Inshore Support Limited - 10 Melbourne Road

We found the following examples of good practice.

¿ Safety procedures were in place to prevent infection entering the home by visitors and staff. Relatives could arrange to visit their family member if they wanted to and would be required to follow safety procedures.

¿ Staff understood the need to promote social distancing within the home to help keep people safe from infection transmission.

¿ Staff implemented safety measures when re-admitting people back home. These included COVID-19 testing, self-isolation and the monitoring of people’s temperature and wellbeing.

¿ Personal Protective Equipment (PPE) was available throughout the home. Management made observations to ensure staff wore PPE and disposed of used PPE correctly.

¿ Staff took a COVID-19 test three times a week and people every 28 days. If people or staff tested positive, they would be required to self-isolate in line with government rules.

¿ The premises were clean and hygienic whilst still retaining a homely atmosphere. Deep and touch point cleaning was maintained to reduce a risk of infection transmission.

¿ Staff had received Infection Prevention Control (IPC), COVID-19 awareness and testing process, and donning and doffing training.

¿ The IPC policy was reviewed regularly. COVID-19 specific guidance for staff was updated as the need arose. Senior management and the registered manager offered staff support and the opportunity to access counselling to promote their wellbeing.

Inshore Support Limited – 10 Melbourne Road is a residential care home providing accommodation for persons who require nursing or personal care and have a diagnosis of a learning disabilities. The home can accommodate three people and at the time of the inspection, three people were receiving support.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives.

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.

People’s experience of using this service and what we found

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support and focused on them having as many opportunities as possible for them to gain new skills and become more independent.

As part of thematic review, we carried out a survey with the management team at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

Staff had a good understanding of safeguarding. There were enough staff to support people safely. Care plans and risk assessments were up to date and reviewed regularly. People received their medicines as prescribed.

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.

People were supported by staff who knew them well. People’s privacy and dignity was maintained. Staff promoted people’s independence.

People were encouraged and supported to take part in activities. Peoples personal preferences were identified in their care plans. People were supported to build and maintain relationships.

The manager was not yet registered with The Care Quality Commission (CQC) but was in the process of doing this. Systems were effective for monitoring the quality and safety of the services provided. There was good involvement with community professionals. Staff knew how to raise concerns.

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 8 February 2017)

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.

The provider is registered to accommodate and deliver personal care to three people who have a learning disability. On the day of our inspection there were two people living at the home. A third person who received respite care was not present.

At our last inspection on 26 November 2015 we found that some improvements were needed to ensure that people’s privacy and dignity was respected. The quality monitoring of the service needed to improve to ensure that people had up to date care plans. At this inspection we found that improvements had been made.

The provider had interim management arrangements in place at the time of the inspection. The previous registered manager had cancelled their registration with the Care Quality Commission (CQC) in October 2016. We were advised that the provider would be submitting an application to register a manager in the next few months. 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 protected from the risk of harm or abuse because staff had been trained to recognise and report abuse. Risks associated with people’s everyday living had been identified and plans were in place to help to reduce risks. Staff were recruited safely and staffing levels ensured that people were safe and received the care and support that they needed in the way that they preferred. People received their prescribed medicines by staff who had been trained to do this safely.

Staff were provided with the training they needed to meet peoples specific needs. Staff had regular supervision to reflect on and develop their practice. The principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguarding (DoLS) were understood by staff who ensured that they sought people’s consent and did not unlawfully restrict their liberty. People’s dietary needs were met and they were supported to eat and drink sufficiently. People had access to a range of health care professionals to meet their healthcare needs.

People were supported by staff who were kind and friendly. Staff involved people in identifying their needs and preferences. Staff protected people’s privacy and dignity and respected them as individuals. People were supported to pursue their hobbies and interests and maintain positive relationships with their relatives.

Staff described the management style as supportive and they felt motivated. They had the training and support to meet people’s specific needs. The quality of the service was regularly monitored to ensure it remained safe and responsive to people’s needs. People’s feedback was sought and there was a system in place to act upon feedback. The process for responding to complaints was effective.

Relatives told us they were involved in the care planning process and would have consented to care. We did not see any records to show people or their relatives consented to care.

Care plans were person centred and provided staff with the appropriate information to care for people. One relative said, 'Yes staff do know people's care needs'.

We observed that the home was clean and tidy and there was an infection control procedure in place that staff followed. One relative said, 'Yes very clean'.

We looked at staff working rotas that showed that sufficient numbers of staff were provided at all times to ensure people's care and support needs were met.

People had access to a complaints procedure in a format they could understand and complaints were monitored to find out if there were any trends.