We carried out a review of the data available to us about Sefton New Directions Limited - Hudson Road on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Sefton New Directions Limited - Hudson Road, you can give feedback on this service.
Hudson Road is a residential care home providing personal care to four people at the time of the inspection. The home is registered for up to six people. People supported at Hudson Road have profound and multiple disabilities including learning, physical disabilities and sensory needs. Accommodation is provided in single bedrooms.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practise guidance. This ensures that people who use the service can live a full a life as possible and achieve the best possible outcomes that include control, choice and independence. People’s support focused on them having as many opportunities as possible.
People’s experience of using this service and what we found
Relatives told us that the standard of care their loved ones received at Hudson Road was exceptional.
We observed peoples’ support during our visits to Hudson Road, staff were gentle and showed people kindness and affection, within their professional boundaries.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care and support were delivered on a very individual basis. People were encouraged to plan and decide their daily routines. Activities were generally planned in advance to ensure staffing levels were appropriate, however all activities were flexible relative to people's well-being.
Staff knew people extremely well care, support and activities were planned around individual likes and dislikes. People were encouraged to participate in activities which were meaningful to them for example bus journeys, lunches out and trips to the cinema.
Professionals also spoke very highly of the home and how the home was able to support people to have good outcomes, helping to maintain good physical health. They commented on the lovely atmosphere in the home, and the professionalism of the staff. Ideally, wherever possible people would be supported until the end of their life in the home by people who know them.
Healthcare records were kept to high standards and staff knowledge of individuals was extremely good. This enabled staff to recognise any changes in people and seek early access to primary healthcare services, this ensured excellent continuity of care.
Staff responded to overcome any constraints presented when supporting people to live fulfilled lives. People enjoyed attending live music events, cycling in summer, swimming and being part of the community despite physical and sensory challenges.
Risks were assessed and managed well. People received their medicines as they should.
Thorough recruitment, staff induction and ongoing training were in place to ensure that staff were suitable to work and provide support within the home. There was a very low change of staffing which meant people were supported by a staff team who knew them and their preferences extremely well.
People had access to food, snacks and drinks throughout the day, food was freshly prepared.
Staff knowledge and understanding of people and the way in which they communicated meant they effectively supported people to live their best life.
Complaints were managed effectively in line with company guidance. Family members told us that they had no complaints. Families felt they were respected, consulted and fully involved with their loved ones care.
People would be encouraged to continue their involvement with their chosen religion after moving to the home.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published April 2017). We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good.
Prior to the inspection we received information of concern relating to the management of finances and the conduct of staff when providing care and support. As part of the inspection process we looked in detail at financial procedures and practice. We saw that people were protected from the risk of abuse or harm because staff knew people well and were vigilant in monitoring risk. Financial systems and checks were robust to ensure that people’s expenditure was accounted for.
Staff had been trained in adult safeguarding and knew what action to take if they suspected abuse or neglect. Each of the staff that we spoke with was clear about their responsibilities to report concerns inside and outside the service. Staff behaved in a professional and caring manner throughout the inspection.
People’s relatives were extremely complimentary about the caring attitude of the staff. It was clear from our observations and discussions that staff knew people well and tailored the provision of care and support to meet individual needs. The language and approach used by staff was exceptionally gentle and caring.
Medicines were safely managed within the service by trained staff and in accordance with best-practice guidance for care homes. We checked the storage, administration and record-keeping for medicines and found that stock levels were correct and records were completed correctly.
Staff were trained in subjects relevant to the needs of people living at Hudson Road. This training was refreshed on a regular basis. Staff were supported through both informal and formal supervision. The registered manager or the assistant service manager was available to offer guidance and support on a daily basis.
People’s capacity was assessed and consent sought in accordance with the Mental Capacity Act 2005.
People were supported to maintain a varied and healthy diet in accordance with their preferences and healthcare needs. People’s nutritional and fluid intake was monitored where there was an identified risk.
We saw from care records that staff supported people to access a range of community based healthcare services on a regular basis. Some people were also supported to access specialist healthcare services where there was an identified need.
The allocation of hours meant that care was not task-led and could be delivered flexibly to meet people’s needs and preferences. Staff involved people in day to day discussions about their care and support and gave them the option to refuse or do something different. People were given information in a way that made sense to them.
The care records that we saw clearly demonstrated that people and their representatives had been involved in the assessment process and planning of their care. Where people had learning disabilities which limited their understanding of the process, the service had made good use of person-centred planning techniques to maximise their involvement.
The procedure for receiving and handling complaints was clear. Compliments and complaints were checked as part of the provider’s audit processes.
Relatives and staff spoke positively about the quality of communication and the general management of the service.
The staff that we spoke with were motivated to provide high quality care and understood what was expected of them. They spoke with enthusiasm about the people that they supported and their job roles.
The registered manager had sufficient systems and resources available to them to monitor quality and drive improvement. Quality and safety audits were completed on a regular basis. Important information was captured and used to produce reports.
Further information is in the detailed findings below.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
Sefton New Directions Ltd - Hudson Road is registered to provided accommodation and personal care for up to six adults. The people living at the home have both physical and psychological support and care needs. The Home is owned and run by Sefton New Directions Limited.
We found people living at the home were kept safe from abuse because the staff understood what abuse was and the action they should take to ensure actual or potential abuse was reported. Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults.
People and their families told us there were sufficient numbers of staff on duty at all times. We observed staff supporting people in a way that ensured their safety whilst maintaining their dignity. The care records we looked at showed that a range of risk assessments had been completed depending on people’s individual needs. These assessments were aimed at trying to get the person to be as independent as possible, including accessing the local community safely.
