Background to this inspection
Updated
22 February 2019
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 16 January 2019 and was unannounced. One inspector undertook the inspection.
The provider had completed 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 looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted the local authority commissioning team to ask them about their experiences of the service provided and three visiting health and social care professionals and received two responses. We also spoke with four relatives for three of the people living in the service for their experiences of the service provided.
People were not able to tell us their experiences of the care and support provided. We spent time observing how people were cared for and supported and their interactions with staff to understand their experience of living in the service. We spoke with the registered manager, the two deputy managers, three care staff and a member of bank staff. We sat in on a staff handover meeting. We spent time looking at records, including two people’s care and support records, three staff recruitment and training records, and other records relating to the management of the service including accident/incident recording and audit documentation. We also ‘pathway tracked’ the care for two people using the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about people receiving care.
We previously carried out a comprehensive inspection on 14 March 2016 and rated the service overall ‘Good’.
Updated
22 February 2019
The inspection took place on the 16 January 2019 and was unannounced.
15 Preston Drove is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. Permanent and respite care and support is provided for up to five for people with a learning disability or autistic spectrum disorder. At the time of the inspection four people were living in the service and one person was receiving regular periods of respite care. The service is situated in a residential area with easy access to local amenities and transport links.
At our last inspection 14 March 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At the last inspection we found some systems had been subject to slippage in the agreed timescales, for example, not all staff had received regular one-to-one supervision at a frequency determined by the provider. The frequency of team meetings had not been maintained. Although staff spoke of a comprehensive induction process for new staff, the supporting paperwork had not been fully completed and was not available to view during the inspection. Records we looked at had not always been fully completed. For example, the recording of people’s weights and where food and fluid charts were required, these had not been consistently filled in. There was no record of the training completed by the bank staff who regularly worked in the service. Although staff told us regular monthly medicines audits were completed there were no records of these, and annual competency checks for people administering medicine had not all been completed. At this inspection we found improvements had been made and the issues highlighted addressed.
There was a new 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. They had drawn up a robust action plan which staff had followed to ensure the continuous improvement in the service.
Systems had been maintained to keep people safe. The building and equipment had been subject to regular maintenance checks from external providers. Infection control procedures were in place. People remained protected from the risk of abuse because staff understood how to identify and report it. People’s care and support plans and risk assessments continued to be developed and reviewed regularly.
Relatives told us they had continued to feel involved and listened to. The culture of the service remained open and inclusive and encouraged staff to see beyond each person's support needs. The registered manager worked with care staff to develop the service with people at the heart of the service.
All the feedback from staff was of a supportive, consistent team with dedicated bank staff. Staff continued to have the knowledge and skills to provide the care and support that people needed. Staff told us they had received supervision and appraisal’s. They had been supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.
People continued to live in a service with a relaxed and homely feel. They were supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had a good understanding of consent.
People were supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health and access healthcare professionals when needed.
Staff and relatives told us the service was well led. A member of staff told us when asked what the service did well, “It feels like a home away from home. They (People living in the service) are safe, I feel really safe and well supported. We have really good managers.” Staff told us the registered manager and senior staff were always approachable and had an open-door policy if they required some advice or needed to discuss something.