Conway House

Conway House is a care home providing accommodation and personal care for up to eight people, living with learning disabilities and/or autistic spectrum disorders. At the time of our inspection there were seven people living at the home.

We found the following examples of good practice.

¿ Professional visitors were asked to evidence a negative lateral flow test (LFT) and COVID-19 vaccination status. Visiting family members were asked to provide evidence of a negative LFT or given the opportunity to have one completed on site at the home. Visitors were provided with appropriate personal protection equipment (PPE) if required.

¿ Furniture in the indoor lounge and dining areas had been rearranged to take account of social distancing.

¿ There was additional cleaning of touch points in communal areas to mitigate the risk of cross infection.

¿ The service kept in contact with family members through essential visits, social media, phone calls, window visits and an outdoor building that could accommodate visits for those visitors who preferred not to enter into the home.

¿ Staff adhered to PPE guidance and practices. There was a plentiful supply of PPE at all PPE stations.

¿ Clear plans were in place for those who may be required to self-isolate. For those people who may struggle with isolation additional support was provided.

¿ Staff continued to support people to access healthcare services. Arrangements were in place should people need to attend hospital and return to the home safely.

Conway House is a care home that is registered to provide care and accommodation to people who need support as they have needs related to learning disabilities or autistic spectrum disorders. The service does not provide nursing care. At the time of our inspection there were eight people living at the home.

People’s experience of using this service: People and their relatives told us they felt safe with staff. Staff could tell us how they should keep people safe and minimise identified risks to their safety.

People were supported by staff that we saw were caring and expressed interest in people who lived at Conway House. People we saw received good care and support that was based on their individual needs and preferences. Whilst care records were not always accurately documented, staff were knowledgeable about people, their needs and preferences and we saw they had a good relationship with the people.

People were supported by care staff who had a range of skills and knowledge to meet their needs, although there were some areas where training updates were needed to refresh their knowledge. The registered manager was aware of and planned to provide these updates. Staff understood, felt confident and well supported in their role, although there was an inconsistent approach to formal staff supervision. People's health was supported as staff worked with other health care providers to ensure people’s healthcare needs were met.

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

People's care plans with limited exception reflected people’s needs and preferences but the staff and registered manager could explain any recent changes to people’s care or gaps in records. Where there was changes staff knew how they should provide care to ensure people were safe, their needs were met, and preferences respected.

People’s representatives knew how to complain. Relatives and staff knew how to identify and respond if people were unhappy with the service. People told us they had no complaints, although where concerns had been raised the provider had responded appropriately and met with people face to face, with the involvement of other professionals to try and reach a suitable conclusion for all parties.

People, relatives and staff gave a positive picture as to the quality of care people received and said the registered manager and staff were approachable. People and relatives said staff would listened and responded to any concerns they had.

Quality monitoring systems were in place but were not always effective or comprehensive however. The registered manager was aware of this shortcoming and told us they would make the necessary improvements.

Please see the detailed findings for more information

Rating at last inspection: The rating for the service at our last inspection was ‘requires improvement’ (Published on 09 December 2017).

Why we inspected: This was a planned comprehensive inspection that was due based on our scheduling targets.

Enforcement:

No enforcement action was required.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

At our last inspection on 13 April 2015 the service was meeting all of the regulations that we assessed.

The provider is registered to provide accommodation and personal care to a maximum of eight people. On the day seven people lived at the home. People had needs in relation to their learning disability/ associated conditions and or/physical disability.

The manager was registered with us as is required by law and they were present on the day. 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 had been in post for a number of years and this promoted consistency of management. People knew who the registered manager was. We saw that the registered manager was visible within the service and had a good insight into the overall operation of the service. Provider visits and quality monitoring processes ensured the service was run in the best interests of the people who lived there. However, the provider had not met their legal duty to notify us of Deprivation of Liberty Safeguarding [DoLS] authorisations. A breach of regulation limits the highest overall rating the service can be awarded to ‘Requires Improvement’.

Staff were provided in adequate numbers to keep people safe and to meet their needs. Procedures were in place for staff to ensure the risk of harm and/or abuse was reduced and people were kept safe. Recruitment processes prevented the employment of unsuitable staff. Medicine systems confirmed that people had been given their medicines as they had been prescribed.

Staff received the training they required to give them the knowledge they needed to support people safely. Staff received supervision on a regular basis and felt supported by the management team. Staff were aware that people’s care must be delivered in line with their best interests and they must not be unlawfully restricted. Where possible people were encouraged to make decisions about their care. People were offered the food and drink they preferred. Health and social care professionals were involved to promote people’s health and well-being.

A homely atmosphere was promoted within the service. People were supported by staff who were friendly, helpful and caring. People were treated with dignity and respect and their independence was promoted. People could see their family whenever they wished to and their families were made to feel welcome by staff.

People and/or their families were involved in their pre-admission assessment of need and follow on reviews. Systems were in place for people and their relatives to raise their concerns or complaints if they had a need to. People were offered in-house activities and were given the opportunity to access the community regularly.

As people had complex needs and were not all able to tell us about the service they received we used different methods to help us understand their experiences, including observation. We observed good interactions between staff and people living there. People were smiling and they looked happy. One person confirmed, 'Yes' when we asked them if they liked living at the home. Another person confirmed, 'Yes' when we asked them if they felt they were safe and well looked after.

We saw that people were treated with respect and dignity.

People's needs had been assessed by a range of health professionals including dieticians and specialist consultants. This meant that people's health care needs had been monitored and met.

Improvements had been made concerning medication management. This meant that there was less risk of medication errors which could have impacted on people's health and well being.

We saw that a complaints process was available for people to access if they were not happy with the service that had been provided.

We found that quality monitoring processes were in place to make sure that the service provided was of a good standard and benefitted the people living there.

As people had complex needs and were not all able to tell us about the service they received we used different methods to help us understand their experiences, including observation. We observed good interactions between staff and people living there. People were smiling and they looked happy. We spoke with a relative who was very complimentary about the care provided and the staff. They said,' I am so pleased with the care that they receive. I think it is a very good home'.

We saw that people were treated with respect and dignity. People's needs had been assessed by a range of health professionals including dieticians and specialist consultants. This meant that people's health care needs had been monitored and met.

Although some improvements had been made concerning medication management further changes to systems were needed to prevent medication errors and risks to people using the service.

Staffing levels were adequate which meant that people living at the home received the care and support that they required.

Records and staff both confirmed that systems had been used to monitor how the home had been run to benefit the people who lived there.