This inspection visit took place at The Old Chapel on 17 August 2016 and was announced. We told the registered manager before our visit that we would be coming. We did this to ensure we had access to the main office and the management team were available. The Old Chapel t/a Honnette Services provide support with personal care to adults with learning disabilities who live in four houses within the Macclesfield area. The office base is within the grounds of Macclesfield Crematorium. At the time of the inspection the service supported 14 people in four houses.
There was a registered manager in place. 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 last inspection in January 2014 the service was meeting the requirements of the regulations that were inspected at that time.
We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to provide safe care for people.
People were kept safe and secure in the supported houses. There were appropriate numbers of staff deployed in the houses to meet people’s needs and provide a flexible service.
We looked at the recruitment procedures followed by the service for two appointed staff members. We found checks had been undertaken including a Disclosure and Barring Service check (DBS), and references. However the applicant had not provided a full employment history on their application form. They had discussed this with the applicants at interview but had failed to record a written explanation of the gaps. This meant the service didn’t have satisfactory information about the person’s previous employment. Also written references were obtained after the commencement of employment date. The provider had received telephone assurances of the employee’s character but had not recorded this.
We recommend the registered provider reviews the services recruitment procedures to ensure all checks for employment were completed before staff commenced work.
People were approached with a supportive and compassionate manner and staff had a good understanding of protecting people’s dignity and privacy. We observed staff were friendly, respectful and caring towards individuals.
We looked at how medicines were administered. The medicines administration record (MAR) sheets were legible and did not contain any gaps. We saw training records that confirmed staff administering medication had received training.
Staff knew the people they supported and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.
People who lived in the supported houses were encouraged to attend to their own dietary requirements as much as possible. Support and guidance was always available at mealtimes. One person who lived in one of the houses said, “I enjoy shopping for my own food and cooking it.”
Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.
People who lived in the supported houses were provided with support and guidance to meet their aims and goals. For example staff provided support for people who wished to achieve education or gain employment. One person who lived in one of the houses said, “I wanted to attend college and do some gardening. Everybody has helped me to do that.”
People who used the service knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns. Where people had expressed concerns appropriate action had been quickly taken.
We found a number of audits were in place to monitor quality assurance. The registered manager had systems in place to obtain the views of people who lived in the supported tenancy houses and their relatives.