Foresight Residential Limited - 66 Leeds Road

Foresight Residential Limited - 66 Leeds Road is a residential care home providing support and some personal care for up to 10 people. At the time of the inspection there were 10 people using the service. The building is an adapted detached house located close to the centre of Harrogate.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, 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

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. People's support focused on them having opportunities for them to gain new skills and become more independent although some goals and objectives needed recording and reviewing in a clearer way.

People told us they felt safe and secure within the home and systems in place supported their safety. Risks to people’s health and safety were assessed and mitigated and positive risks were taken to help ensure people accessed the community. Medicines were managed in a safe and proper way. There were enough staff deployed to ensure people received a high level of support. Incidents were recorded and lessons learnt when things went wrong.

People received effective care that met their needs. People had a good choice of food and nutritional needs were met. The service liaised with the range of health professionals to help ensure needs were met. 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. The premises were appropriately adapted to meet people’s individual needs.

Staff were kind and caring and treated people well. People had influence on their care and how the service was run. Staff treated people with dignity and respect and helped promote their independence.

People’s care needs were assessed, and a range of care plans put in place which were regularly updated. These were clear and person-centred. The service was meeting the requirements of the accessible information standard, ensuring the needs of those with communication difficulties were met. Care plans needed more information recording about how the service helped people to maintain relationships. We have made a recommendation relating to this.

There was an open and inclusive culture within the home. People and staff praised the management team and said they felt able to approach and discuss issues with them. A range of audits and checks were undertaken, and these had been improved since the last inspection. Provider visits were however still inconsistent. We have made a recommendation regarding this.

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 21 July 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.

We inspected on 7 June 2017 and the visit was unannounced, which meant the provider did not know we would be visiting.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained good.

Quality assurance checks in place were basic and did not include oversight from the provider. We have made a recommendation that the provider review their approach to quality assurance to include quality checks by them or their representative to ensure quality and safety of the service.

Staff worked within the principles of the Mental Capacity Act in every aspect of their work with people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Records relating to consent or decisions made in people’s best interests required development.

Staff had a good understanding of safeguarding and were aware of types of abuse and how to report incidents. They knew the people they supported well which resulted in people feeling safe and behaving in a confident way around staff.

There were robust recruitment processes in place to assist the manager in making safe decisions about who they employed. Staff received appropriate training. They were supported well through regular supervision and appraisal.

People’s medicines were managed safely. Risks to people’s health and safety had been identified and risk assessments were in place to guide staff. Regular servicing of equipment and checks of services such as gas, electric and water took place.

People told us they enjoyed good food and were supported to eat a healthy balanced diet. Where needed people’s nutrition was monitored by staff. People had good access to healthcare professionals to support all of their health needs.

The environment supported people’s needs and their personal space reflected their preferences and personalities. We saw that people mattered to staff and staff respected their privacy and dignity. People’s preferences were taken account of when planning their care and they could choose how that care was delivered.

Although care plans would benefit from being updated people’s needs were assessed and care plans reflected people’s preferences regarding their care and how they liked to spend their time. People had activities they took part in that were individual to them. Where they had friends or family they were supported to maintain those relationships in a meaningful way.

People's needs were assessed and their rights were respected by the staff. We saw that people were encouraged to make their own decisions or were supported by the staff to consider options available to them. We observed staff treating people in a dignified way and with understanding and kindness. We saw that people were supported to maintain their independence and observed a warm and friendly rapport between those living and working at the home.

People had care plans and risk assessments in place, which helped staff to understand and meet their needs.

We found people who used the service were safe and staff were aware of how to recognise and report any concerns about people's safety and wellbeing. We saw staff were supported to maintain and develop their knowledge, abilities and skills.

We saw that there were sufficient staff on duty. Staff received training to ensure that they had the skills they needed to be able to look after people safely and competently. Staff told us they received plenty of training and that it was good. One member of staff told us, "We work together as a team. There is always someone to ask for guidance if you are unsure.' Another member of staff told us, 'Our training is up to date; the manager makes sure we receive updates.'

There were quality monitoring systems in place, which included relatives and staff giving feedback about the care and treatment provided and routine audits (checks). This gave a good overview of the quality of the service and provided feedback which if required, could be acted upon by the provider. This also meant that the quality of the service was being kept under review.

We also spoke with two visiting relatives who were positive about the service, saying 'It's fantastic, I've never had cause to complain in all the years my relative has lived here' and 'I can tell my relative is happy here, and the staff do more than their duty'.

We observed that staff interacted with people living at the home in a relaxed, friendly manner.

We looked at the care plans for three people who live at the home. Records for each person showed that the home had carried out sufficient assessment of the needs of each person, to enable appropriate care and support to be given.

Staff told us they enjoyed working at the home, and had been given sufficient training to enable them to feel confident in their roles. Training and staff records showed that staff had suitable qualifications and skills, and that appropriate character checks had been carried out prior to a person being employed.

We looked at medication administration records and checked some people's medication to make sure that the records were correct. In general, the home had sufficient procedures in place to ensure medication was managed safely.