Archived: Apple House

Updated 21 October 2016

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.

The inspection visit took place on 29 September 2016 and was unannounced. The inspection team included an inspector and an expert by experience (ExE). An ExE is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit, we reviewed the information that we held about the service to inform and plan our inspection. This included information that we had received and statutory notifications. A statutory notification contains information relating to significant events that the provider must send to us. We also contacted Healthwatch (the consumer champion for health and social care) and the local authority who has funding responsibility for some people living at the home to ask them for their feedback about the service.

We spoke with four people who used the service and with two of their relatives. We also spoke with the manager, a senior member of staff and a support worker who all offered people help and support when required. We observed staff offering their support to people throughout our visit so that we could understand people’s experiences of care. We received feedback from a social care professional during our inspection.

We looked at the care records of two people who used the service. We also looked at records in relation to health and safety, people’s medicines as well as documentation about the management of the service. These included training records, policies and procedures and quality checks that the manager had undertaken. We looked at three staff files to look at how the provider had recruited and how they supported their employees.

Updated 21 October 2016

We inspected the service on 29 September 2016 and the visit was unannounced.

Apple House provides care and support for up to eight people with learning disabilities or autism. At the time of our inspection eight people were using the service. The accommodation was offered over two floors accessible by stairs. There were two communal lounges and a dining area. There was a large accessible garden for people to use should they wish to.

The manager oversaw the daily running of the home and supported people with personal care and support where required.

People felt safe with the staff supporting them. Staff understood their responsibilities to protect people from abuse and avoidable harm and to remain safe. The provider had a system to manage accidents and incidents to make sure people received the support they required. Risks to people’s health and well-being had been regularly assessed. For example, where people accessed the local community independently, measures were in place to support them to keep safe.

The provider had a suitable recruitment process in place for prospective staff including undertaking relevant checks. People and staff were satisfied with the number of staff available to offer them support. We found that staffing numbers were suitable to help people to remain safe.

People received their prescribed medicines safely. Staff received regular guidance and understood their responsibilities to handle people’s medicines safely. Medicines were suitably stored in line with manufacturing guidelines. Guidance was available and followed by staff about how people preferred to take them. The manager told us they would speak with people’s GPs where people bought over the counter medicines to make sure they were safe to use with their prescribed medicines.

People received support from staff with suitable knowledge and skills. Staff received regular training in topic areas such as food safety and first aid. New staff received an induction when they started to work for the provider so that they knew their responsibilities. They had regular meetings with the manager so they could receive guidance on their work.

People were supported in line with the Mental Capacity Act 2005. People were supported to make their own decisions and the manager had documented their capacity to make decisions where this was necessary. Staff understood their responsibilities under the Act. The manager had made an application to the local authority where they had sought to deprive a person of their liberties.

People chose what they ate and drank and were satisfied with what was available to them. People had regular access to healthcare services such as to their doctor or a community nurse where this was required to maintain their health. Staff had guidance on people’s health conditions so they knew how to provide effective support.

People received support from staff who showed them respect, kindness and compassion. Staff protected their dignity. The provider had arrangements for storing people’s care records safely and discussions about their care needs occurred in private.

People were supported to be as independent as they wanted to be, such as making their own snacks, in order to retain their skills. People were involved in decisions about their support including how they chose to spend their time. The manager told us they would make information about advocacy services available to people should they require support from independent sources.

People had contributed to the planning and review of their support requirements. They had support plans that were centred on them as individuals and contained guidance for staff to follow to provide responsive support to them. Staff knew about the people they supported and offered their assistance in line with people’s preferences. People spent their time in ways that were important to them including attending local social and activity groups.

People knew how to make a complaint. The provider had a complaints policy in place that outlined what they would do should they receive a complaint.

Staff knew their responsibilities as the manager had arrangements in place for them to receive regular guidance and support. Staff knew how to report the inappropriate or unsafe practice of their colleagues should they have needed to.

People and others involved in their support had opportunities to give feedback to the provider. The manager was aware of their responsibilities and had arranged for quality checks of the service to take place to make sure that it was of a high standard. For example, checks on the equipment within the home routinely occurred. However, their checks did not always identify where improvements were required in relation to the cleanliness and décor within the home.