Business Hub, Simms Cross

Updated 2 March 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.

This inspection took place on 1 & 2 February 2018. We gave the registered provider 48 hours’ notice of our inspection. This is because the service delivers personal care to people living in a supported living setting and we wanted to be sure the registered manager and people who used the service would be available to answer our questions during the inspection.

The inspection team consisted of an adult social care inspector 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, in this case, the care of someone who had a learning disability.

Prior to the inspection we contacted the local authority quality monitoring team to seek their views about the service. We were not made aware of any concerns about the care and support people received. We also considered information we held about the service, such as notification of events about accidents and incidents which the service is required to send to CQC. We used all of this information to plan how the inspection should be conducted.

As part of the inspection we visited the office and met with the registered manager and nominated individual for the service. We spoke to three members of office staff including two team leaders and a senior officer. We spoke to four members of care staff. We spoke with 12 people who used the service and five relatives. We visited a further two people in their own homes with their permission. We also looked at seven care plans for people who used the service, MAR's for five people, six staff personnel files, staff training and development records as well as information about the management and governance of the service.

Updated 2 March 2018

This inspection of Grenfell House took place on 1 & 2 February 2018. This was the first inspection of the service which began operating from its current location in 2016. We gave the provider 48 hours’ notice of our inspection because the service delivers personal care to people living in a supported living setting and we wanted to be sure the registered manager and people who used the service would be available to answer our questions during the inspection.

The inspection was carried out by an adult social care inspector 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 caring for someone with a learning disability.

There was a registered manager in post. 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.

Grenfell House is run by PossAbilities, a social enterprise designed to help individuals with mental health difficulties, learning and physical disabilities live the life they choose. This service provides care and support to people with learning disabilities and mental health needs in 25 ‘supported living’ settings within Halton, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. We conducted our site visit at Grenfell House which is the registered office; however, we also visited two of the properties in which people lived during our inspection. At the time of our inspection, the service was providing support to 74 people.

People told us they felt safe when being supported by the Grenfell House staff.

Risks to people’s health, safety and welfare were assessed and detailed information was available to guide staff on how to support people to stay safe, whilst promoting their independence as far as possible. Bespoke Positive Behaviour Support plans were in place for those people who displayed challenging behaviour. These plans were comprehensive and enabled staff to understand people’s behaviour and how best to manage this for the safety of the individual and others.

Medication was managed safely and administered by staff who were appropriately trained. Support plans were in place regarding PRN (as needed) medication. The registered manager had addressed previous issues in relation to the recording of medications and implemented further training and development for staff in response.

Staff recruitment procedures were robust and ensured that staff appointed were suitable to work with vulnerable people.

There were appropriate numbers of staff deployed to meet people’s needs and to ensure people received consistent support. Staff we spoke with were able to describe the course of action they would take if they felt someone was being harmed or abused, and understood the reporting procedures.

Accidents and incidents were recorded and reviewed and the registered manager had implemented changes to the service after reviewing the findings of safeguarding investigations. We saw evidence that ‘lessons learned’ were regularly incorporated into the on-going learning and development of the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service operated within the principles of the Mental Capacity Act 2005 (MCA). Records demonstrated that processes were in place to assess people’s capacity and make decisions in their best interests with a focus on the least restrictive option.

Staff were assisted in their role through induction, training and supervisions and staff told us they felt well supported in their role. The Care Certificate was undertaken by newly recruited staff. Staff were also trained in specialist subjects such as epilepsy, autism and positive behaviour support to help their understanding when supporting people with these needs.

Staff supported people to maintain their health and well-being. Staff devised health action plans for people in consultation with people’s relatives. The service maintained good links with community health partners to ensure people’s health needs were met.

People told us they liked the staff who supported them. One person commented, “They are nice to me, they speak nice and help me if I am upset, they are never unkind.” Staff had developed strong relationships with the people they supported and had a good understanding of people's individual communication needs and this enabled people to be involved in decisions about their day.

Staff we spoke with were able to describe how they protected people’s dignity and right to choose how they wanted their care delivered. The service held ‘Dignity Days’ to promote dignity within the service and considered what dignity meant to the people they supported. There were relevant policies and procedures in place around confidentiality, data protection and equality and diversity to support good practice.

Care plans contained a high level of person centred information. Person centred means based on the needs of the person and not the service. Each care plan provided detailed information regarding people’s individual likes and dislikes and how they wanted their care delivered. This level of detail enabled staff to get to know the people they supported.

People were consulted in relation to the staff team that supported them. People and their relatives were involved in the recruitment and selection process of new staff and exercised choice in respect of who delivered their care.

People had access to an easy read complaints procedure and complaints were dealt with appropriately and in accordance with the registered provider’s policy. People and their relatives felt confident in raising concerns and they would be listened to. Opportunities were available for people to provide feedback regarding the service through the use of questionnaires, family forums and service user advisory board meetings. The registered provider had plans for the further development of these systems to include the implementation of ‘quality checkers’ and family advisory groups.

Staff supported people to access the local community and to engage with activities of their choice. People spoke enthusiastically about the range of individual activities they engaged with such as theatre trips, theme park visits and holidays. Staff were responsive to people’s changing needs and told us that activity plans could be changed to reflect the well-being or wishes of the individuals.

Staff spoke positively about working for the organisation and the registered manager who they described as ‘hands on’, ‘approachable’ and ‘a fountain of knowledge’. Staff we spoke with were able to describe the visions and values of the service, and felt supported by registered manager and registered provider in delivering them. The organisation had employee recognition schemes in place to acknowledge and celebrate good practice within the organisation.

The registered manager had a number of different systems in place to assess and monitor the quality of the service, ensuring that people were receiving safe, compassionate and effective care. The organisation's governance framework ensured that audits were completed on a regular basis with a focus on continued improvement. This included quality assurance checks at registered provider level.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred at the service in accordance with our statutory requirements. This meant that CQC were able to monitor risks and information regarding the service.