Background to this inspection
Updated
12 August 2017
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.
This inspection took place on 27 June 2017 and was unannounced.
Our inspection team consisted of one inspector, a specialist advisor who is a specialist in Speech & Language Therapy and one expert-by-experience. Our expert by experience had knowledge, and understanding of residential services and of supporting family and friends with their health care.
Before the inspection, we asked the provider to complete 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 also reviewed previous inspection reports, the provider’s action plan and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used this information to help us plan our inspection.
People were not always able to verbally express their experiences of living in the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed staff interactions with people and observed care and support in communal areas. We observed staff interactions with people and observed care and support in communal areas.
We spent time speaking with two people and one relative. We spoke with three care staff, the deputy manager, the manager and the operations and development manager. We also spoke with a visiting healthcare professional and requested information from healthcare professionals, local authority care managers, commissioners of the service, and GP involved in the service.
We looked at records held by the provider and care records held in the home. These included three people’s care records, medicines records, risk assessments, staff rotas, three staff recruitment records and a selection of meeting minutes, quality audits, policies and procedures.
We asked the manager to send additional information after the inspection visit, including the staff training records. The information we requested was sent to us in a timely manner.
Updated
12 August 2017
The inspection was carried out on 27 June 2017. The inspection was unannounced.
Walsingham Support, 56-58 Turnbull Close is a care home located near Dartford, Kent. The service provides accommodation and personal care to a maximum of 12 people with learning and physical disabilities. At the time we visited there were 11 people living at the service. The people who lived at Walsingham Support, 56-58 Turnbull Close had diverse and complex needs such as learning disabilities, cerebral palsy, epilepsy, severe sight impairment and limited verbal communication abilities.
There was a new manager at the service. The new manager was undergoing registration with the Care Quality Commission. 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 and associated Regulations about how the service is run.
At our previous inspection on 02 August 2016, we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Healthcare professional's guidance were not being followed. People's healthcare needs were not being adequately met. Staff had not appropriately adhered with eating and drinking guidelines. Premises and equipment had not been properly managed to keep people safe. The provider failed to operate an effective quality assurance system and failed to maintain accurate records and Staff had not received appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. We asked the provider to submit an action plan by 03 October 2016. The provider submitted an initial action plan on 05 September 2016 which showed how they planned to improve the service by November 2016. They then provided an update to this on 24 November 2016, 05 December 2016 and 28 April 2017, which showed some of the action plans had been met and some were still on-going.
At this inspection, we found that the provider had met all the breaches of the regulations.
Premises and equipment had been properly managed to keep people safe. We found a number of maintenance issues which were identified at our last inspection had been rectified. There was an on-going plan of maintenance in the home. The home smelt fresh and clean.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. All staff had received training in the Mental Capacity Act 2005 and all had an awareness of Deprivation of Liberty Safeguards.
There were sufficient staff on duty to support people with their needs. Staff attended regular training courses and refresher training was provided at regular intervals. This ensured staff had the skills to provide appropriate care. All staff received induction training at the start of their employment.
Staff had received regular individual one to one supervision meetings and appraisals as specified in the provider’s policy.
Robust recruitment practices in place. Applicants were assessed as suitable for their job roles.
Robust systems for the management of medicines were followed by staff and we found that people received their medicines safely. People had access to health and social care professionals when required.
People’s care plans contained information about their personal preferences and focussed on individual needs. People and those closest to them were involved in regular reviews to ensure the support provided met their needs. New care plans had been introduced and were clear and detailed.
Our observations showed that people had a variety of activities. Activities were diverse enough to meet people’s needs and the home was responsive to people’s activity needs.
The provider and manager of Walsingham Support, 56-58 Turnbull Close had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the provider’s whistleblowing policy. They were confident that they could raise any matters of concern internally with the manager, or externally with the local authority safeguarding team.
Care files included communication passports, which provided clear descriptions of how people communicate.
People had access to nutritious food that met their needs. We observed that staff followed people’s nutrition and eating guidelines throughout the day.
Staff were clear about their roles and responsibilities. The staffing structure ensured that staff knew who they were accountable to. Staff meetings were held regularly. Staff old us they felt free to raise any concerns and make suggestions at any time to the manager and knew they would be listened to.
There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken. The manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained.