Background to this inspection
Updated
6 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection was prompted in part by notification of an allegation of abuse. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of restraint at the service and this inspection examined those risks.
This inspection took place on 11 April 2018 and was unannounced and was carried out by one inspector.
The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed information we held about the service, this included information received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. We also contacted the local authority who commission services to gather their feedback.
We spoke with the quality manager, a director and three members of care staff. We also spoke with all three people living at the service and following the inspection spoke with one relative and a healthcare professional over the telephone.
We reviewed a range of documents and records including the care records of two people using the service, three medication administration records, two staff files, training records, accidents and incidents, complaints systems, minutes of meetings, activity records, surveys and audits.
Updated
6 June 2018
This inspection took place on 11 April 2018 and was unannounced. The service was last inspection in November 2015 and was rated as ‘Good’ in all questions asked.
5 Trinity Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 5 Trinity Street accommodates three people in one adapted building.
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. We saw that the service conformed to these standards.
There was a registered manager, but they were not present during the 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 were supported by a group of staff who had received training in how to recognise signs of abuse. Staff were aware of the risks to people and what actions they should take if they suspected a person was a risk of harm. Where safeguarding concerns arose, they were responded to appropriately. Behaviour management plans in place provided staff with information on how to support people safely and in line with their specific needs.
People were supported by sufficient numbers of staff who benefitted from an induction and training which would provide them with the skills to care for people effectively and safely. People received their medicines as prescribed by their GP but medication audits had failed to identify some medication records were inconsistently recorded.
Systems were in place to protect people from the spread of infection. Accidents and incidents were reported, investigated and recorded and where appropriate individual lessons were learnt and practice changed.
Staff were provided with the information required to support people’s care, health and social well-being. People were supported to visit their GP and other healthcare professionals in order to maintain good health. People were encouraged to make choices regarding their daily living, including planning and preparing their meals.
Staff routinely obtained people’s consent prior to offering support. 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.
People received support from staff who treated them with dignity and respect. Staff were described as kind and caring and supported people to maintain their independence. People were provided with information in a format they understood.
People were routinely involved in the planning of their care and supported to take part in activities they enjoyed.
Where complaints were raised, they were investigated and responded to appropriately. People were confident that if they did raise concerns they would be listened to and action would be taken.
People spoke positively of the new staff who had been bought into the service and the management team who were supporting them. Staff felt supported in their role and were equipped with the information required to meet people’s needs.
Systems were in place to provide people with the opportunity to give feedback on the service. A variety of audits were in place to assess the quality of the service provided, but not all audits had identified the concerns raised during the inspection.