This inspection was carried out on the 7 and 11 December 2015 and was unannounced.
1 & 2 Crosby close provides nursing care and support for up to 12 people with physical and learning disabilities.The location consists of two houses side by side and 6 people reside in each House. There were five people living at 1 Crosby close and 6 people living at 2 Crosby close on the two days of our inspection.
People were not always kept safe, although there were risk assessments in place they were not always followed. Medicines were not managed safely. Permanent staff employed at the service had received appropriate training for their role, but the interim manager told us they did not know what training agency staff had completed and this may well have compromised people’s safety. We saw that agency staff had a ‘profile’ which provided some information but not in relation to training they had undertaken. Staff told us they felt supported and had recently had one to one meetings with their line manager.
There were systems in place to monitor the quality of the service and action plans developed to address any issues found. However, actions relating to the improvement of the safe administration of medicines had not been addressed at the time of our inspection.
There was not a registered manager in post. The registered manager had recently left the service and the provider was in the process of recruiting a new manager for the service. There was an interim manager who was overseeing the day to day management of the service. 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.
The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS)
We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that most people living at the service were able to make their own decisions and those who were unable had their capacity assessed. The manager and staff understood their roles in relation to DoLS. DoLS applications had been completed for people who received constant supervision and were awaiting an outcome.
People received care that met their needs and we observed staff knew them well. People were unable to contribute to planning their care, however in the case of some people, family and relatives had been involved.
People attended day centres and were supported with other activities both in the home and the community.
You can see what actions we have asked the provider to take in the full version of the report.