We observed staff support and interactions and we saw how staff communicated and supported people as individuals. Staff were able to explain in detail how each person communicated their needs. Staff explained that they had worked in the home for a long time and had built up solid relationships with all of the people living at Hudson Road.
A relative we spoke with was very aware that staff had the skills and approach needed to ensure people were receiving the right care. We were told, ‘’The staff are absolutely fantastic. They are very attentive and caring. [Person] does lots of activities and gets out and about. [Person] sees this as home and can’t wait to get back. It’s a really good quality of life.’’ We saw comments from another relative in a relative feedback survey which said, ‘’People living at Hudson Road have a brilliant life socially. This is the happiest [person] has been in their life.’’
We saw that local health care professionals, such as the person’s GP, speech therapist and dietician were regularly involved with people if they needed it. We spoke with a visiting health care professional at the time of our inspection and another professional following our visit. Both gave positive feedback about the home. Both described an extremely proactive service which identified any issues regarding people’s health very quickly and ensured they received the right support and intervention. A nurse who visits told us, ‘’They are one of the most organised and proactive homes I go to.’’ We were told that people’s individual care plans and details around hospital visits were always up to date and it was very easy to carry out any medical review.
We observed the lunch time meal. This was clearly a positive experience for people. Staff supported people as needed and knew about each person’s individual preferences, likes and dislikes. We saw that there was plenty of food available and drinks were readily available and easily accessible. Care records showed that careful attention was taken to monitor people’s weight and daily food and fluid intake charts were maintained to ensure people were having an adequate diet.
We looked at how medicines where managed in the home. We found safe medicine practices which were monitored and reviewed. People’s medication was regularly reviewed. A visiting health care professional advised us that the home were particularly proactive at ensuring regular medication reviews took place.
We saw that staff were caring, considerate and respectful. Staff had a good understanding of people’s needs and their preferred routines and had developed care so that it was planned individually. We observed positive and warm interactions between people living at the home and staff throughout the inspection. These observations were reinforced by comments from a relative we spoke with as well as comments seen in feedback surveys.
Staff told us they were well supported through the induction process, supervision and appraisal. We saw there was a training programme in place and staff told us they were supported and encouraged to develop their skills. All of the care staff had a formal qualification in care which evidenced a good knowledge base for their role.
The principles of the Mental Capacity Act (2005) [MCA] were adhered to for people who lacked mental capacity to make their own decisions. We saw examples where care and treatment had been carried out in people’s best interest. This had included assessment of the person’s mental capacity and good practice with reference to the MCA Code of Practice. None of the people living at Hudson Road were on an order which restricted or deprive them of their liberty. The Deprivation of Liberty Safeguards [DoLS] is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. We found the manager and senior staff knowledgeable regarding the process involved.
Arrangements were in place for checking the environment to ensure it was safe. We observed that the building was clean and tidy. There were regular checks made by staff to help ensure the building was maintained safely.
We spent time talking to the manager who was able to talk positively about the importance of a ‘person centred approached’ to care; meaning care was centred on the needs of each individual rather than the person having to fit into a set model within the home. The manager felt this was evidenced through the development of positive relationships with people living at Hudson Road by staff that supported people based around each person’s preferred lifestyle and choice of daily activities.
There was a process in place for managing complaints. There had been no complaints about the service at Hudson Road. A relative we spoke with told us staff and the manager were approachable and felt that any issues would be addressed.
A registered manager was 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.
Staff told us the district nursing service provided on-going clinical support and people's GPs visited regularly to review people as needed. The care files contained daily records of the care and support people received and this included visits by health professionals where appropriate.
People were supported to be able to eat and drink sufficient amounts to meet their needs. People's nutritional needs were documented. We also saw that people were offered regular drinks and meals throughout the day.
Hudson Road was being maintained satisfactorily, with all areas safe and comfortable for people to live in. we looked at maintenance records and also saw good on-going monitoring [auditing] of the service carried out by the provider.
People living at Hudson Road and their relatives spoken with on the day of our inspection were very positive about the staff and the care provided. Relatives said that staff were available and provided good support. These comments were supported by our observations of people's wellbeing on the inspection.
We looked at a series of records maintained on the home. These ranged from care records for people living at Hudson Road, maintenance records and staff records. All of these were maintained satisfactorily.
We were shown how people who live at 2 Hudson Road were involved in choosing the menu for the week ahead. Meal times were flexible and changes to the time and menu were made in line with individual preferences. Although most of the food shopping was done by care workers, people went shopping regularly for food, clothing and items for their rooms.
We spoke with two relatives and they told us, 'This is the best place we have seen. P has really come on since they came here and we are very happy with the care and attention that the staff give'. They told us that their relative was always smartly dressed and seemed very settled whenever they visited and that they were made to feel very welcome at any time. They told us they were always invited to any reviews or meetings and if they couldn't attend they always got written minutes. If P was unwell they were always contacted immediately and were always kept informed.
Relatives said staff supported people well. We saw there was good communication when staff carried out care. They said the standard of care was consistent and their relative was being well cared for. This showed the home was responsive to people's care needs.
We received positive comments from relatives, about the staff which helped evidence their competency and approach to care. We also saw further comments from relatives collected as part of the provider's ongoing review of the service. For example we saw comments from surveys which included:
'Staff are very good and friendly. They always make me welcome and give 110% care'
'Staff give the best attention at all times'
'The staff go out of their way to please'
'Could not get more friendly caring staff'