Archived: Henshaws Society for Blind People - 12 Robert Street

About the service: The service is a care home for up to five people some of whom have a sensory impairment and/or a learning disability and/or autism. Five people lived in the service when we inspected.

Why we inspected: This inspection was a scheduled inspection based on the previous rating.

People’s experience of using this service:

People told us they were happy and felt staff had an excellent understanding of their needs and preferences. That staff listened to what they wanted and acted quickly to support them to achieve their goals and aspirations. Staff were innovative and looked to offer people solutions to aid their independence and develop their skills. Use of technology had supported people to receive information in an accessible way either through easy read, large print or audio to enable them to be fully involved in their care and support.

People had good community networks which were personal to them. This included supporting people to use technology to connect with family and friends. People had been supported to develop and maintain positive relationships with friends and family.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people. Staff encouraged positive risk taking so people could experience new things and develop. This had led to people feeling fulfilled and living an active life.

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.

The registered manager and staff team worked together in a positive way to support people to achieve their own goals and to be safe. Checks of safety and quality were made to ensure people were protected. Work to continuously improve was noted and the registered manager was keen to make changes that would impact positively on people’s lives.

The values of the organisation of offering choice, inclusion and respect were embedded. This supported people to receive the positive service described.

The service met the values that underpin the ‘Registering the Right Support’ and other best practice guidance such as ‘Building the Right Support’. These values include choice, promotion of independence and inclusion. Also, how people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A full description of our findings can be found in the sections below.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We undertook this short-notice inspection on the 18 March 2016. There were five people using the service at the time of the inspection. At the last inspection on 2 April 2014, the registered provider was compliant in the areas we assessed.

The service had a registered manager, although there was a process underway with the Care Quality Commission (CQC) to update this and register a new person as the manager. A registered manager is a person who has registered with the CQC 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 told us they liked living at the service and felt safe.

We found people’s health care needs were met. They had access to a range of community health care professionals when required. There had been one occasion when a person could have been supported to see their GP about a specific issue in a more timely way. This was mentioned to support staff and the deputy manager and an appointment was organised for them.

People received their medicines as prescribed. Medicines were obtained, stored, administered and recorded appropriately.

We found staff had received training in the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. Staff had a good understanding of the need to obtain consent from people prior to delivering care and support. They were aware of the need to make applications to the local authority when people who lacked capacity were deprived of their liberty. There were plans to discuss with the local authority as to whether one person met the criteria for DoLS. We have made a recommendation regarding the use of a code of practice when assessing criteria for DoLS.

We saw people had their needs assessed and were involved in planning their care and support. This enabled them to make decisions about how care should be delivered to them in ways that met their preferences and wishes, and what goals they wanted to achieve.

We saw people were encouraged to make their own decisions. We saw staff had developed good relationships with people who used the service and treated them with dignity and respect.

Staff encouraged people to maintain and develop their independence skills. Staff supported people to be involved in household tasks such as laundry and cleaning. People planned their own menus, shopped for their food supplies and prepared their own meals with support from staff. We saw there were plenty of fresh fruit, drinks and snacks available in between meals.

We saw people participated in a range of meaningful activities to promote their interests and hobbies. Staff supported people to access community facilities and to keep in touch with their friends and family.

We found there were sufficient staff on duty to support people’s needs. Staff were recruited safely and all employment checks were in place prior to them starting work in the service.

Staff had received training in how to safeguard people from the risk of harm and abuse. They knew who to raise concerns with. Risk assessments were completed to help guide staff in how to minimise risks whilst ensuring people could make their own choices.

Staff had access to a range of training in order to meet people’s needs. They also received support and appraisal in order for them to feel confident when supporting people. There was a system to identify when refresher training was required. The supervisions and appraisals were behind schedule for some people but management was aware of this and had plans in place to address this.

Equipment was maintained and the environment was safe, clean and tidy.

There was a quality monitoring system in place which included audits and questionnaires. This helped to identify shortfalls so action could be taken to address them. People told us they felt able to complain and staff had a policy and procedure to provide guidance when complaints or concerns were raised with them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Support workers were knowledgeable about published guidance on positive environmental factors and adaptations to assist people with a visual impairment. They were sensitive to those factors that might impact people's sensory and mobility needs.

Systems were in place to make sure that equipment was well maintained and serviced regularly. However, some areas of repair and refurbishment needed attention. Specifically, the front door, the garden wall, and dining room chairs needed repairing or replacing. The manager told us about the plans that were in place to address these areas.

Systems were in place to make sure that the manager and support workers learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

Support workers knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Arrangements were in place for senior support workers to receive updated training to confirm their understanding of when an application should be made, and how to submit one.

Is the service effective?

Support workers were knowledgeable about the people they supported and knew people very well. People's health and care needs were assessed with people using the service, and they were actively involved in developing their plans of care. One person told us 'I'm treated really well, I feel appreciated.'

Staff had received training to meet the needs of people they supported. Comments included, 'We receive all the training we need' and 'It's a really good organisation to work for. They treat us very well.'

Is the service caring?

People spoke positively about the care they received. We observed a relaxed and friendly atmosphere in the home throughout our visit. Good professional relationships appeared to exist between people using the service and support workers. We saw that support workers tailored how they communicated with individuals and gave lots of encouragement and praise.

People told us that they were supported by kind and caring workers who knew them well. One person said 'I like it here, it's good.' Another person told us how 'nice everyone is'. They said 'It's really well equipped here for us.'

Is the service responsive?

People received specialist support from the organisation's vision support team to assist with their sensory and mobility needs. This support helped people to access the environment and the wider community independently. Suitable aids and equipment were provided to promote and maintain people's skills and independence.

People's needs were assessed and people told us they received specialist equipment or aids that they needed. We spoke with two people who told us they benefitted from their contact with the vision support team which they said was a 'very good' service.

Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People we spoke with told us they knew who to speak to if they had any worries or concerns. They were confident that any issues they raised would be looked into and action taken.

People had access to activities that were important to them and had been supported to maintain relationships with friends and relatives.

Is the service well-led?

Effective management systems were in place to promote and safeguard people's safety and welfare.

Support workers had a good understanding of the organisation's ethos and the quality assurance processes that were in place.

People told us that support workers always checked out their preferences with them before any decisions were made. One example of this was the proposed changes to the staff rota. This incorporated people's views and made sure that support workers were available at times to enable people to follow their interests and pursuits including at the weekend and in the evening.

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Support workers told us they were clear about their roles and responsibilities.

During our inspection we looked at how people were respected and involved in the service. We looked at care records and found people had been involved in deciding what support would work for them and how that support would be delivered.

We saw from people's care plans that people were supported to live as independently as possible. The home had carried out an assessment of the needs of each person, and kept this under review, to enable appropriate care and support to be given.

People who lived at the home were protected from risks of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The staff we spoke with had received training in safeguarding adults.

We reviewed the level of staffing for the home. People told us that there was always enough staff to support them with their care needs.

The home had systems in place to make sure people were safely cared for. This included policies and procedures and quality monitoring systems.

People living at the home talked to us about the meals they have. They told us that the food was good and that most people living at 12 Robert Street continue to cook their own meals with support from staff. People we spoke with told us that they receive the necessary support from staff when they need it.

People living at the home confirmed that they received their medication as needed. People who looked after their own medication had locked facilities in their rooms.

People living at the home described the staff as being 'nice' and 'supportive.' One person said, 'The staff are very good here.'

Everyone we spoke with said that if they were upset or had a complaint that they would either speak to a member of staff or the manager of the home.

We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.