280-282 Wells Road

We found the following examples of good practice.

Government guidance was followed for visiting arrangements. Visitors were provided with hand washing facilities and personal protective equipment [PPE]. Only essential visits were taking place at the time of our inspection. People living at the home were supported to use alternative methods to remain in contact with relatives.

People had been supported to isolate in their bedrooms. Commodes had been purchased so that people did not need to share the communal toilet facilities. Other communal areas were monitored by staff and temporary changes were in place to enable social distancing.

Staff were wearing appropriate PPE. PPE stations were accessible with hand sanitiser around the home. Staff had been trained and observed in practice before being signed of as competent in the correct use of PPE and handwashing. Pictorial guidance was displayed appropriately around the home as a reminder for staff.

People were tested regularly and monitored for signs of COVID-19. Temperatures were taken twice daily to help identify new cases and monitor people with the virus for signs of deterioration.

The premises looked clean, cleaning was scheduled for morning, afternoon and night. The registered manager had sought advice on cleaning products. Touch points were cleaned more frequently with anti-bacterial wipes.

Shift patterns were changed and staff worked longer hours to reduce the risk of staff bringing COVID-19 in to the home. Staff met outside once a week as a team, this enabled staff to support each other and pass on new information so that staff were following the most up to date government guidance.

The service provides accommodation and personal care for up to six people living with a learning disability and or autistic spectrum disorder. At the time of our inspection there were six people living at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using this service and what we found

Staffing levels provided, did not ensure people’s dependency needs were continuously met; this was particularly at weekends. Where people had additional needs and required one to one staff support, we were not sufficiently assured this was being provided. Staff had not received training in learning disability and autism awareness, despite the registered manager assuring us at the last inspection this would be provided. Inconsistencies were also identified in record keeping. National best practice guidance in the management of medicines were not always followed.

Staff recruitment procedures were in place to ensure only staff suitable to care for people were employed. Risks associated with people needs had been assessed and planned for.

The internal and external environment was clean, well maintained and met people's individual needs and choices.

Staff were knowledgeable about people's needs and what was important to them and were described by people and relatives as being kind and caring. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were involved in day to day choices.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People were active citizens of their local community and received opportunities to pursue their interests and hobbies.

People’s individual communication needs had been assessed and staff used effective communication and listening skills and provided information in easy read to support people. People's end of life wishes had been discussed with them and plans reflected their end of life care wishes.

Systems and processes were in place to monitor, analyse and manage complaints, however, no complaints had been received since our last inspection. Whilst staff were clear about their role and responsibilities, accountability needed to be improved upon.

Audits and checks were in place to monitor the quality and safety of the service. People received opportunities to give feedback about the service they received. The provider and registered manager had met their registration regulatory requirements.

Rating at last inspection

The last rating for this service was Good (published 10 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service provides accommodation and personal care for up to six people living with a learning disability and or autistic spectrum disorder. At the time of our inspection there were five people living at the service.

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. At the time of the inspection a registered manager was in post.

People received a safe service. Staff were aware of the safeguarding adult procedures to protect people from avoidable harm and had received appropriate training. Risks associated to people’s needs had been assessed and were known by staff and managed appropriately. Accidents and incidents were recorded and action had been taken to reduce further risks. People received their medicines as prescribed and these were managed correctly.

People were supported by staff that received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people’s needs. People’s dependency needs had been reviewed and were monitored for any changes. Staff were recruited through safe recruitment practices.

People were involved in the menu planning and their nutritional needs had been assessed and planned for. People’s healthcare needs were regularly monitored. The service worked well with visiting healthcare professionals to ensure they provided effective care and support.

The manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people’s rights were protected. People were asked for their consent before care and support was provided and this was respected.

Staff were kind, caring and respectful towards the people they supported. They had a clear understanding of people’s individual needs, preferences and routines.

People were involved in their care and support. There was a complaint policy and procedure available and confidentiality was maintained. People had access to independent advocacy services. There were no restrictions on people visiting the service.

People were supported to participate in activities, interests and hobbies of their choice. Independence was promoted and there were no restrictions placed upon them. People accessed the community independently as they wished.

The provider asked people, relatives and representatives for their experience about the service. There were plans in place to drive forward further improvements. The provider had systems in place that monitored the quality and safety of the service. There was a registered manager in place.