This inspection took place on 22 August 2016 and was unannounced.Cherry Cottage is a residential service which provides accommodation and personal care for a maximum of six people with complex health and care needs. At the time of the inspection six people were living at the home. The main accommodation consists of six self-contained flats and a shared kitchen and lounge. Cherry Cottage also has a small supported living service adjacent to the main building for people who are more independent. At the time of the inspection three people were living there.
A registered manager was 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.
People told us that they felt safe living at Cherry Cottage and receiving support from the supported living service.
At the previous inspection we identified concerns relating to the currency and accuracy of risk assessment documentation. At this inspection we looked at risk assessments for two different people and found that improvements had been made immediately following the previous inspection.
At the previous inspection we identified that the home’s policy and procedure relating to missing person’s did not accurately reflect current practice. We looked specifically at the procedure and saw that it had been revised appropriately.
Staff had been trained in safeguarding procedures. They clearly understood different types of abuse and neglect and what signs to look out for. Staff were able to explain what action to take if they suspected that abuse was taking place.
Staff were recruited safely subject the completion of appropriate checks. This included a requirement for two references and a Disclosure and Barring Service (DBS) check. DBS checks are used to determine that people are suited to working with vulnerable adults. Each of the staff records that we checked contained an application form, references, DBS check and photographic identification.
People’s medicines were stored and administered in accordance with good practice. We spot-checked Medicine Administration Record (MAR) sheets and stock levels. Each of the MAR sheets had been completed correctly. Stock levels tallied with the figures recorded on the MAR sheets.
We saw evidence that staff had been trained in a range of topics relevant to the needs of people living at the home.
Applications to deprive people of their liberty had been submitted appropriately and in accordance with the Mental Capacity Act 2005 and had been made in people’s best interests. Each application had been reviewed and renewed as required.
People were supported to maintain good health by accessing a range of community services. We saw evidence in care records that people had a GP, optician and dentist and had regular check-ups.
Throughout the inspection we observed staff interacting with people living at the home in a manner which was kind, compassionate and caring. Staff adapted their communication style to meet the needs of each person.
We saw that people had choice and control over their life and that staff responded to them expressing choice in a positive and supportive manner.
At the previous inspection we identified a concern relating to the completeness and accuracy of person-centred plans. At this inspection we saw that people’s plans were sufficiently detailed to inform staff of people’s needs and preferences and had been regularly reviewed. The plans had a focus on developing people’s skills and independence which was in-line with the purpose of the home.
People talked positively about the progress that they had made since moving to Cherry Cottage and their plans for the future.
Staff were deployed flexibly so that people had a degree of choice in who provided care and support. Where practical, keyworkers and other staff were matched to people so that they had shared interests.
The registered manager’s interactions with people living at the home and staff were relaxed and informal, but they also led the team in a direct manner when required.
The registered manager and other members of staff that we spoke with described the home’s values in similar terms. Each said that the home promoted people’s independence and helped people to move-on to more independent living. We saw that these values were applied in communication with the people living at the home and in the delivery of care and support.
Staff were clearly motivated to do their jobs and enjoyed working at the home. Staff understood their roles and demonstrated that they knew what was expected of them as they provided care and support.
The home had a robust approach to the monitoring of safety and quality. Audits were completed regularly by the registered manager and a specialist auditor.