Background to this inspection
Updated
9 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 23 November 2017 and was unannounced.
The inspection was carried out by one Adult Social Care Inspector and an expert by experience whose areas' of expertise was learning disabilities and autism. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We received the completed PIR within the time scale given.
During the inspection, we spoke with one person who used the service, two visiting relatives and two healthcare professionals. The expert by experience had telephone conversations with a further two relatives. We spoke with the registered manager, two senior carers and three care staff.
A tour of the service was completed to check the general maintenance, cleanliness and infection control and prevention and spent time observing care. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who were unable to talk with us.
The care files of three people who used the service were reviewed and other important documentation relating to the people who used the service such as their Medication Administration Records (MARs).
We looked at a selection of documentation relating to the management and running of the service. These included four staff recruitment files, training records, the staff rotas, and minutes of meetings with staff, accident and incident records, quality assurance audits and maintenance of equipment records.
Updated
9 December 2017
281-287 St George’s Road is registered to provide care and accommodation for 12 adults who are living with a learning disability or physical disability. The service consists of four bungalows situated close to local shops, transport links and local amenities.
At the time of our inspection there were 11 people using the service.
The service had a registered manager in post. 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 on 10 September 2015 and was rated as ‘Good’ overall. At this inspection we found the service remained ‘Good’.
People who used the service were supported by staff who understood the importance of protecting them from harm. Staff had completed training in how to identify abuse and report this to the appropriate authorities. We found staff were recruited in a safe way and all checks were in place before they started work. The staff had completed an in-depth comprehensive induction and essential training at the beginning of their employment and we saw periodic refresher training to update their knowledge and skills had followed this. Staffing levels were sufficient to meet people’s needs.
Risks to people were identified and plans were put in place to help manage the risk and minimise them from occurring. Medicines were managed safely with an effective system in place. Staff competences, around administering medication, were regularly checked.
We found the service to be clean and tidy. Staff told us the infection control practices were good and we saw the service was well maintained.
We looked at how the service used the Mental Capacity Act 2005 to ensure when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.
We observed staff were kind and caring in their approach and interactions with people who used the service. They had a good understanding and knowledge of people’s individual needs and their preferences for how they wished to be supported. We saw staff obtained consent and offered explanations to people before undertaking any support tasks.
People who used the service and their relatives told us they were supported by kind and caring staff who knew them well and understood their preferences for how their care and support should be delivered. We saw people were treated with dignity and respect throughout our inspection. It was clear staff were aware of people's preferences for how care and support should be provided.
Staff supported people in the least restrictive way possible, the policies and procedures within the organisation supported this practice. People who used the service were supported to access health care professionals when required.
We saw records confirming that reviews took place periodically and people who used the service or those acting on their behalf were involved with the planning and on-going assessments of their care when possible.
The provider had developed and embedded an effective quality assurance system that consisted of audits, daily checks and questionnaires. Action was taken to improve the service when shortfalls were identified. People who used the service, relatives and staff were able to express their views on how the service was run through surveys and a range of meetings.
There was a complaints policy in place and available in easy to read format within the service. The registered manager understood the requirements to report accidents, incidents and other notifiable incidents to the CQC.
Further information is in the detailed findings below.