Pritchard Street

Pritchard Street provides rehabilitative support for four adults with enduring mental health needs. The home is a terraced property situated in a residential area close to local amenities. There is a communal lounge, a kitchen diner and laundry room. All bedrooms are single with shared bathroom and toilet facilities. There were four people using the service on the day of our inspection.

At our last inspection we rated the service good. 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.

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At this inspection we found the service remained Good.

People who used the service told us they felt safe when staff members were in their homes. Staff had received training in safeguarding and knew their responsibilities to report any concerns. The service also had a whistleblowing policy in place.

Risk assessments were in place to keep people safe. These were reviewed and updated regularly or when changes occurred.

Robust recruitment systems and processes were in place. We saw references, identity checks and Disclosure and Barring Service checks were completed before staff were employed. People who used the service and records we looked at showed adequate numbers of staff were on duty.

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 practice.

All new staff members were expected to complete and induction when they commenced employment. Training courses were available to staff which were relevant to their roles. Staff members told us, and records confirmed that staff members received supervisions and appraisals on a regular basis. All staff members told us they were able to discuss any training requirements they had.

People who used the service told us staff were kind and supportive. We observed throughout our inspection that staff were kind, caring and supportive of people who used the service.

Staff members knew people very well, including their preferences, background and history. People’s care records contained information relating to their sexuality, cultural/spiritual needs and relationships.

Throughout our inspection and from records we looked at, we saw people were encouraged to be independent.

The service delivered person centred care using the recovery model. The aim of this was for people to eventually become independent and move on. We saw detailed, person centred care plans were in place.

The service had a complaints procedure in place. Records we looked at showed that one complaint made had been dealt with in line with company policy.

We found that the interim manager had notified CQC of any accidents, serious incidents and safeguarding allegations as they are required to do. This meant we were able to see if appropriate action had been taken to ensure people were kept safe.

The registered manager had processes and systems in place to monitor and improve the quality of the service.

We saw regular staff meetings were also held. Staff told us these were regular and they were able to bring up topics for discussion.

The service was meeting all relevant fundamental standards.

Further information is in the detailed findings below.

We last inspected this service on 02 September 2014 when the service met all the regulations we looked at.

The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

On the day of the inspection we were notified of an outbreak of a viral illness. We visited briefly, toured the communal areas, talked to two staff and asked a person who lived at the home how they were feeling. We took paperwork to a safer environment (Lancaster House) to avoid contact and possible spread of the infection. The registered manager had contacted the public health department for advice and to take any action as may be required. One person who used the service remained in the home and two people who used the service who had recovered were out.

Staff had been trained in safeguarding people from abuse and were aware of the need to report any suspected issues of abuse. One person who used the service said they felt safe.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults. There were sufficient staff to meet people’s needs.

We found the ordering, storage, administration and disposal of medication was safe.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities to help protect their health and welfare.

People told us they were encouraged to plan their menus, shop for their food and cook their meals with support from staff when required. Some people told us they were proud of the skills they were learning.

New staff received induction training to provide them with the skills to care for people. All staff were well trained and supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards and followed the correct procedures using independent professionals.

There were systems to repair or replace any broken equipment and electrical and gas appliances were serviced regularly. Each person had an individual personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

The home was warm, clean, well decorated and fresh smelling. People who used the service were responsible for cleaning with staff support. People made good use of the covered seating area in the garden.

We saw that independent living was the aim of the service and how people’s recovery plans reflected this.

We observed there was a good interaction between staff and people who used the service. We observed the good relationships staff had formed with people who used the service and how they responded well to any questions or advice people wanted.

We observed that staff were caring and protected people’s privacy and dignity when they gave any care. The care was mainly around people’s mental health needs but we did not see any breaches in people’s confidentiality.

We saw that the quality of recovery plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed. People agreed to the restrictions placed upon them to help them get better.

We saw that people who used the service were able to attend meetings, 1 – 1 sessions and activities to gain their views. Professionals were asked for their views in the way the service was managed. Staff were encouraged to participate in how the home was run.

Policies and procedures were updated regularly and management audits helped managers check on the quality of the service.

People were able to access the community on activities, were helped to gain employment or attend courses to improve their knowledge.

Was the service safe?

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. A person who used the service said, "I have no complaints whatsoever. They would listen to me if I had". This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one.

The service was safe, clean and hygienic. There were policies and procedures for the control of infection. A person who used the service said, "I do all my own cleaning but for those who cannot do it staff help them".

Was the service effective?

People's health and care needs were assessed with them if possible, and they were involved in writing their plans of care. One person told us, "Staff talk to us every week about our goals".

Specialist dietary, medication and community support needs had been identified in care plans where required. Most people were younger adults and did not require any specialist equipment.

The service helped people with mental health problems to recover and if possible achieve independent living. One person who used the service told us, "I have completed my level one training for the gym but that is now on hold. I been offered a voluntary job helping young people get over addiction or bad behaviour. I may be able to get a job as a mentor if it all works out. My aim is to live independently soon". The care service was providing an effective recovery program.

Was the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person who used the service told us, "I am more than happy with the support I have received from the staff. Staff allow us to take risks and have a personal life. I am happy here. It has been a positive experience. We have recently had a staff change and I was able to help with the choice of the staff here".

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People who used the service were encouraged to provide as much information about their past lives and what they liked or did not. This information gave staff the knowledge to treat people as individuals.

Was the service responsive?

People completed a range of activities in and outside the service regularly. Each person had their known hobbies and interests recorded. of the four people who lived at the home three people were out following hobbies and interests of their choice. One person told us, "I like to go to the gym. I go out with my girlfriend, go swimming, attend meetings and the relapse prevention group meals. I also go to the pictures, out for meals and meet my family. They are very pleased with my progress. Staff allow us to take risks and have a personal life.

The registered manager and key staff held regular meetings with people who used the service. There was a staff meeting held at least once a week for various grades. Staff were able to voice their opinions. We saw that results from questionnaires had led the service to provide extra staff or improve the environment. The service produced a newsletter called 'The Voice'. With the agreement of people who used the service their achievements and activities were recorded as was useful information and some staff profiles to explain to people what their role was.

Was the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. There was a system for providing information to other providers in an emergency.

The service had good quality assurance systems. The registered manager undertook regular audits of the service. Records seen by us showed that identified shortfalls were addressed promptly and as a result the quality of the service was continually improving.

Staff training was on-going, as was supervision and appraisal. A staff member we spoke with said, "I like working here. The managers are very supportive. We get plenty of training. We get enough training to do the job relevant to our role. We get regular supervision and it is a two way process".

People using the service had opportunities to express their views and opinions about their care and support. This included being involved in making decisions about their individual care needs and choices. Records showed people were involved in the planning of their care and support and had agreed to the services provided.

People told us staff treated them well and talked to them about their daily needs and preferences. We spoke with one member of staff who explained how they asked permission before carrying out care and support tasks.

People were involved in and supported with a range of meaningful activities. From discussion, observation and looking at records we found people's activities were tailored to their individual needs and preferences.