24 February 2016
During a routine inspection
The inspection took place on 24 February 2016 and was unannounced.
The service did not have a registered manager in post. 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. The previous registered manager had left the organisation on 22nd January 2016 and the provider was actively recruiting to this position. The day to day management of the home was being undertaken by a team leader who was being overseen by the deputy manager and a service manager.
Due to some wider changes within the RNIB services, the people living at The Clockhouse had previously been living at another location. Due to the closure of their previous service, the people had moved to The Clockhouse in October 2015. Feedback indicated that overall this move resulted in positive outcomes for people in terms of a better living environment and greater community access. The process of achieving this move however had not always been effectively communicated by the provider. This had led to a period of uncertainty and anxiety within the service.
The service had a number of staff vacancies which whilst being recruited to were being covered by the use of agency and relief staff. Whilst it is beneficial to have a core of permanent staff, we were told that the service had taken appropriate steps to mitigate the impact of this by using regular agency staff who had become familiar to people and their needs.
Appropriate systems were in place to ensure only suitable staff were employed and all staff received relevant training to enable them to undertake their roles. People were protected from the risk of abuse, avoidable harm or discrimination because staff understood their roles and responsibilities in protecting them. Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005.
People received personalised care that was responsive to their needs. Each person had a detailed plan of care that was kept under regular review. Risks to people were identified and managed in a proactive and enabling way that balanced their safety and independence.
The service had a relaxed and friendly atmosphere. Staff were kind and caring towards people and upheld their privacy and dignity at all times. Staff had a good understanding of people’s needs and engaged with and supported them effectively.
People were supported to maintain good health. The service had good links with other health care professionals to ensure people kept healthy and well. Medicines were managed safely and there were good processes in place to ensure people received the right medication at the right time.
People had choice and control over their meals and were effectively supported to maintain a healthy and balanced diet. Specialist dietary needs were managed well.
People were actively involved in making decisions about their care and staff understood the importance of respecting people’s choices and allowing them to live their lives as they wished. People were supported to follow their own daily routines and had opportunities to engage in meaningful activities.
The daily management of the home was good and staff felt the team leader was an excellent mentor for them and ambassador for people. The culture within the service was open and positive and provided care that placed people at the centre. The provider’s monitoring systems had recently improved and the service had been encouraged to adopt reflective learning.