Archived: Care Management Group - 287 Dyke Road

Updated 20 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on 12 April 2018 and was announced. We gave the registered manager 24 hours’ notice of the inspection because the service is small and staff are often supporting people with activities in the community. We did this to ensure that both staff and people who use the service were on site. The inspection was carried out by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by experience had expertise in the area of Learning Disabilities.

Before the inspection we reviewed information held about the service. The provider had submitted a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make. We viewed previous inspection reports and statutory notifications sent to us by the registered manager concerning events and incidents that had occurred at the service. Notifications are events, incidents or changes which the service must inform us of.

During the inspection, we spent time with the people who lived at the service and observed the support that they received within the communal lounges, sensory room and kitchen and dining areas. We spent time seeing how staff interacted and communicated with people who use this service. People had a range of non-verbal ways in which they communicated, which included non-verbal gestures and signs. Therefore, we observed the reactions, facial expressions and physical responses of people to determine their experiences and degree of satisfaction with activities and events.

We spoke with four relatives, three care staff and the registered manager. We spent time observing how people and staff interacted, including at lunchtime, specifically to see how nutritional and hydration needs were being managed. We reviewed care and support plans of five people, their associated risk management assessments and health records. We also reviewed three staff files including documentation on recruitment, training and supervisions.

We looked at records relating to the management of the service such as policies and procedures, quality assurance audits and medication administration. We also ‘pathway tracked' the care and support for two people living at the service. This is a process where we ensure that the support detailed within support plans is the same as that delivered to that person by the provider. We obtain feedback from people and their relatives which, together with observations, allow us to capture specific information about people’s experiences of the care they receive.

At the last inspection on 5 January 2016 the service was rated Good.

Updated 20 September 2018

We carried out a comprehensive inspection of Care Management Group, 287 Dyke Road on 12 April 2018. The registered manager had been informed of the inspection 24 hours prior to us undertaking the inspection. We gave the registered manager 24 hours’ notice of the inspection because the service is small and staff are often supporting people with activities in the community. 287 Dyke Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The home provides accommodation and support for up to eight people, primarily young adults, aged 18-30 with profound learning disabilities, physical disabilities, communication and sensory impairments and complex needs such as epilepsy. 287 Dyke Road currently has one person outside of this age group, but who meets the criteria of support that the service provides. At the time of the inspection seven people were living at the home with one person about to move to 287 Dyke Road from another service. The home accommodates those it supports within one self-contained building. The building has eight ensuite bedrooms over three floors, two connecting communal areas, a dining room and large gardens. The home had a lift that allowed access to each floor and each room is adapted with ceiling tracking hoists.

At the last inspection on 5 January 2016 we rated the service as Good. At the last inspection we had identified a breach, (areas of practice that needed to improve) because medicines were not always managed safely. At this inspection we found that improvements had been and that medication management and administration was being managed safely and effectively, and in accordance with guidance and regulations.

People and their relatives were happy with the care provided by staff who held a detailed working knowledge of each person’s needs and requirements. One relative told us, “They judge what level of assistance he needs at that time. They know when to keep out of his face as he gets cross sometimes. They know him so well.” Another relative commented that, “The staff have given me back my confidence in the care system”.

Staff had been recruited in line with regulations and good practice and had received training appropriate to their roles and responsibilities. There were enough staff to care for people safely.

Staff were knowledgeable about safeguarding procedures and aware of what action they needed to take when they suspected abuse or harm had occurred. Staff had a good understanding of equality, diversity and human rights.

People’s needs had been assessed appropriately. People’s care plans and daily activities had been developed in a person-centred way that placed them at the forefront of their support. People’s rooms had been decorated and personalised to a high standard that reflected their cultural, ethnic and lifestyle preferences.

Risks associated with care and support, environment and the use of equipment within the service had been appropriately identified and assessed. The service was effective in the management of risks to people with complex needs within the service to ensure they remained safe. One relative told us, “They judge what level of assistance he needs at that time”

The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Applications for DOLS had been made where appropriate.

People’s nutritional and hydration requirements were managed well and in accordance with their specific clinical health requirements. People were actively supported to access healthcare professionals and support when required.

People were provided with opportunities to participate in in-house activities and to regularly access the local and wider community. People were supported to make choices in every aspect of their daily routines and activities, while relatives were actively encouraged and supported to engage in the support of their family members. One relative told us, “It is a beautiful place, I think it is always clean and they make it happy”.

The provider undertook quality assurance audits to measure and monitor the standard of care provided to people and to enable improvement in standards.

Quality Assurance surveys were undertaken by the provider to ensure that people’s relatives were satisfied with the service provided.

Further information is in the detailed findings below