Archived: Friendship Care & Housing Association - 39 and 41 Derwent Road

39-41 Derwent Road is a purpose built care home consisting of two bungalows. It provides care and accommodation for up to six people with learning disabilities. At the time of our inspection visit, six people were living at 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 home was last inspected in April 2016, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, the home was awarded an overall rating of 'requires improvement'. This was because, where people lacked capacity to make day to day decisions, this was not always assessed. We found applications to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS) had not been made as required. We also found systems designed to check the quality and safety of the service provided were not always effective in identifying areas for improvement so these could be acted upon.

At this inspection, we found some actions had been taken to make the improvements required.

Where people lacked capacity to make decisions, this had been assessed and documented so people received the right level of support with decision-making. Where people were being deprived of their liberty, applications had been made to the local authority as required to ensure these were authorised and people’s rights were protected.

The provider had a range of measures in place to check the quality and safety of the service so that improvements could be made. They regularly consulted with people, their relatives and others to gather and respond to their feedback.

People were comfortable with staff, and relatives were confident that people were safe living in the home. 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. There were systems and processes used to identify and minimise risks to people’s safety. These systems were flexible so people could take risks to support their independence if they were able to do so.

People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped to ensure any issues of concern were identified and acted upon.

There were enough staff to meet people’s needs. The provider conducted pre-employment checks 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 the checks had been completed.

People told us staff treated them with dignity and respect. We saw interactions between people at our inspection visit were respectful, and the staff approach to people was also reflected in care records. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink and when, and were supported to maintain any activities, interests and relationships that were important to them.

People had access to health professionals whenever necessary, and we saw that the care and support provided was in line with recommendations. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on people being supported in ways they preferred. 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 whilst they had not had cause to complain, 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.

39-41 Derwent Road is a purpose built care home consisting of two bungalows. It provides care and accommodation for up to six people with learning disabilities. At the time of our inspection visit, six people were living at 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.

People were comfortable with staff and relatives were confident people were safe living in the home. 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 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 supported with their medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped ensure any issues were identified and action was taken as a result. There were enough staff to meet people’s needs.

The provider conducted pre-employment checks 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 decisions. We found that assessments of capacity for these people had not always been completed, and DoLS (Deprivation of Liberty safeguards) applications had not been made as required. However, staff and the registered manager had a good understanding of the Mental Capacity Act, and the need to seek informed consent from people wherever possible.

People told us staff treated them with dignity and respect. We also saw this in interactions between people at our inspection visit, and it was reflected in care records. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink and when, and were supported to maintain any activities, interests and relationships that were important to them.

People had access to health professionals whenever necessary, and we saw that the care and support provided was in line with recommendations. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on people being supported in ways they preferred. 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 in place to monitor the quality of the support provided in the home. However, these systems had not always identified gaps and inconsistencies in records, designed to keep people with specific health conditions safe.

We followed the care of two people; this included looking at their care records, observing care and speaking with their relatives. This gave us an understanding of people's needs and their experience of the care provided.

We also spoke with four members of staff and the registered manager. People were offered choices and their decisions were respected by staff. We saw that people appeared comfortable and relaxed in their surroundings and with the staff members on duty.

We saw that people were supported to attend and participate in a variety of activities throughout the week as well as spending time at the home.

We found that staff were kind and caring in their approach to people who lived in the home. There were sufficient numbers of staff on duty to ensure people received the support they needed.

We saw that there were processes in place for monitoring the health safety and welfare of people and assessing the quality of the service provided.

The people using the service had complex needs which meant they were not able to tell us their experiences. When we met with them they smiled when we asked them how they were. We found that staff knew people as individuals and understood their personal needs and ways of communicating those needs. We saw that people were relaxed and at ease with staff and within the home environment.

Relatives we spoke with told us, 'I am very happy ' staff know and understand XX well', 'I am more than happy with XX's care' and 'They do a good job at Derwent Road.'

The environment was homely with framed photographs displayed of people enjoying their holidays and other activities they did. We saw each person's bedroom was clean, warm, well furnished and reflected the person's individuality.

Each person had a nominated staff member, a 'key worker', who worked closely with them in planning the activities they wanted to try, for example, horse riding, swimming and gardening. Relatives we spoke with were complimentary about the support their family members had to do the activities they enjoyed.

Staff told us they felt supported by the manager and had the skills they needed to deliver the care people using the service needed.