Archived: Quarrydene

Quarrydene is a residential care home that supports people with learning or physical disabilities. Quarrydene is a large home bigger than most residential properties, it is currently registered to support up to 13 people. At the time of our inspection, Quarrydene was providing care for 11 people. People were accommodated in two adapted bungalows on the same site. This is larger than current best practice guidance. The size of the service having an impact on people had been mitigated by the absence of identifying factors such as uniforms for staff or obvious signage.

People’s experience of using this service:

People told us they liked living at Quarrydene, their relatives told us they like the family atmosphere. People were supported to maintain good relationships with their family and friends, visitors to the service told us they always felt welcome.

We saw good interactions between staff and people, people were not rushed and were supported with their activities and choices at their own pace.

The outcomes for people using this service reflected the principles and values of registering the right support in the following ways: Promotion of choice and control, independence and inclusion.

People were able to utilise local provisions and to be part of their local community. Staff assisted people to pursue their hobbies and interests.

Assistive and adapted equipment was in place, staff were knowledgeable about its use and maintenance. This enabled people to do many daily activities without staff assistance and promoted independence.

Staff and management had good knowledge of the Mental Capacity Act 2005. 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.

Staff were recruited safely and knew how to keep people safe from avoidable harm. There was enough staff to meet people’s needs.

Management had good oversight of the service, they completed regular audits and observations. The registered manager knew the people who lived at the service well.

Staff told us they felt supported by management, they were kept informed as to the development of the service.

The service was clean, staff followed infection control and food hygiene standards.

Rating at last inspection:

At the last inspection the service was rated Good (published 13 December 2016).

Why we inspected

This was a planned inspection to check/confirm that this service remained Good.

Follow up:

We will continue to monitor this service to ensure people using this service receive good quality care.

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

The inspection was unannounced and took place over two days on 18 and 19 October 2016.

The service had a registered manager who was responsible for the day to day running of the home. 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.

People appeared happy and contented living at the home. Relatives spoke positively about the care and support their family member received. Staff showed concern for people's wellbeing in a caring and considerate way, and they responded to their needs quickly. Staff told us that people were encouraged to be as independent as possible.

The service had a positive culture that was person-centred, open, inclusive and empowering. Staff told us they loved working at the service and people were at the centre of the home. People had regular meetings with their keyworker and also attended house meetings, where they had opportunities to raise any concerns or make suggestions. The service was family orientated and worked towards maintaining relationships that were important to people.

People told us they felt safe when receiving care. Staff were able to tell us how to recognise signs of potential abuse and what action to take if they had any concerns. Risks to people’s health and safety had been assessed and associated risk assessments were in place.

The service had a clear understanding on the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). People were given choice and were involved in decision making. Where people lacked mental capacity to make specific decisions, mental capacity assessments were completed and best interest decisions recorded.

People had access to sufficient food and drink and were supported to maintain a balanced diet. Where people had special dietary requirements, staff ensured these were met. People were encouraged to take part in cooking and menu planning.

Staff understood the needs of people they were providing care for. Care plans were individualised and contained information on people’s preferred routines, likes, dislikes and medical histories.

There were safe medicine administration systems in place and people received their medicines where required. Care records showed relevant health and social care professionals were involved with people's care.

Safe recruitment practices were followed before staff were employed to work with people. Checks were undertaken to ensure staff were of good character and suitable for their role. People received care and support from staff who had access to training and supervision to develop the skills, knowledge and understanding needed to carry out their role.

People had a range of activities they could be involved in. People were able to choose what activities they took part in. Staff were encouraged to support people in expanding the range of activities available to them. People were supported to follow their individual interests and hobbies.

People, their relatives and staff were encouraged to share their views on the quality of the service. They told us management were approachable and they were confident if they had any concerns they would be taken seriously and addressed accordingly.

We spoke with the registered manager and four staff, three people living in the home and looked at four records. We observed that some people were unable to tell us what they thought about the care and support they received.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

People were cared for in an environment that was safe.

Staff training records showed that staff had access to relevant training which demonstrated that staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home. We found staff had completed safeguarding training and demonstrated skills and knowledge in this area.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 which applies to all services providing care and support for people. We found that the provider had followed legal requirements in obtaining appropriate consent for some people who did not have capacity to consent to some decisions made on their behalf.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that some people were deprived of their liberty and applications needed to be submitted. We found that applications had been made and the provider was waiting for these to be actioned. We found the manager had relevant training and demonstrated an understanding of when an application should be made.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us. "Staff look after them alright". Another person told us that 'they liked living in the home'.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people.

We found that people's privacy, dignity and independence were respected.

We found that people were treated with respect and kindness when interacting with staff.

We found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Is the service responsive?

Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

Quality assurance processes were in place but these were not effective in some areas.

People that were able to communicate, were not asked or supported to complete satisfaction surveys. One person told us they had made a complaint and nothing had been done about it. However feedback forms had been sent out to relative's carer's and other professionals. Some people were unable to tell us what their views were because of their communication difficulties.

The registered manager had ensured the maintenance of appropriate standards of cleanliness and hygiene relating to the premises for the purpose of carrying out the regulated activity.

We found the manager did not have an effective enough system in place to monitor the quality of services provided to protect people against the risk of inappropriate or unsafe care.

The home provided a varied menu and people were supported to chose their meals. The home ensured that people's nutritional needs were monitored and met.

People who lived in the home we spoke with told us that Quarrydene was a safe place to live and that they felt they could report any concerns to the managers.

Staff were trained to administer medication and there were correct procedures in place for staff to follow.

Sufficient staffing levels were provided and maintained to ensure care and support was delivered safely and effectively. Staff interacted positively with the people in the home and had developed excellent communication skills in order to ensure they could promote choice and consent. Staff had a good knowledge of the support needs and treated people as individuals and with dignity and respect.

We found that the home was kept clean and hygienic.

We found that the staff were appropriately trained to manage medicines and that medication was correctly stored.

The home had followed the correct procedures when recruiting staff with the required checks being completed before employment commenced.