Background to this inspection
Updated
15 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 comprehensive inspection took place on 11 May 2018 and was announced. We gave the service 48 hours' notice that we would be attending as the service provides special support provision for young adults who are often at college during the day and we wanted to be sure someone would be available to speak to us.
The inspection team consisted of an adult social care inspector.
Before our inspection visit, we reviewed the information we held about 57 Chestnut Street. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people who used the service. We viewed the provider information return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
Due to people’s individual communication needs we were not able to gage a good understanding of their thoughts and feelings with regards to living at the home. However, we did speak with one person who lived at the home. Additionally we spoke with three relatives and two staff. We also contacted two health and social care professionals by email to ask for feedback. We looked at the support plans for the three people who lived at the home and the recruitment and training files for two staff. We also looked at other documentation associated to the running of the service.
Updated
15 June 2018
We inspected this service on 11 May 2018.
At the last inspection of 57 Chestnut Street in 2015, we rated the service as 'Good'.
At this inspection we found that the service remained 'Good'.
57 Chestnut Street is a semi detached house in Southport situated close to the town centre and it’s amenities. It is part of Arden College that provides specialist further education for young people aged 16-25 years of age with learning disabilities. 57 Chestnut Street currently provides accommodation for three young adults aged over 18 who attend the college and there are support staff available 24 hours per day. Accommodation can be term time only and outside of term time if required.
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.
At the time of our inspection three people were living at the home and attending the college.
There was a process for analysing incidents, accidents and near misses to determine what could be improved within the home. There was personal protective equipment (PPE) available within the home, such as gloves, aprons and hand sanitiser.
Medication was well managed and only administered by staff who had the correct training to enable them to do this. Medication was stored securely within the home.
There were enough staff to help people with their day to day support needs, such as accessing the community or support with their personal care. There was some agency use, however the same staff were often requested.
There were systems and processes in place to ensure that people who lived at the home were safeguarded from abuse. This included training for staff which highlighted the different types of abuse and how to raise concerns within the infrastructure of the organisation. Staff we spoke with confirmed they knew how to raise concerns.
Risk assessments were detailed and specific, and contained a good descriptive account for staff to follow to enable them to minimise the risk of harm occurring to people who lived at the home. We saw there were detailed protocols in place around people for when their behaviour escalated and placed them in harm’s way.
The service was operating in accordance with the principles of the Mental Capacity Act (MCA) and consent was sought in line with people’s best interests. People’s mental health needs were assessed appropriately, and people were treated with equality and diversity which was evidenced in the outcomes of their support. Appropriate referrals were made when people were required to be deprived of their liberty. Staff had the correct training to enable them to support people safely. Staff engaged in regular supervision with their line managers, and had annual appraisals. Consent was also sought and clearly documented in line with legislation and guidance.
Menus were varied, people told us they had input into the menus and often cooked their own meals. There was access to other medical professionals who often visited the home and were involved with people, and regular meetings with external healthcare professionals took place when needed. Staff said they were up-to-date with the training they were required by the organisation to undertake for the job and training records confirmed this.
People were treated as individuals, and their choices and preferences were respected by staff. This was evident throughout our observations around the home, and the information recorded in people’s support plans. Staff also described how the ensured they protected people’s dignity and choices when providing personal care. Staff spoke with people and about them with warmth and sensitivity. There were examples of accessible information for people who used the service. This was presented in various formats to support peoples understanding.
There was a complaints process in place which we were able to view as part of our inspection. There were no on-going complaints and there had been no complaints since our last inspection.
Staff undertook training to enable them to respectfully care for someone who was at the end of their life, however most people who lived at 57 Chestnut Street were younger adults enrolled on college placements. The registered manager informed us that if someone's health did decline their wishes would be respected and provisions would be made to support them. People’s support plans were person centred and contained a high level of detail about the person, their likes, dislikes, how they want to be supported and what successful support looks like for them.
The service worked in partnership with the local community, as well as other professionals such as the Local Authorities, GPs, the college, and the police. The vision of the organisation was person centred and the staff we spoke with told us they liked working for the company. Quality assurance systems were robust and sampled a wide range of service provision. We saw that were issues had been identified they had been subject to an action plan which was reviewed regularly and updated with the latest action points.
Further information is in the detailed findings below.