Rainham House

Updated 15 August 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.

We inspected both supported living sites on 11 July 2018. This inspection was announced, and was carried out by one inspector. We gave the provider 36 hours’ notice because we wanted to ensure that someone would be available to support us with the inspection.

Before the inspection we spoke with three relatives. We also reviewed relevant information that we had received about the provider. Healthwatch confirmed they had not heard anything adverse about the service. The local authority, who have a commissioning role with the service, sent us a copy of their quality assurance monitoring report which provided feedback and recommendations that had been made to the service. Due to technical problems, the provider was not able to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made our judgements in this report.

During the inspection we spoke with the four people who used the service. Although communication was limited due to people’s support needs we observed people in their homes and interact with staff. We spoke with the registered manager and three members of care staff. We reviewed documents and records that related to people’s care and the management of the service, including two care plans, two risk assessments, two staff files, Medicine Administration Records (MAR), service audits and policies and procedures. After the inspection, we received further documents including the staff training matrix, resident meeting minutes and pre-admission assessments.

Updated 15 August 2018

We carried out an unannounced inspection of this service on 11 July 2018. This was the first inspection of this service since they registered with the Care Quality Commission (CQC) on 20 July 2016.

This service provides care and support to people living in two supported living settings, so that they can live 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.

At the time of our inspection four people were receiving personal care and support across two different sites. We visited both supported living sites as part of our inspection.

The service had 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.

Safeguarding procedures were in place and staff had a clear understanding of what abuse was and what to do if they had any safeguarding concerns. Staff were recruited safely, and pre-employment checks had been carried out to ensure they were suitable to support vulnerable adults. Staffing levels were sufficient, which meant the service could meet people's needs. Infection control was being managed in a safe way to prevent the spread of cross infection. Medicines were administered and managed safely. Records showed staff had signed when medicines had been received and counted; however, this was not audited. We recommended the service seek out and follow best practice guidance to oversee the auditing processes. Risk assessments were in place, but they did not always give a detailed and concise explanation of risk. We recommended that the service develop their risk assessments based on best practice guidance.

The service had completed pre-admission assessments for all people to ensure their needs could be met. Staff received a detailed induction to the service including completing the Care Certificate and additional specialist training to allow them to provide the best support to people. People had a choice around their meals and the service promoted healthy living through diet and exercise. The service worked well with other health and social care teams to ensure the care and support offered was complete. Staff understood the Mental Capacity Act 2005 (MCA). The MCA is a law protecting people who are unable to make decisions for themselves. Where people did not have the capacity to consent to their care and support, the appropriate applications had been made to the Court of Protection.

Staff demonstrated an understanding around equality and diversity. Staff spoke to us about how they maintained people's privacy and dignity, particularly in relation to personal care. This ensured people felt safe and comfortable. Staff were observed to be kind and respectful and had a positive relationship with people. The service promoted people to be as independent as possible.

People received personalised support that was responsive to their individual needs and each person had an up to date care plan. People were encouraged to engage in activities of their choice, both within the home and the local community. People and their relatives were fully involved in their care and support and felt comfortable raising any issues they might have about the care they or their relative received. The service had arrangements in place to deal with concerns and complaints.

The registered manager and the provider were open and transparent and this meant the service had clear values about wanting people to be well. They gathered feedback from people, relatives, staff and stakeholders. This feedback alongside the audits and quality checks meant the service were always monitoring and improving. Staff felt valued by the registered manager who was approachable and supportive.