Archived: The Goddards

We previously inspected this service in March 2016 when the service was rated as good. The rating for the service from this inspection is requires improvement overall. This is the first time the service has been rated requires improvement.

The Goddards 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 accommodates 14 people in one adapted building. At the time of this inspection the service supported 12 people with learning disabilities or an autistic spectrum disorder.

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 place. 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.

Staff did not always follow the provider’s medicine policy and procedure. This meant people were at risk from not having their medicines managed safely and administered as prescribed.

The provider failed to maintain records of checks completed on equipment that people used to assist them with their mobility and to keep them safe.

Systems and processes in place failed to ensure staff received training or refresher training to ensure their skills and knowledge remained up to date to carry out their role and meet people’s individual needs.

The provider told us on their PIR in February 2018 that they would implement spot checks , to check and record if staff were competent in their role or the activity of care they provided. However, we found this had not been put in place.

The provider completed a range of checks and audits to maintain and improve the service. However, the systems and processes were not robust and failed to highlight and action the concerns we found during this inspection. There was a lack of oversight to evaluate for example, any accidents and incidents that had occurred and to share outcomes with staff to improve experiences for people.

We observed there were enough staff on duty to meet people’s needs. People confirmed they received care and support from regular care workers who they knew.

People told us they felt safe living at the home and staff understood how to recognise and report any signs of abuse.

Staff had completed training on the Mental Capacity Act 2005 (MCA) and were able to discuss the importance of supporting people with their independence.

People received information in a format they could understand. Where people had communication difficulties, staff understood their needs and recognised their body language and expression. This ensured their ability to communicate was enhanced.

The provider included people or their representatives in annual discussions regarding their health and wellbeing. Any positive behaviour support plans were evaluated and included input by appropriate health professionals for effectiveness.

The provider had systems and process in place to ensure care workers were appropriately recruited into the service and had the necessary skills and personality to support individuals with their everyday needs and preferences.

Care plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details of people's preferences and any specific dietary needs they had, for example, whether they were diabetic, had any allergies or religious needs.

Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was information available on how to express concerns and complaints. People were encouraged and supported to raise their concerns and processes were in place to ensure these were responded to.

People were supported to live fulfilled meaningful lives. The provider supported people to obtain skills to take up opportunities of work and attend college.

People discussed the activities and interests they could follow. People who chose to remain at the home participated in daily events. The provider supported people to maintain meaningful relationships and they were protected from social isolation.

We found the provider was in breach of three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). You can see what action we told the provider to take at the back of the full version of the report.

The Goddards is registered to provide accommodation and care for up to 14 people. The service supports people with learning disabilities or an autistic spectrum disorder.

The registered provider is required to have a registered manager in post and there was a registered manager at this service. 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.

People told us that they felt confident about their safety. We found that the care staff had a good knowledge of how to keep people safe from harm and the staff had been employed following robust recruitment and selection processes. We found that the management of medication was safely carried out.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. The plans of care were individualised to include preferences, likes and dislikes. People who used the service received additional care and treatment from health professionals based in the community. People had risk assessments in their care files to help minimise risks whilst still supporting people to make choices and decisions.

People that used the service were cared for and supported by qualified and competent staff that were regularly supervised and received appraisal regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing. They told us they were satisfied with the meals provided by the service. People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on.

People were able to see their friends and families as they wanted. There were no restrictions on when people could visit the service. People spoken with said staff were caring and they were happy with the care they received. They had access to community facilities and most participated in the activities provided in the service.

We observed good interactions between people who lived in the service and staff on the day of the inspection. We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People’s comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that the registered manager met with people on a regular basis to discuss their care and any concerns they might have. This meant people were consulted about their care and treatment and were able to make their own choices and decisions.

People’s well-being, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible. This ensured people were respected, that they felt satisfied and were enabled to take control of their lives.

The people who used the service and the staff told us that the service was well managed. The registered manager monitored the quality of the service, supported the members of staff and ensured that there were effective communication and response systems in place for people who used the service.

There were clear processes in place for what should happen when a person moved to another service, such as a hospital, which ensured that the person's rights were protected and that their needs were met.

We found that the service was clean, tidy and there were no malodours in the building. However, we had a few minor concerns about infection control practices which we have addressed in our report.

We saw that there were sufficient numbers of staff on duty to meet the needs of the people who used the service. One person told us 'I love living in this home, the staff are great and we are well looked after.'

The provider had an effective quality assurance system in place and people's views and opinions of the service were listened to and acted on where necessary.

Records about people who used the service enabled staff to plan appropriate care, treatment and support. The information needed for this was systematically recorded and kept behind locked doors to keep it safe and confidential.

We observed staff and people interacting during our visit. They were able to communicate to a good level of understanding using verbal and non verbal methods. We observed staff with people who used the service in the activity lounge and in the dining room at lunch time. We saw that staff were genuinely caring towards people and treated them with respect at all times.

People were able to participate in a number of activities both internal and external to the service and were offered choice in what they wanted to do. People were provided with support and choices around eating and drinking. They were offered a selection of meals from a monthly meal plan that they had helped devise. They could choose to eat in the dining room or the activity room.

People told us that they understood how to make a complaint if needed and that they received help and support from their key worker or the manager. One person told us 'I like it here. The staff are nice and I have lots of friends.'