Archived: Disabilities Trust - 29 Briants Avenue

Disabilities Trust - 29 Briants Avenue is a care home without nursing that provides a service for up to three people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were three people living at the service.

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.

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We have made a recommendation about keeping records and evidence of best interest decisions in line with the MCA legal framework.

People were kept safe living at the service. Relatives felt their family members were kept safe in the service. The assistant manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks. Staff recruitment and staffing levels supported people to stay safe while working towards their goals and going about their lives. The management of medicine was safe, and people received their prescribed medicine on time. There were contingency plans in place to respond to emergencies. The premises were cleaned and well maintained.

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. People received effective care and support from staff who knew them well. The assistant manager had planned and booked training to ensure staff had appropriate knowledge to support people. People enjoyed the food and could choose what they ate and where to eat. People had their healthcare needs identified and were able to access healthcare professionals such as their GP.

We observed kind and friendly interactions between staff and people. Relatives confirmed staff were caring and respected their privacy and dignity. The assistant manager was working with the staff team to ensure caring and kind support was consistent. People and their families were involved in the planning of their care.

The service encouraged feedback from people, families, and professionals, which they used to make improvements to the service and protect people against the risks of receiving unsafe and inappropriate care and treatment. People were encouraged to live a fulfilled life with activities of their choice and were supported to keep in contact with their families. People and staff had meetings to ensure consistency in action to be taken. The staff team had daily communication to discuss matters relating to the service and people’s care.

The assistant manager had quality assurance systems in place to monitor the running of the service and the quality of the service being delivered. With the help of the staff team, they took actions to address any issues. Staff felt the assistant manager was supportive and open with them and communicated what was happening at the service and with the people living there.

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

Rating at last inspection

At the last inspection the service was rated good (Report was published 31 August 2016).

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.

Disabilities Trust - 29 Briants Avenue is a care home without nursing that provides a service for up to three people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were three people living at the service.

The service did not have a registered manager as required. The previous registered manager left in March 2016. The service had an acting manager and plans were underway to recruit a new 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. The acting manager was present and assisted us during this inspection.

Staff were professional and skilful when working with people, it was obvious they knew them well and people were treated with care and kindness. Staff were aware of people's abilities and encouraged them to be as independent as possible.

People received support that was individualised to their personal preferences and needs. People said staff knew what they liked and how they preferred to be supported.

People received appropriate health care support. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were stored and administered safely.

People were protected from the risks of abuse and from risks associated with their health and care provision. They were protected by recruitment processes and people could be confident that staff were checked for suitability before being allowed to work with them. There were sufficient numbers of staff on each shift to make sure people's needs were met. People benefitted from staff who were well supervised and received training to ensure they could carry out their work safely and effectively

Risks related to the premises were assessed and monitored. Checks were in place and action taken, where necessary, to address any identified risks.

People's rights to make their own decisions were protected. Managers and staff had a good understanding of the Mental Capacity Act 2005. They were aware of their responsibilities related to the Act and ensured that any decisions made on behalf of people were made within the law and in their best interests.

People knew how to raise concerns and felt they were listened to and taken seriously if they did. Staff recognised early signs of concern or anxiety from people living at the service and took prompt and appropriate action to reassure people when needed.

People benefitted from living at a service that had an open and friendly culture. People felt staff were happy working at the service. People's wellbeing was protected and all interactions observed between staff and people living at the service were caring, friendly and respectful. People's rights to confidentiality were upheld and staff treated them with respect and dignity.

During our last visit we found the provider had some systems in place to identify, assess and manage risks to the health and welfare of people who use the service and others. However, the provider was not effectively monitoring other safety issues around the home. At this visit we found the provider had taken appropriate action to ensure that safety issues we identified had been addressed and effective monitoring systems had been put in place.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People who use the service, family members, staff, and other health care professionals were involved in regular reviews of care. Staff were knowledgeable of people's individual needs and how to meet those needs. One member of staff said they 'try and involve them (people who use the service) as much as possible'.

There were effective systems in place to reduce the risk and spread of infection. We observed the home to be clean and tidy. Staff described how cleaning was monitored and how people who use the service were supported in maintaining standards of cleanliness when needed.

There were effective recruitment and selection processes in place. We looked at the personnel records of three members of staff. All of them showed evidence the relevant checks such as Disclosure and Barring Service (DBS) enquiries, and conduct in previous employment, had been undertaken before staff began work.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. Staff described how they regularly sought feedback from people who use the service and acted it on it where appropriate.

The provider had some systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. However, the provider was not effectively monitoring other safety issues around the home. These included unsafe water temperatures, gas safety tests, legionella risk assessments, and fire equipment maintenance.

In this report the name of two registered managers appear who were not in post and not managing the regulatory activities at this location at the time of the inspection. Their names appear because they were still a registered manager on our register.

We spoke with the newly appointed team senior of the home and the newly appointed assistant service manager. We were told that one person living at the home was due to go away for a few days and the other two people were booked on activities at the local leisure centre. Time available for people to be spoken with as part of the inspection was understandably limited owing to the need for the people to attend pre-booked pursuits.

During our inspection we saw staff treated the people using the service with respect and dignity. We saw staff encouraged people to make informed choices about how they lived their lives. For example, we observed staff providing people with appropriate support and information to choose the social activities they participated in. We also saw staff encouraged people to maintain their independent living skills and to do as much for themselves as they could do safely.