This unannounced inspection of Red Roof took place on 29 February and 1 March 2016. The home provides accommodation and support for up to eight people who have learning disabilities, autism or mental health diagnoses. The primary aim at Red Roof is to support people to lead a full and active life within their local communities and continue with life-long learning and personal development. The service consists of a large detached house with a small bungalow annexe in the rear garden divided into two self-contained apartments. At the time of the inspection there were eight people living in the home. The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 felt safe at Red Roof supported by staff who knew them well. People benefited from the consistency and continuity of care and support provided by staff who knew how to protect and keep them safe. Staff had completed safeguarding training and had access to current legislation and guidance. Staff had identified and responded appropriately to safeguarding incidents to protect people from harm. People were safeguarded from the risk of abuse as incidents were reported and acted upon.
People were protected from potential harm associated with their care and support because these risks had been identified and managed appropriately. Risk assessments were completed with the aim of keeping people safe yet supporting them to be as independent as possible.
There were sufficient numbers of staff deployed with the necessary experience and skills to support people safely. The registered manager completed a weekly staffing needs analysis in order to ensure that any changes in people’s needs were met by enough suitable staff. Staff told us there were enough staff to respond immediately when people required support, which we observed in practice. The registered manager completed required pre-employment checks to ensure people were protected from the risk of being supported by unsuitable staff. Staff had received an induction into their role, required training and regular supervision which prepared them to carry out their roles and responsibilities. People were cared for by sufficient numbers of well trained staff who were effectively supported by the registered manager and senior staff.
Medicines were administered safely in a way people preferred, by trained staff who had their competency regularly assessed by the registered manager. Medicines were checked and administered by two staff at all times, to ensure that safe procedures were followed.
People were actively involved in making decisions about their care and were always asked for their consent before any support was provided. Staff supported people to identify their individual wishes and needs by using their individual and unique methods of communication. People were encouraged to be as independent as they were able to be, as safely as possible.
Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. The MCA 2005 legislation provides a legal framework that sets out how to support people who do not have capacity to make a specific decision. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made in their best interests. People were supported by staff to make day to day decisions.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide a lawful way to deprive someone of their liberty, where it is in their best interests or is necessary to protect them from harm. The registered manager had completed appropriate DoLS applications where required, which had been authorised. The registered manager had taken the necessary action to ensure people’s human rights were recognised and protected.
People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice. Where people had been identified to be at risk of choking staff supported them discreetly to minimise such risks, protecting them from harm and promoting their dignity.
Staff were aware of people’s health needs, and quickly recognised when they were unwell. Where people’s needs had changed these were identified by staff and reported to relevant healthcare services promptly, to ensure they received effective treatment. Staff understood the impact of health appointments on people’s anxieties, and liaised in advance with healthcare services to minimise any distress.
Staff had developed trusting and caring relationships with people and spoke with passion about peoples’ needs and the challenges they faced. They were able to tell us about the personal histories and preferences of each person they supported. Staff understood people’s care plans and the events that had informed them.
The caring qualities of prospective care staff were evaluated through the provider’s recruitment and induction process, which was confirmed by records. Staff had undertaken equality and diversity training and understood how to support people to maintain their privacy and dignity.
The registered manager and other supervisors had completed training in relation to person centred care planning, which records confirmed. This ensured people’s care plans accurately reflected their wishes in relation to the way staff were to support their assessed needs. Staff had undertaken personalised care training to ensure they delivered care tailored to meet people’s needs in accordance with their support plans.
The provider had deployed sufficient staff to provide stimulating activities for people. The activities programme ensured people were supported to participate in social activities which protected them from social isolation.
People had access to information about how to make a complaint, which was provided in an accessible format to meet their needs. All complaints had been acknowledged, recorded and investigated in accordance with the provider’s policy, to the satisfaction of the complainant.
The registered manager operated a system of regular audits to assess and monitor the quality of the service provided and to identify and plan required improvements. The provider also completed monthly compliance audits and an annual survey to monitor the quality of the service provided.
Records accurately reflected people’s needs and were up to date. Detailed care plans and risk assessments were fully completed and provided necessary guidance for staff to provide the required support to meet people’s needs. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons, whilst remaining accessible to authorised staff.