Archived: Livability Westminster Croft

Westminster Croft accommodates three people in one adapted residential house on a residential street. At the time of the inspection two people were living there. The care service has 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.

This inspection took place on the 22 and 23 February 2018 and was announced. We had previously inspected this service in February 2016, at that inspection the service was rated ‘Good’. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The was 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 continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated people with respect, kindness and compassion. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive. Information was available in various formats to meet the communication needs of the individuals.

The service had a positive ethos and an open culture. The registered manager was approachable, understood the needs of the people in the home, and listened to staff. There were effective systems in place to monitor the quality of the service and drive improvements.

There was a registered manager in post at the time of our inspection. 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 felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. There were sufficient staff to meet the needs of the people and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Care plans were written in a person centred approach and focussed on empowering people; personal choice, ownership for decisions and people being in control of their life. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People had caring relationships with the staff that supported them. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to. There was a stable management team and effective systems in place to assess the quality of service provided.

Is the service caring?

People were supported by kind and attentive staff. We observed a care worker spending one to one time with a person. The care worker showed patience and gave encouragement to the person to promote their independence. People's preferences, interests, personal objectives and diverse needs had been recorded and provided in accordance with their wishes. Before we held a conversation with a person a care worker asked for the person's permission for us to enter their room and speak with them. One person was receiving one to one attention from a care worker and we observed that they were relaxed with each other and the care worker respected the decisions the person made about their personal support.

Is the service responsive?

People were involved in varied activities including attendance at day centres, going to social clubs, bowling and meals out. Staff told us what they had done when a person became at risk of becoming unwell when a piece of their health equipment failed to function properly. We saw recordings that confirmed staff had taken appropriate actions to promote the person's health and well-being. We saw recordings where staff had supported and assisted people in developing new friendships. The service worked well with external professionals such as, community nurses and doctors to make sure people received good standards of care. When changes were made about people's needs the changes were recorded in people's support plans. This ensured that all staff were made aware of any changes in people's care and support needs.

Is the service safe?

People were treated with dignity and respect by staff. Staff had received appropriate training and received regular supervisions with their line manager. These ensured that staff provided a safe environment and care to prevent accidents from occurring whenever possible. Any accidents or incidents that did occur were recorded by staff and investigated by the manager. Improvements were put in place to prevent similar occurrences. There were robust checking systems in place to ensure that medicines were administered to people in a safe way.

Is the service effective?

People's health and care needs had been assessed and support plans were in place. There was evidence of people and or their relatives being involved with the development and regular reviews of their support plans. Staff supported people in leading interesting and enriched lifestyles that met with their individual preferences. We found that people's capacity to consent to treatment had been assessed and that treatment had been discussed with people in order to prepare them in advance of their medical appointments.

Is the service well led?

The service had a quality assurance system in place that involved people who used the service, relatives and health and social care professionals. Regular audits were carried out by the home manager and senior managers regarding all aspects of the service. Records showed us that when improvement needs had been identified that staff had acted upon them. Staff told us they were clear about their roles and responsibilities and had a good understanding of the ethos of the service. We found that staff were knowledgeable of people's the needs. Managers supported staff in updating their knowledge and skills.

We spoke with two staff members who worked at the service. When asked about the service one staff member told us 'We provide an excellent service'. Another staff member told us 'I enjoy my work and feel well supported'.

We spoke with a relative of a person that used the service who when asked about the service told us 'They do their best for him (our relative) and he's happy'.

We found that people's care needs were assessed and people had care plans in place to ensure their needs were met. We found people that used the service were involved in weekly planning of menus at the service and we saw how people's food choices were respected.

We found there were systems in place to reduce the risk and spread of infection and that people were protected from unsafe or unsuitable equipment.

We spoke with a staff member that worked at the service. They told us "We cater for each individual's needs and we are a very flexible service".

We found that people's needs were assessed and that they had a care plan in place to ensure that there needs were met. We saw that people were encouraged to participate in the daily running of the home. We found that where risks had been identified there were measures put in place to reduce the risks.

We found that people's medication was managed appropriately. We saw that there was a detailed recruitment and selection policy and procedure in place and that people that used the service were involved in the interview process. We saw that adequate pre-employment checks were carried out on staff to ensure that they were suitable for their roles before beginning work. We found that there was a suitable complaints policy and procedure in place and that people that used the service were made aware of it.