Archived: Streatfeild House

Updated 13 October 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.

We inspected the service on the 7 and 11 September 2017. This was an unannounced inspection. The inspection was undertaken by an inspector.

We reviewed the information we held about the home, including previous inspection reports and the Provider Information Return (PIR). This is a form in which we ask the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the action plan provided following our last inspection. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we reviewed the records at the home. These included staff files which contained staff recruitment, training and supervision records. Also, medicine records, complaints, accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

We looked at four support plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at the home. This is when we looked at their care documentation in depth and how they obtained their care and treatment at the home. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection we spoke and met with 15 people and two relatives to seek their views and experiences of the services provided at the home. We also spoke with the registered manager, deputy managers, five care staff and two members of ancillary staff. During the inspection process we spoke to health and social care professionals that worked alongside the service to gain their views.

We observed the care which was delivered in communal areas and spent time sitting and observing people throughout the home and were able to see the interaction between people and staff. This helped us understand the experience of people who could not talk with us.

Updated 13 October 2017

We inspected Streatfeild House on 7 and 11 September 2017.This was an unannounced inspection. The service provides care and support for up to 22 people living with a range of learning disabilities and a variety of longer term complex healthcare needs such as epilepsy and diabetes. The age range of people at this time was from 50 years upwards. Several people have been living at the service for over 20 years. There were 20 people living at the service on the day of our inspection.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

Streatfeild House was last inspected in June 2016. At this comprehensive the overall rating for this service was Requires Improvement. Two breaches of Regulation of the Health and Social Care Act 2008 (Regulated Activities) 2014 were identified. This was because the provider had not taken adequate steps to ensure people’s safety in relation to fire risks, medicines and checks on staff suitability to work within the service. We also found kitchen staff had not consistently followed basic food hygiene principles. Following the inspection, we received an action plan which set out what actions were to be taken to achieve compliance by May 2017.

This inspection on 7 and 11 September 2017 was to see if improvements had been made and embedded into practice. We found that significant improvements had been made and the breaches of Regulation met.

This inspection found that the management and storage of medicines were safe. As discussed with us on inspection, there were areas to further develop in respect of the management of ‘as required’ (PRN) medicines and these were immediately actioned. Risks related to fire exit safety had been reviewed and advice sought as required. Fire exit safety was now effectively managed and all exits could be accessed immediately in the event of an evacuation. The provider had systems to monitor and drive improvements in the quality of the service.

People who were supported by the service felt safe. Staff had a clear understanding on how to safeguard people and protect their health and well-being. People had a range of individualised risk assessments to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. Staff were aware of people's needs and followed guidance to keep them safe.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of the MCA. The registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety. Staff received a wide range training to ensure they could support people safely and received support to carry out their roles effectively. People felt supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager) and team meetings to help them meet the needs of the people they cared for. People's nutritional needs were met. People were given choices and were supported to have their meals when they needed them. Staff treated people with kindness, compassion and respect and promoted people's independence and right to privacy.

People received care that was personalised to meet their needs. People were supported to maintain their health and were referred for specialist advice as required. There were good systems that ensured safe transitioning between services. Staff knew the people they cared for and what was important to them. Staff appreciated people's life histories and understood how these could influence the way people wanted to be cared for. Staff supported and encouraged people to engage with a variety of social activities of their choice in house and in the community.

The service looked for ways to continually improve the quality of the service. Feedback was sought from people and their relatives and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider's complaints policy. Leadership within the service was open, transparent and promoted strong staff values. This had resulted in a caring culture that put the people they supported at its centre.

People, their relatives and staff were complimentary about the management team and how the service was run. The registered manager informed us of all notifiable incidents. Staff spoke positively about the management support and leadership they received from the management team.