281-287 St Georges Road consists of four separate bungalows that are registered to provide care for up to a maximum of twelve people with a learning disability. They are all part of the Avocet Trust organisation, which is a registered charity.
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.
This inspection took place on 29 September 2015 and was unannounced. The previous inspection of the service took place on 12 September 2013 and was found to be compliant with all of the regulations that were inspected.
The Care Quality Commission [CQC] monitors the operation and implementation of the Deprivation of Liberty Safeguards [DoLS]. The registered manager had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep people safe. At the time of the inspection there were no DoLS authorisations in place and the service was waiting for assessments and approval of the applications that had been submitted.
The people who lived at the service had complex needs which meant they could not tell us their experiences. We used a number of different methods to help us understand the experiences of the people who used the service including the Short Observational Framework for Inspection [SOFI]. SOFI is a way of observing care to help us understand the experiences of people who were unable to talk with us.
We saw staff engaging with the people who used the service in a kind and considerate way. The staff knew people’s preferences for how care and treatment was to be provided and had developed a clear understanding of how to meet people’s assessed needs.
Staff had undertaken a range of training pertinent to their role and were supported during one to one meetings and annual appraisals with the manager. They told us they had completed a nationally recognised qualification in care and were encouraged to continually develop their skills and knowledge.
Staff were deployed in sufficient numbers to meet the needs of the people who used the service. We saw that before prospective staff were offered a role within the service checks were carried out to ensure they were suitable to work with vulnerable people.
A quality monitoring system was in place that consisted of audits, checks, monthly assessments and stakeholder surveys. We saw that when shortfalls were noted; action was taken to improve the service as required. However, the system required further development to ensure all aspects of care delivery were assessed. The audits and monthly assessments had failed to ensure infection control practices were reviewed which led to shortfalls not being highlighted.
We undertook a tour of every bungalow and found them to clean, tidy and free from odours. A bathroom in one of the bungalows had open shelving which meant towels and other linen were not stored appropriately and increased the risk cross infection and the spreading of infections through the home. The bath lowering table was not clean after being serviced, we mentioned this to the manager who ensured it was cleaned thoroughly.
People who used the service had their health and social care needs assessed periodically. The assessments were used to develop support plans which stated how staff should provide care and support using the least restrictive interventions. Throughout the inspection we observed staff treating people with dignity and respect.
People were supported to maintain a healthy balanced diet. Food was provided to meet people’s needs for example cut into small pieces or blended to reduce the risk of choking. When required, relevant professionals had been contacted for their support and guidance in this area.
Medicines were ordered, stored, administered or disposed of safely. Personalised support plans had been developed to ensure people received the medicines in line with their preferences and needs.