a clear vision of the aims of the service. Staff told us the managers were approachable and they were confident to raise any concerns they had with them. Plans were in place to continually improve the service.
There were enough staff, who knew people well, to meet peoples’ needs at all times. The needs of people using both services had been considered when deciding how many staff were required on each shift. Staff had the time and skills to provide the care and support people needed. Staff were clear about their roles and responsibilities.
Staff recruitment systems were in place and information about staff and volunteers had been obtained to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
Staff were supported to provide good quality care and support. The manager had a plan in place to keep staff skills up to date. Most staff held recognised qualifications. Staff met regularly with their supervisor to discuss their role and practice and any concerns they had. Action was taken to improve staff practice when shortfalls were identified.
People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to keep people safe and support them to be as independent as possible. A plan was in operation to make sure that staff had detailed guidance about how to provide all areas of the care people needed. People received consistent care as staff knew them well. People were supported to participate in hobbies and activities they enjoyed.
People got the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care they needed to keep them as safe and well as possible.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. People living at Yoakley House were free to come and go as they pleased and their liberty was not restricted. Systems were in place to assess people’s capacity to make decisions and to make decisions in people’s best interests. Most people had capacity and were supported to make decisions and choices.
People were involved in choosing their own food and drinks and were supported to have a balanced diet. A variety of cups was provided to support people to remain independent when drinking. Choices were offered to people and staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained.
People were confident to raise concerns and complaints about the service. When necessary safeguarding alerts had been raised with the local authority. Complaints and concerns were investigated and people had received a satisfactory response. Staff knew the possible signs of abuse and were confident to raise concerns they had with the management team or the local authority safeguarding team. Staff knew how to keep people safe in an emergency but more detailed plans were required to support staff to take consistent action.
The manager and trustees completed regular checks of the quality of the service provided. When shortfalls were found action was taken to address these and prevent them from occurring again. People, their relatives, staff and visiting professionals were asked about their experiences of the care. These were used to improve and develop the service.
The environment was safe, clean and homely. Maintenance and refurbishment plans were in place. Appropriate equipment was provided to support people to remain independent and keep them safe. Safety checks were completed regularly.
Accurate records were kept about the care and support people received and about the day to day running of the service and provided staff with the information they needed to provide safe and consistent care and support to people.
We last inspected Yoakley House in December 2013. At that time we found that the registered provider and manager were complying with the regulations.