21 August 2015
During a routine inspection
HCS (Enfield) Limited, 20-24 Southbury Road, provides accommodation, care and support for 12 people with a learning disability or people on the autistic spectrum. There were 11 people using the service on the day of our inspection.
This inspection took place on 21 August 2015 and was unannounced. Two inspectors carried out the inspection. The home was last inspected on 08 July 2014 and was compliant in all areas inspected.
There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of law; as does the provider. The registered manager had left the home several weeks prior to inspection. A new manager had been appointed, was in post and was planning to apply for registered manager status.
Procedures relating to safeguarding people from harm were in place and staff understood what to do and who to report it to if people were at risk of harm. Staff had received training in the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS), although some staff were unable to explain how this would impact on people when we spoke to them.
There were person centred care plans written from the point of view of the people they were supporting. Care plans were detailed and provided information to allow staff to carry out their duties and support people properly. People were involved in their care and where this was not possible, there were records of best interest meetings and decisions involving families and healthcare professionals.
People told us that they felt safe within the home. Relatives said that they felt their loved ones were safe. People were well supported by staff appropriate for the role. Staff received on-going training and support from the manager. People were treated with respect and dignity and relaxed around staff.
People were supported to have healthcare appointments and staff were aware of how to refer people to healthcare professionals when necessary. There were records of appointments and reviews in people's files. People were supported to have their medicines safely and on time. There were records of medicines audits and staff had completed training on medicine administration. The home had a clear policy on administration of medicine which was accessible to all staff.
People were supported to have enough to eat and drink. Staff ensured that people had adapted cutlery and crockery that enabled people to be as independent as possible. Staff were aware of specialist diets, such as pureed food and had a good understanding of ensuring that food was appetising and were offered a choice of meals.
People using the service and relatives told us that they were happy with the care provided and felt that staff were kind and caring. Staff were trained and appropriately skilled to care. Training was regularly reviewed and updated and monitored by the manager. Staff had regular supervisions and annual appraisals that helped identify training needs and improve quality of care.
The manager was present and accessible and spent a lot of time with people. We were told, and saw, that there was an open culture at the home. Staff felt able to raise any concerns with the manager.
There was a complaints procedure as well as an accident and incident reporting. Where the need for improvements were identified, the manager used this as an opportunity for learning and to improve care practices where necessary. There was evidence of audits around medicines and health and safety which helped identify areas for improvement or good practice.