Archived: Trinity Street

The registered manager had recently been recruited to another post in the organisation and had retained their registered manager status for this service. The incoming manager was in the process of registering. 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. There was a new manager in place who had made an application to be the registered manager.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The manager and staff understood how to keep people safe. There were clear policies and procedures to follow for staff to raise concerns and staff were aware of these. There were good reporting and robust auditing mechanisms in place. Risk assessments were comprehensive and people’s support plans were centred around their safety.

Staff were trained to give medicines safely, all training was monitored and competencies in all aspects of care and support were thoroughly checked. Staff received regular support from the manager through supervision, appraisals and regular team meetings.

People could chose what to eat, they were supported to develop healthy menus and shop accordingly. They chose when and where they ate their meals. People were encouraged to eat healthily and their nutritional intake was monitored.

People were involved at all stages in developing their support plans and in reviewing their progress on a weekly basis. People chose their own goals and how they wanted to be supported to meet these. People were supported to have choice and control of their lives in the least restrictive way possible. Mental capacity assessments were in place.

The manager was known throughout the home. Staff said management was approachable and supportive. The home had thorough governance processes in place.

Further information is in the detailed findings below.

Trinity Street provides support and accommodation for up to 12 people with mental health needs. Located in a quiet suburb of Batley it is operated by the Richmond Fellowship, a national charitable organisation. Accommodation is provided on the ground floor of three interlinked bungalows. Each bungalow offers communal use of a kitchen, laundry, lounge, dining room, bath and shower rooms and individual bedrooms for up to four clients. Secure gardens provide a private leisure area.

The service is undergoing a period of change and on the day of inspection only four people were living there as others had been moved on to different accommodation that enabled them to be more independent.

The service has three registered managers, although one is in the process of de-registering. There were two registered managers at the service on the day of our inspection. 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.

We found that people were supported by well trained and informed staff who knew how to safeguard people. Incidents were reported in detail and appropriate analysis followed with scrutiny form senior managers where required. Risk assessments were comprehensive and reflected a person’s specific needs.

Staffing levels were appropriate for the service on the day we inspected, especially as two people spent much of the day out of the service. Medicines were administered and stored in line with guidance and people were encouraged to self-administer where they felt able to.

We saw staff received regular supervision allowing them to reflect on their practice and consider areas of their own personal development. This was supported by an annual appraisal where staff and line managers evidenced the fulfilment of agreed objectives and outlined future learning needs.

Consent was sought from people in the service at every opportunity and it was clearly recorded where people had either refused to undertake a particular activity or where they did not wish to give written consent. Staff encouraged people to make decisions in their best interests, especially in regards to visiting GPs or dentists explaining the benefits to people and the consequences of missing such appointments.

People had access to nutritious meals, especially during the evening when they ate together.

Although observation of interactions were limited during the day as people went out into the community, we saw staff engage with people in a patient and kind manner, clearly knowing people well by the conversations that were held. As everyone in the service had capacity staff provided support sensitively and empathetically to ensure that people felt supported but not overwhelmed. We saw good examples throughout the day as to staff’s awareness of the importance of privacy, both in terms of where conversations were held and in the management of personal information.

Care records were written in conjunction with the person and showed their abilities and aspirational goals. These were regularly monitored by weekly meetings with their keyworkers and goals adjusted as required.

Complaints were handled efficiently and in depth, pulling out key areas of learning for the organisation where this had been identified.

The service was run by two enthusiastic and visionary registered managers whose skills complimented one another. They had a shared vision for the service and promoted the wellbeing of people using it at all times. Quality assurance was detailed and uncompromising revealing whether further work needed to take place which was then completed.

On the day of our visit there were nine clients living at Trinity Street. During our visit we spoke with the administrator, two clients, two support workers and the cleaner. We also looked at two sets of care records.

We found that the manager of the service had left a week prior to our inspection visit. As the deputy manager was on leave when we visited we were unable to find out the company's plans for recruiting a replacement manager.

The two care workers we spoke with told us the Richmond Fellowship was a good company to work for and they felt confident the service provided to the clients was good. However they did share their concerns with us about proposed restructuring within the company. They told us they were unsure how this would affect the staff and the service in the future. They told us they got regular updates from the area manager about this issue; they felt this was helpful.

Staff told us that, at the time of our visit, they felt there were enough staff to meet the needs of the clients living at Trinity Street. One of them said 'We keep people on an even keel.' They said 'if people who used the service had different levels of dependency we would ensure support was provided with increased levels of staffing'. This was confirmed by the administrator.

The two staff we spoke with told us they had the qualifications, skills and knowledge needed to carry out their role and support the present needs of the client group. One of them said 'It's a lovely team to work for, we all get on well.'

Each property was clean, tidy and maintained to a good standard. Trinity Street had recently been audited by Kirklees Infection Control. Except for two staff, all staff had received appropriate Infection Control Training.

Staff told us clients knew how to complain and several of them had done so. We saw evidence that complaints were dealt with effectively and to the satisfaction of the person making the complaint. Clients confirmed that they felt their complaints were dealt with appropriately.