Aspire Living - 94 Chatsworth Road

Aspire Living - 94 Chatsworth Road provides accommodation and personal care for up to four people who have a learning disability who may also have physical disabilities. At the time of the inspection, four people were living at the home.

The service is required to have a registered manager and there was a registered manager in post when we inspected. 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 avoidable harm and abuse. Staff had received training in, and understood, how to work safely and recognise and report abuse. The risks to people had been assessed, kept under review and plans put in place to manage these. The involvement of people’s relatives, where appropriate, in decisions about risks affecting their family members was actively encouraged. Staffing levels at the service meant people’s needs were met safely and flexibly. The provider followed safe recruitment procedures to ensure prospective staff were suitable to work with the people living at the home. People received their medicines safely and as prescribed from trained staff.

Staff had the training and ongoing management support required to work effectively. People’s rights under the Mental Capacity Act 2005 were understood and protected by the provider and staff team. People had enough to eat and drink, and any associated needs or risks were managed with appropriate input from nutritional specialists. Staff helped people to access healthcare services and took prompt action in response to any significant changes or deterioration in their health.

Staff adopted a kind and compassionate approach towards people’s care and support, taking the time to get to know people well. People’s involvement in decision-making that affected them was actively encouraged. People were treated with dignity and respect by staff who understood their associated responsibilities.

People received personalised care and support shaped around their assessed needs and preferences. Staff understood the importance of, and followed, people’s care plans. People had support to spend time doing things they found interesting and enjoyable, both inside the home and out in the local community. People’s relatives knew how to raise concerns and complaints with the provider, and felt comfortable doing so.

The management team promoted positive, open communication with people. their relatives and the community professionals involved in their care. Staff felt valued, supported and able approach the management team for any additional guidance or advice needed. The provider carried out effective quality assurance activities to assess, monitor and improve the quality of the service.

Aspire Living 94 Chatsworth Road provides accommodation and personal care for up to four people with a learning disability who may also have physical disabilities. There were four people living at the home when we visited.

A registered manager was 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 were not appropriately supported to pursue their hobbies and interests and to participate in activities of their choosing. People were also not fully empowered to make choices and express their preferences regarding their day to day care and support.

The registered manager did not feel fully supported by the provider’s senior management team and was not confident requests for additional resources associated with developing and driving improvement at the service would be met. The CEO told us that the provider had worked closely with the registered manager, but had not been made aware of their concerns before this point. The provider undertook to discuss and address any areas of concern with the registered manager, ensuing that they had the regular support sessions and resources they required.

The provider and registered manager carried out regular quality assurance checks, but these had not identified the shortfalls we saw in the home’s management of people’s medicines, which did not always reflect professional guidance.

The provider had developed a formal statement of their aims and values. However, staff had a limited awareness of this mission statement.

People were protected from harm and abuse because staff understood the different forms of abuse and knew what to do if they were concerned about people’s safety or wellbeing. The provider had clear procedures for reporting any such concerns to the relevant authorities.

The provider had assessed the risks associated with people’s individual care and support needs and the overall running of the home and had developed plans to manage these risks. Staff worked in accordance with the risk assessments completed.

The provider and registered manager monitored any accidents or incidents at the home and took appropriate action to minimise the risk of reoccurrence.

There were enough staff on duty to meet people’s needs. The provider had identified the need to increase night-time staffing levels and had approached the local authority regarding this matter. The provider followed safe recruitment procedures.

Staff had the necessary skills and knowledge to support people effectively and recognised people’s communication needs and preferences. Staff had received an appropriate induction to the home and benefitted from an ongoing programme of training. Staff were well-supported by the registered manager with whom they had regular one to one sessions.

The home worked in accordance with the requirements of the Mental Capacity Act 2005 (MCA). Staff understood what the MCA meant in the context of their day to day work. The provider had made DoLS applications on the basis of their assessment of people’s individual care and support arrangements.

People received appropriate support with eating and drinking. Any risks associated with people’s eating and drinking had been assessed, recorded and plans developed to manage these.

Staff supported people to attend routine health appointments and check-ups. A range of external healthcare professionals were involved in monitoring people’s health and referrals were made as needed.

Staff spoke with and responded to people in a warm and friendly manner. People were relaxed and at ease in the home’s environment. Staff treated people with dignity and respect.

There were no unnecessary restrictions upon visitors to the service and they were made to feel welcome at the home by the staff team. People were supported by staff to maintain relationships with those of importance to them. People’s relatives were involved in decision-making about the support provided to their family members.

The provider had developed formal procedures for handling and responding to complaints. People’s relatives were clear about how to raise complaints and felt confident these would be listened to.

The registered maintained a positive and open dialogue with the people living at the home, those representing them and the staff team as a whole. Staff understood what was required of them and were comfortable bringing issues to the attention of the registered manager. The registered manager had assessed the culture within the home and had put plans in place to ensure the care and support reflected what mattered most to people.

We found that improvements had been made in the guidance issued to staff about how to meet people's complex needs. Staff had been supported to understand the guidance through individual and group meetings with senior staff. People had been offered more opportunities to go out for leisure activities. Specialised training about how to respond to complex behaviours had been applied for.

Clearer guidance had been issued to tell staff when 'as needed' medicines should be offered to people.

We found that some further improvements were needed in some areas, which the manager addressed promptly after our inspection.

We found that the staff engaged with people in a friendly and caring way. People had been supported to look their best. We saw that lunchtime was calm and unrushed.

The staff team knew people and their preferences well. The staff were able to tell us about the support people needed with areas such as nutrition and pressure area care. Guidance was in place about how staff should meet people's needs. In one case we found this was inadequate. Monitoring of how specific health needs were being met was not always effective.

Suitable equipment was in place to meet people's special needs. External professionals were regularly involved to reassess the equipment used as people's needs changed.

The premises was well maintained and homely. Regular checks were carried out to manage health and safety hazards and ensure repairs were actioned quickly.

People were provided with a nutritious and interesting diet and supported to eat their meal safely and as independently as possible. Arrangements had been made to meet special dietary needs.

Suitable systems were in place to support people with their daily medicines. Staff were trained in safeguarding vulnerable people and systems were in place should a concern or complaint be made.

The staffing levels were adequate to support people while at home and when out in the community. Staff were well informed about people's care and support needs and they had been provided with appropriate training and support.