Background to this inspection
Updated
6 December 2017
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 visit took place on 28 September 2017 and was unannounced. The inspection team consisted of one inspector.
We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also spoke with the local authority who provided us with current monitoring information. We used this information to formulate our inspection plan.
On this occasion, we had not asked the provider to send us a provider Information return (PIR). A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant.
We spoke with five people who used the service and three members of care staff, the deputy manager, the registered manager and the provider. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.
We looked at the care plans of three people to see if they were accurate and up to date. We reviewed one staff file to see how staff were recruited. We checked records to see how staff were trained and supported to deliver care appropriate to meet each person’s needs. To ensure the service was continuously monitored and reviewed we looked at records that related to the management of the service including quality checks.
Updated
6 December 2017
This inspection was unannounced and took place on 28 September 2017. The service is registered to provide accommodation and personal care support for up to 12 people. At the time of our inspection, nine people who had learning disabilities were using the service.
Our last inspection visit took place on 7 February 2017, and the overall rating for the service was ‘requires improvement.’ The key question ‘is the service well led?’ was rated as ‘inadequate.’ We found the provider was in breach of six Regulations, and we arranged a meeting with the provider and registered manager on 20 March 2017. They told us how they would ensure that the improvements needed would happen, and sent us an action plan on 16 May 2017, with the details of how they would do this. As one key question was rated as ‘inadequate,’ this meant we would visit the service to complete another inspection within six months of the report being published.
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.
At this inspection, we found that improvements had been made, but further were needed to ensure the service was consistently well led. This was because some people’s care records still had to be reviewed to ensure they were up to date. Certain relevant assessments still needed to be completed. The provider did not have a systematic approach to determine the levels of staffing that were required.
People continued to be safe living at the home. Staff understood how to protect people from harm and abuse. Risks to individuals were assessed, monitored and reviewed, and people were involved in these decisions when able. There were enough staff to meet people’s needs, and the provider followed safe recruitment practices. People’s medicines were managed safely, and they were protected from any harm associated with them.
When people were not able to make certain decisions for themselves, the provider followed the guidance available to ensure support was in their best interests. Staff gained people’s consent before they assisted them, and were aware of how to support people to make decisions. Staff received training to ensure they could carry out their roles effectively. People were supported to maintain a balanced diet and access healthcare services when needed.
People were supported by staff who had developed positive, caring relationships with them. People were listened to, and they were involved in making day to day decisions about their care. Their independence was promoted, and people were supported to have control in their lives. Staff understood how to ensure people’s privacy and dignity were respected.
People were able to participate in various activities they enjoyed, and were protected from the risk of social isolation. People were involved in the planning of their support, and received care that was individual to them. Their views were taken into account when improvements were made in the service and they knew how to raise concerns.
There were now systems in place to monitor and assess the quality of care people received. Actions were taken to make improvements and staff felt supported in their roles. The registered manager and provider showed a clearer understanding about their responsibilities as registered persons.
We will continue to review this service to ensure these improvements continue and are embedded and sustained in the future.