Archived: 148 Hornsey Lane

Updated 13 April 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 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 6 February 2018 and was unannounced.

This inspection was carried out by one adult social care inspector and one Expert by Experience. An Expert by Experience (ExE) is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed the information we held about the service. These included statutory notifications that the provider submitted to the CQC as part of their legal responsibility.

During our visit, we spoke with eight people who used the service. We also spoke the registered manager and five staff members.

We looked at records, which included care records for three people using the service, recruitment, supervision and training records for four staff members. We also looked at other documents relating to the management of the service.

Following the inspection, we received feedback from three external health and social care professionals.

Updated 13 April 2018

This inspection took place on 6 February 2018 and was unannounced. At our last comprehensive inspection in December 2014, the service was rated Good overall with a Requires Improvement rating in the safe section. Following the inspection in December 2014, we carried out further two focused inspections to check if improvements planned by the provider had been made to meet the legal requirements. Following the final focused inspection 12 May 2016 the service overall rating remained Good and the safe domain was changed to Good as the service had met all legal requirements.

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.

148 Hornsey Lane provides accommodation and personal care to a maximum of 12 people with long-term mental health needs. At the time of our inspection there were 11 people using the service.

There was a registered manager in post. 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. The registered manager had been registered with the CQC since 14 May 2014. They knew the service well and they had appropriate skills and experience to provide the regulated activity.

There were systems in place to ensure people received their medicines in a safe way and as intended by a prescriber. Medicines were stored and managed well, and staff had received medicines administration training to ensure they knew how to administer medicines safely.

People felt safe at the service and staff took appropriate action to ensure people were safe from avoidable harm and abuse. Various systems were in place, which ensured that people were living in a safe environment and risks to their health and wellbeing had been regularly assessed. These related to regular health and safety and fire checks, infection control and management of incidents and accidents. Appropriate recruitment process helped to protect people from unsuitable staff.

People’s care needs and preferences had been assessed before they moved into the service. A thoughtful and planned transition process supported people in settling in the new environment after they came to live at the service.

Staff received appropriate training to ensure they had the right knowledge and skills to support people in a safe and effective way. The registered manager supported staff by providing them with regular supervision, yearly appraisal of their performance and regular practice reflection sessions.

People were supported to live a healthy life. Staff supported people to have a healthy and nutritious diet that was in line with their individual dietary needs and preferences. People had access to health professionals when needed.

The service’s design allowed people to spend their time on their own or in the company of others. There were communal areas to socialise with other people using the service and individual rooms to spend time on their own if preferred. The décor was homely and we saw people were comfortable in their environment.

The service worked within the principles of the Mental Capacity Act 2005. Staff had appropriate training and they had good understanding of the principles of the Act. Staff sought people’s consent before any care and support was provided.

People told us they were supported by kind and compassionate staff who respected their privacy and showed an interest in people’s health and wellbeing. Staff told us they empowered people to be independent and to continuously develop their life skills. Staff respected people privacy and dignity and we saw that people using the service were comfortable in staff presence.

People received care that was in line with their care needs and individual preferences, which were described in comprehensive care plans. Care plans included guidelines for staff on how to support people effectively. Staff knew people’s needs and preferences well and were able to give us numerous examples of how people liked to receive their support.

The service had a formal complaint procedure in place which was available to people. People told us they had not had any complaints and they felt listened to by staff who offered their advice when required.

Staff thought the service was well led. They felt supported by the registered manager who they described as approachable and willing to participate in support worker’s tasks to help when needed.

There was good communication between staff members at the service. Effective systems were in place to ensure formal discussion were recorded and agreed actions were followed. Staff were encouraged to participate in the running of the service. This gave them the opportunity to lead on allocated areas of responsibility and to develop their professional skills and knowledge.

There were regular residents’ meetings taking place at the service. In these meetings, people were encouraged to voice their opinion about the support they received and participate in decision making about day-to-day matters related to living at the service.

The registered manager had effective systems in place to monitor staff performance and various elements of the service provision. Regular audits helped to identify any gaps in the service delivery. When gaps in the service delivery were identified, action was taken to ensure required quality of the service at all times.

External health and social care professionals spoke positively about the quality of care and support provided by the registered manager and the staff team at the service.