This inspection took place on 19 January 2018 and was an unannounced visit. At the last inspection carried out in August 2015 we found that the provider was meeting all of the legal requirements set out by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and those associated with their registration and was rated as ‘Good’. At this inspection, we found that the provider continued to provide a good standard of care to people.109 Grange Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 home comprises of one purpose built building which is registered to accommodate up to five people who require personal care and support associated with their learning disabilities. At the time of our inspection, there were five people living at the home. 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.
There was a registered manager in post at the time 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.’
Everyone we spoke with without exception, were extremely positive about the management of the service. Relatives and staff we spoke with reported the registered manager to be approachable and supportive in their leadership style.
Systems and processes in place to monitor the safety and quality of the service included the involvement of people, relatives and other stakeholders. The provider ensured that information was available in different formats to meet the needs of people and promoted their involvement in providing feedback on the care and support they received. Relatives we spoke with knew how to complain and were confident that any concerns they rose would be dealt with efficiently and effectively.
We found that people were protected from the risk of abuse and avoidable harm because safeguarding systems and processes were in place and implemented effectively. People were supported by sufficient numbers of staff who had the knowledge and the skills they required to care for people safely and effectively.
People were also protected against any risks associated with their health and care needs because risk assessments and associated care plans were developed holistically, reviewed and monitored. This ensured that people received the support they required to remain safe. People and their relatives were involved in this process alongside any key professionals and care staff, to ensure that care was person-centred and any decisions made in respect of their care and support needs, were done so within their best interests and in accordance with the Mental Capacity Act 2005. Where people were assessed to lack the capacity to consent to the support they received, the provider had followed key processes to ensure that care was provided in the least restrictive ways possible. Applications had been made and authorisations received to safeguard people against the unlawful deprivation of their liberty, where necessary. People’s privacy, dignity and independence were respected at all times.
Quality assurance practices within the home ensured that the maintenance of the premises and equipment within the home were monitored for their function, safety and cleanliness. We saw that the property had been adapted to ensure people were supported to remain safe within a homely environment. Staff were also aware of risks to people when supporting them outside of the home in order to promote people’s safety within the community.
People received support from staff to take their prescribed medicines as and when required. Systems and processes were in place to ensure medicines were managed safely and only senior members of staff who had undergone specific training and supervision were permitted to administer medicines within the home.
Staff sought the expertise of specialist services and health and social care professionals to ensure that the care they provided to people was in keeping with legislation and best practice guidelines. This included advice and support specific to learning disabilities, autistic spectrum disorders and any associated physical health symptoms such as epilepsy and dysphagia (swallowing difficulties).
People were supported to maintain a healthy diet and all health needs were met with the support from staff. It was evident that people had developed positive relationships with staff and there was a friendly, calm, relaxed atmosphere within the home. Staff knew people’s likes, dislikes and preferences well and supported them to engage in activities of interest. People lived active and fulfilling lives and were supported to maintain and develop relationships with their relatives and friends. Visitors were always made to feel welcome.