This inspection took place on 27 January 2016 and was announced.
92 Cromwell Road is a supported living scheme where people live in their own home under a tenancy agreement, and is registered to provide personal care. People received personal care or social support in their flat to promote their independence. The support provided was tailored to meet people’s individual needs and enable the person to be as autonomous and independent as possible. At the time of the inspection there were three men with a learning disability receiving a service of personal care and support, and whose behaviour can be complex. The service is based in a four storey detached Victorian building, situated in a residential area with easy access to local amenities, transport links and the city centre.
The service had a registered manager, who was present throughout the inspection. They had been in their current post for a number of years and knew the service well. 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.
The service was going through a significant period of review, where the provider and local stakeholders were looking at the service provision and what was needed and how the service would best be provided in the future.
Care staff were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Care staff had been able to attend refresher training to meet the provider’s requirements, plans were in place to promote good practice and develop the knowledge and skills of staff. They told us they felt well supported. However, care staff had not received regular supervion at a frequency to meet the provider’s policies and procedures. This is an area in need of improvement.
Relatives told us people were safe in the service. One relative told us, “He seems very happy there. He is in good hands. “People were supported by staff that were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. There were systems in place that ensured this knowledge was checked and updated. Medicines were managed and administered safely. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.
Care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence. People’s care and support plans and risk assessments were up-to-date, detailed and reviewed regularly. One relative told us, “I could not be happier where he is.” Another relative told us, “He is looked after extremely well.”
Consent was sought from people with regard to the care that was delivered. Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation, which they put into practice. Where people were unable to make decisions for themselves staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.
People were supported to eat a healthy and nutritious diet. People had access to health care professionals. They had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans.
People were supported by kind caring staff. There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. The number of staff on duty had enabled people to be supported to attend social activities. One relative told us, “They make sure they take people out. It’s wonderful. “
Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the registered manager and senior care officer, who they described as very approachable.
Relatives, staff and visiting healthcare professional told us the service was well led. People and their representatives were asked to complete a satisfaction questionnaire to help identify any improvements to the care provided. People had the opportunity to attend regular weekly ‘tenants' meetings’. The registered manager told us that staff carried out a range of internal audits to review the quality of the care provided, and records confirmed this. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.