Cabrini House 1 (Diagrama Healthcare)

Cabrini 1 is one of three small separate care homes run by the provider in the same road that provides accommodation care and support to seven people with learning difficulties and some physical disability or health needs. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were six people living at the home.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. So that people with learning disabilities and autism using the service can live as ordinary a life as any citizen

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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. They were aware of their responsibilities' and had submitted notifications as required. They were aware of their legal requirement to display their current CQC rating which we saw was on display at the home and on the provider’s website.

At this inspection we found there were systems to monitor the quality of the service although the provider did not carry out their own separate recorded quality checks but relied on the managers own audits. The provider was in the process of reviewing their quality assurance systems at the time of the inspection.

We have made a recommendation that the provider seeks appropriate guidance on the implementation of new quality monitoring systems. We will check on the progress with this at the next inspection.

There were effective safeguarding procedures in place to protect people from the risk of abuse. Staff understood the different types of abuse and knew who to contact to report any concerns. There were processes in place to learn from accidents and incidents. Individual risks to people were assessed and detailed guidance provided to staff to reduce risk. Medicines were safely managed.

There were sufficient numbers of staff at the service. The environment had been adapted to meet people’s needs. The service was clean and staff understood how to reduce the risk of infections.

Staff received sufficient training supervision and support to fulfil their roles and responsibilities. New staff completed an induction when they started work and staff received regular training and supervision that helped them support people’s individual needs.

Prior to joining the service people's needs were carefully assessed in partnership with people, their families and health and social care professionals where relevant.

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 support this practice.

People were supported to meet their dietary and nutritional needs safely and provide them with sufficient choice. The service worked with health and social care services and professionals to maintain the good health of people they supported. The service supported people when they moved between services through effective communication to ensure their care and support were coordinated well.

People and relatives told us staff treated people with kindness and consideration. Staff respected people’s individuality and promoted their independence. People were involved as far as possible in decisions about their care.

People’s care and support was responsive and personalised to their needs. The service used positive behaviour support (PBS) where appropriate. This is a person-centred approach to supporting people who display or are at risk of displaying behaviours which may require a response with the aim of improving their quality of life. The service promoted equality and people’s diverse needs were respected and supported. Information was available in a range of formats.

People were supported to engage in the community and in activities that they enjoyed. People were supported to socialise, learn new skills, and maintain relationships. People and their relatives knew how to complain about the service should they need to. Information was available in a range of formats.

Relatives, staff and professionals gave positive feedback about the management of the service and said their views were listened to. We saw there were areas where the service worked to keep up to date with best practice and share learning in the team. There was a clear ethos of providing good quality person centred care at the service.

This inspection took place on 7 and 8 April 2016 and was unannounced. 1 Healy Drive was registered with the Care Quality Commission on 19 January 2015. This was the first inspection at the home.

There was a manager in post at the time of our inspection who had been appointed in March 2016 and was going through the process of registration. At the time of the inspection the registered manager had resigned and was applying for de-registration. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 using the service could not express their views so we observed the support offered and spoke with relatives and staff. Relatives told us that their family members were safe and well treated. During the inspection we saw that people appeared happy and content and not at risk of harm. Where relevant, people had an independently appointed professional such as an advocate who could express their views and help them to ensure their voice was heard.

Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work. People were being supported to have a healthy balanced diet. People’s medicines were managed safely and they received their medicines as prescribed by health care professionals.

Staff had received training specific to the needs of people using the service, for example, mental health awareness and safeguarding adults. They received regular supervision and an annual appraisal of their work performance. The manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People’s relatives and health care professionals had been involved in planning for their care needs. Care plans and risk assessments provided clear information and guidance for staff on how to support people to meet their needs. Staff encouraged people to be as individual as possible and to do things they wanted to do. People’s relatives were aware of the complaints procedure and were confident their complaints would be fully investigated and action taken if necessary.

The manager recognised the importance of regularly monitoring the quality of the service provided to people. The provider sought the views of relatives of people using the service, staff and health care professionals through annual surveys and regular meetings. They used feedback from these events to make improvements at the home. Staff said they enjoyed working at the home and they received good support from the manager.