Archived: Grantham Street

This service provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of the inspection, there were nine people using the service.

At the last inspection on 23 September 2015, the service was rated as ‘Good’. During this inspection, we found the service remained ‘Good’.

People using the service said they felt safe and staff treated them well. Appropriate recruitment checks took place before staff started work. There were enough staff on duty and deployed throughout the service to meet people's care and support needs. Safeguarding adults’ procedures were robust and staff understood how to safeguard the people they supported from abuse. People's medicines were managed appropriately and safely.

Staff had completed an induction when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the principles associated with the Mental Capacity Act 2005 (MCA) and acted according to this legislation. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were appropriate arrangements in place to ensure people were supported to follow a healthy diet. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. We observed staff had a good relationship with people and supported them in an attentive and unhurried manner. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. Support plans and risk assessments provided guidance for staff on how to meet people’s needs. People were supported to participate in activities that were personalised and meaningful to them. We noted people participated in a wide range of activities and had a weekly activity planner to help them structure their time.

People were aware of how they could raise a complaint or concern if they needed to and had access to a complaints procedure.

All people and staff told us the service was well managed and operated smoothly. The registered manager provided leadership and took into account the views of people, their relatives and staff about the quality of care provided. The registered manager used the feedback to make improvements to the service.

Was the service safe?

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. We saw that an application had been made to act for a person who lacked the mental capacity and that it had been in her best interests. Relevant staff had been trained to understand when an application should be made, and how to submit one.

We saw that applications had been made, when appropriate, to the local authority safeguarding team. This meant that people were safeguarded as required.

The service was safe, clean and hygienic. There were policies and procedures for the control of infection. Two people who used the service said, "I like to help in the kitchen and to keep my room clean" and "They help me keep my clothes and room clean".

Was the service effective?

People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. Two people who used the service told us, "I am well looked after. My care is good" and "I think they care well for us".

Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw that although people were tenants within their own home the premises had been sensitively adapted to meet the needs of people with physical impairments.

We saw that medication policies and procedures were adhered to in order to ensure people who used the service had the correct medication administered at prescribed times.

Was the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. There was a friendly atmosphere within the home and we observed that staff chatted to people who used the service throughout the day. Two people who used the service told us, "The staff are my friends" and "The staff are very nice and look after us".

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People who used the service or a family member were encouraged to provide as much information about their past lives and what they liked or did not. This information gave staff the knowledge to treat people as individuals.

Was the service responsive?

People completed a range of activities in and outside the service regularly. Each person had their known hobbies and interests recorded. On the day of the inspection people had gone out shopping, to the swimming baths, to work and for personal reasons such as a hair cut. People were offered a wide range of activities they could attend. Some people who used the service had already taken one holiday and six more were going to Spain the week following the inspection. One person told us she was going to church for a social activity and went to church on Sundays to follow her religion.

The registered manager held regular meetings with staff, family members and people who used the service. The families of people who used the service helped run and direct the home and held meetings every two months to discuss the homes progress with part of the agenda being to discuss any matters related to the housing or care. One family member told us, "We keep an eye on things to ensure the houses and staff are all right. The registered manager attends the meetings and is very good".

Was the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. There was a system for providing information to other providers in an emergency.

The service had good quality assurance systems. The registered manager undertook regular audits of the service. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually improving.

Care plans and risk assessments gave staff the knowledge to deliver care effectively.

There was a well equipped office with fax machine, email, computers and all other equipment required to manage the service on a daily basis.

One person told us, "I have been at work today. I like working. I help in a kitchen. I like living here, the staff and I can go out a lot. I have been to Spain lately. I really enjoyed it and I will go again. I go out on a Saturday. We go shopping and out for a meal. My friend is coming for a meal tonight". The person we spoke with was pleased with the activities and social life she was enjoying since her admission to this care service.

Staff said they were supported and well managed. They told us they had completed all the mandatory training such as health and safety and were able to access training they felt they needed at supervision and appraisal.