This inspection took place on 19th November 2015 and was announced.The service is registered to provide care and accommodation for to up to four people with a learning disability. At the time of our inspection there were four people living in the home.
The service had a registered manager. 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 registered manager also manages another service. As the other service is next door, the registered manager is at the home on a daily basis.
People were comfortable with staff and relatives were confident people who lived in the home were safe. Staff received training in how to safeguard people, and had access to the provider’s safeguarding policies and procedures if they had any concerns. Staff understood what action they should take in order to protect people from abuse. Systems were used effectively to identify and minimise risks to people’s safety. These systems were flexible so people could take risks if they were able to do so and build their independence.
People were administered their medicines by staff who were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines ensured errors were identified and action taken as a result. There were enough staff to meet people’s needs, with numbers of staff increased recently to support people effectively.
Checks were carried out prior to staff starting work to ensure their suitability to support people who lived in the home. Staff told us they had not been able to work until checks had been completed.
Some people were considered to lack capacity to make day to day decisions such as what to eat, what to drink, what to wear. This had been assessed so staff knew how much support people needed with decision making. However, where applications had been made to deprive people of their liberty under Deprivation of Liberty Safeguards (DoLS) because they did not have capacity to decide where they wanted to live, this was not clearly linked to an assessment of capacity. Staff had a good understanding of the Mental Capacity Act, and the need to seek informed consent from people wherever possible. Staff followed the principles of the Act throughout our visit.
Staff were respectful and treated people with dignity. We saw this in interactions between people at our inspection visit, and this was also reflected in records kept. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink, and were supported to prepare their own meals if they wanted to.
People had access to health professionals whenever necessary, and we saw that the care and support provided in the home was in line with what had been recommended. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on the achievement of goals. Staff tried to ensure people were fully involved in how their care and support was delivered, and people were able to decide how they wanted their needs to be met.
Relatives told us they were able to raise any concerns with the registered manager, and they would be listened to and responded to effectively, and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions. There were systems to monitor the quality of the support provided in the home, and recommended actions were clearly documented and acted upon. This was achieved through unannounced provider’s visits to check different aspects at each visit.