St Anne's Community Services - Queensway

St Anne’s Community Services Queensway is a residential care home providing personal care to six people at the time of the inspection. The care home accommodates six people in one adapted building.

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. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Medicines were managed safely. Staff were recruited safely, and there were enough staff to take care of people. Care plans and risk assessments detailed what care and support people needed to reduce risk to them. Relatives told us they felt people were safe. We have made a recommendation about the management of disclosure and baring services (DBS).

Staff received appropriate training. A plan was in place to ensure training was kept up to date. Staff were supported and felt supported by the management team. Staff received supervision. People’s needs were assessed, and outcomes recorded. People were offered a choice of food and drink. The service worked with other health care professionals.

We observed some kind and caring interactions throughout the day between staff and people using the service. Relatives told us staff were kind and caring. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems at the service supported this practice. Relatives told us staff treated people with dignity and respect, they were involved with the planning of their relative’s care and their views were listened to.

Some people’s end of life wishes had been explored and documented. There was a complaints procedure and people knew how to complain. Peoples likes, and dislikes were recorded in their care plan and staff knew people and their preferences well. People’s communication needs were in their plans. People had a good range of activities in place and people were happy with what was on offer.

People spoke highly of the manager who they said was approachable and supportive. The registered manager understood the regulatory requirements. People told us they thought the service was well led.

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.

As part of thematic review, we carried out a survey with the registered manager 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was good. (Published February 2017)

Queensway is a care home. The home can accommodate up to six people with learning disabilities. It consists of living and communal accommodation over two floors and has an enclosed garden.

At the time of our inspection the service had 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.

Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. Risk was well managed and were the least restrictive for people. There were enough staff to keep people safe.

People received their prescribed medication when they needed it and appropriate arrangements were in place for the storage and disposal of medicines. Staff were trained in medicines management.

People’s needs were met by staff who had the right skills, competencies and knowledge. Systems were in place to support staff to do their job well formal supervisions were in place. All staff had completed an appraisal.

Health, care and support needs were assessed and met by regular contact with health professionals. However in two care plans people were overdue on an optician’s appointment. The registered manager booked these in at the time of our inspection. People were supported by staff who treated them with kindness and were respectful of their privacy and dignity.

People told us they were happy living at the home and enjoyed the company of staff and others they lived with. People were supported to make decisions and received consistent, person centred care and support. However, Daily records were not always effective due to areas of information missing from these.

The service had good management and leadership. Relatives and stakeholders got opportunity to comment on the quality of service and influence service delivery. Effective systems were in place that ensured people received safe quality care.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people who used the service understood what was going to happen.

The people who used the service appeared happy and comfortable with their surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities which were personalised to their individual needs and documented clearly in the care plans. We spoke with on person who used the service he told us he was 'happy' with his care.

Each of the bedrooms belonging to the people who used the service were personalised and we saw staff knock on the door before entering a person's bedroom.

Report writing in the care records reflected the changes in care and treatment that people received. We also found that staff were supported and monitored in their working practice and had training and appraisals programmes in place.

Staff we spoke to told us that they enjoyed working at the home. They felt they were supported by management and they received regular training. We saw from the staff files we looked at that staff received regular supervision and were appraised annually.

The staff we spoke to told us they thought people were treated with respect and dignity. We saw that interaction between the staff and the people who used the service was positive.

Staff told us that annual satisfaction questionnaires were carried out at the home, they would use pictures and signs to help the people who use the service express their views.

We looked at people's care plans and saw that care was planned in a way that ensured their health and well being. We saw that risk assessments had been reviewed and were up to date.

Staff told us that the quality of service was monitored by the service provider through monthly audits. The provider carried out annual stakeholder satisfaction questionnaires. The staff we spoke to had training in safeguarding and we saw that there were policies and procedures in place to support staff.