The inspection visit took place on the 27 March 2017. This was an announced inspection and we gave the provider short notice of our visit to ensure someone would be available at the home. We last inspected the service on 14 December 2014 and found the service was not in breach of any regulations at that time.
Sabre Court is a service for people with mental health problems who have issues with alcohol misuse. There were currently eight people using the service. The service was a located close to the centre of Scarborough near to all community facilities
There is 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 (2014) about how the service is run.
People told us they felt safe at Sabre Court. We discussed safeguarding with the registered manager, the registered provider and two care staff members on duty and they were knowledgeable about the procedures to follow if they suspected abuse. We saw information displayed for staff and people using the service to use to contact external agencies if they had any worries or concerns.
There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.
Individual care plans contained risk assessments which were reviewed twice daily. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: the mental health crisis team and care managers.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with substance misuse issues. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. There was a very consistent staff team who worked a 24 hour shift pattern that provided continuity of support for people.
There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development.
The staff team encouraged people to maintain their independence. People were supported to be involved in the local community as much as possible. People were supported to access regular facilities such as the local G.P, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals. The staff team respected people’s lifestyle choices that may not be seen as the correct one to ensure good health and wellbeing. It allowed people to drink alcohol on site and stated this was because they would rather know that they were in a safe environment rather than being vulnerable on the streets and the service could monitor people’s consumption and report to relevant agencies if necessary. We found that people were encouraged and supported to take responsible risks and positive risk-taking practices were followed. People told us that they made their own choices and decisions and these were respected.
There was a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that the staff or registered manager and provider would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
People told us they were involved in planning their meals and were supported to maintain a healthy diet. We saw people had nutritional assessments in place and people with specific dietary needs were supported. Specialist advice was sought quickly where necessary.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and risk assessments and how they had worked with staff to develop and review them.
We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.
We found that the building was clean, well-furnished and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety requirements were met. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.
We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people who used the service on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.