Archived: Houghtons

Houghtons can accommodate up to six people living with a learning disability or autistic spectrum disorder. The accommodation is single storey and is accessible for people who may also have a physical disability. At the time of this inspection there were six people living at the service.

At the last inspection in January 2016, the service was rated Good. During this inspection, which took place on 6 September 2018, we identified some areas requiring improvement. Consequently, we have changed the rating from Good to Requires Improvement. This is the first time the service has been rated Requires Improvement.

Why we rated the service Requires Improvement:

We found some anomalies with medicines and how medicine records were being maintained. Although there was no evidence that people were not receiving their medicines as prescribed, there was also no clear audit trail to explain some of the concerns we found, such as gaps in Medicine Administration Records (MAR) and tablets taken from the wrong day in medicine packaging.

Systems were in place to make sure people's consent was sought in line with legislation and guidance, but these needed strengthening. This included the processes for gaining people’s consent to care and support, and for managing people’s finances where they lacked capacity to manage their own money.

The provider had systems in place to monitor the quality of service provision, to drive continuous improvement. Quality audits had identified several areas where improvements were needed, and a new management team was working to make the required changes. As stated above we also identified some areas requiring action, for the service to become fully compliant with legal requirements (regulations). The registered manager took swift action to address our inspection findings and provided evidence soon afterwards that improvements had already begun to take place. There was still more work to be done, but some good progress was being made to improve the service for the people living there.

We did find that the service continued to provide a good service in other areas that we checked. For example, people were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely and they were protected by the prevention and control of infection.

Arrangements were in place to make sure there were enough staff, with the right training and support, to meet people’s needs and help them to stay safe. The provider carried out checks on new staff to make sure they were suitable and safe to work at the service.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards.

People were supported to eat and drink enough. Risks to people with complex eating needs were being managed appropriately.

Staff worked with other external teams and services to ensure people received effective care and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

The building provided people with sufficient accessible space, including a garden, to meet their needs. The service operated 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.

Staff provided care and support in a kind and compassionate way. People were enabled 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 supported this practice.

People’s privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to take part in activities, both in and out of the service.

Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

Arrangements were in place to support people at the end of their life to have a comfortable, dignified and pain free death, if the need arose.

There was strong leadership at the service which promoted a positive culture that was person centred and open. Arrangements were in place to involve people in developing the service and seek their feedback.

Opportunities for the service to learn and improve were welcomed and acted upon, and the service worked in partnership with other agencies for the benefit of the people living there.

Further information can be found in the detailed findings below.

We observed that people experienced effective, safe and appropriate care.

Care plans were well documented to promote continuity of care.

During our inspection we saw evidence that people's nutritional requirements were assessed and managed in line with their needs, and that these were reviewed on a regular basis.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

We found the premises to be maintained to ensure the home remained safe for people using the service, staff and visitors.

Suitable arrangements were in place to address people's comments and complaints and ensure they were listened to.

We noted that people were encouraged to express their views using various methods of communication. People were involved in planning their care and making decisions about their support and how they spent their time. We observed people were engaged in one to one activities of their choice, such as sessions in the sensory room, and shopping in the local community.

The provider had systems in place to ensure people were involved in the quality monitoring processes for this service. People were encouraged to share their views and opinions to help improve the standard of care provision.