Archived: Charlton Road

30 Charlton Road is a care home providing accommodation and personal care support for up to four people with learning and physical disabilities. At the time of the inspection the home was providing care and support to four people.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

We found the outcomes for people using this service reflected the principles and values of Right support, right care, right culture. These included promotion of choice and control, inclusion and independence. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Right support

People’s care and support needs were assessed before they started to use the service. Risks to people had been assessed to ensure their needs were met safely. Staff supported people to achieve their aspirations and goals. Staff supported people to take part in activities and pursue their interests in their local area.

Right care

People received kind and compassionate care. Staff respected people’s privacy, dignity and promoted their independence. Staff understood and responded to people’s individual care and support needs. People had a choice about their living environment and were able to personalise their rooms. They had access to health care professionals when they needed them.

Right culture

People received good care, support and treatment because staff were trained in areas related to their care and support needs and they received regular supervision from the registered manager. People and those important to them were involved in planning their care. People, their relatives and staff views were considered through questionnaires and meetings. There was a complaints procedure in place in formats that people could understand.

We found breaches of our regulations because staff were not always following Government COVID 19 Guidelines (current on the first day of our inspection) by wearing appropriate PPE and ensuring visitors had completed COVID 19 tests.

We also found that records essential for the running of the service were not readily available to demonstrate peoples care needs and safety was always effectively managed. We found no evidence during this inspection that people were at risk of harm from this concern.

The provider had safeguarding and whistleblowing procedures in place and staff had a clear understanding of these. People’s medicines were managed safely. Appropriate recruitment checks took place before staff started working at the service. There were enough staff available to meet people’s needs.

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 supported this practice. Peoples preferences for their end of life care was held in their care records.

The registered manager and staff worked in partnership with health and social care providers to deliver an effective service. There were systems in place to monitor the quality and safety of the service and any learning was identified and acted on. Staff said they received good support from the registered manager and deputy manager.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

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

The last rating for this service was good (published 12 October 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Charlton Road on our website at www.cqc.org.uk.

30a Charlton Road is a care home providing accommodation and personal care support for up to four people with learning and physical disabilities. At the time of the inspection the home was providing care and support to four people.

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. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People and their relatives gave us positive feedback about their safety and told us that staff treated them well. The provider had a policy and procedure for safeguarding adults and the registered manager and staff understood what abuse was, the types of abuse, and the signs to look for. Risk assessments and management plans were completed for people and the home environment to ensure safety. There was a system to manage accidents and incidents and to reduce them happening again. People were supported by effectively deployed staff. There were effective recruitment and selection procedures in place to ensure people were safe and supported by staff that were suitable for their roles. People received their prescribed medicine and were protected from the risk of infection.

People’s needs were assessed to ensure these could be met by the service. Where appropriate, staff involved relatives in this assessment. The provider trained staff to support people and meet their needs. Staff supported people to eat and drink enough and to maintain good health. The provider worked with other external professionals to ensure people received effective care. People’s capacity to consent to their care and support was documented.

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.

Staff supported people and showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and their relatives were involved in the planning and review of their care and people were supported to be as independent as possible.

Care plans were person centred and contained information about people’s personal life and social history, their health and social care needs. The provider had a clear policy and procedure for managing complaints and this was accessible to people and their relatives in a format that met their needs.

The provider had a policy and procedure to provide end-of-life support to people. However, people did not require end-of-life support at the time of the inspection. The provider had systems and process in place to monitor the quality of the service. The registered manager and staff worked well together as a team. People who used the service completed satisfaction surveys and the results were positive. The registered manager remained committed to working in partnership with other agencies and services to promote the service and to achieve positive outcomes for people.

The service applied the principles and values consistently 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. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Rating at last inspection: The last rating for this service was good (published 15 March 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received 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 had a registered manager 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 and associated Regulations about how the service is run.

Most of the people using the service could not communicate their views to us verbally. We contacted some of their family members for their views about the care provided to their relatives. They told us their relatives were safe and that staff treated them well. 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. Risks to people were assessed and support plans and risk assessments provided clear information and guidance for staff on how to support people to meet their needs. People’s medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had completed training specific to the needs of the people they supported and they received regular supervision and annual appraisals of their work performance. People were provided with sufficient amounts of nutritional food and drink to meet their needs and staff knew how to support people with eating and drinking. People had access to a GP and other health care professionals when they needed them. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were provided with appropriate information about the service. This ensured they were aware of the standard of care they should expect. People and their relatives, where appropriate, had been involved in planning for their care needs. There was a range of appropriate activities for people to partake in if they wished to. There was a complaints procedure in place in a format that people could understand. Relatives were aware of the complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

The provider recognised the importance of regularly monitoring the quality of the service provided to people. People were enabled to express their views and opinions about the service. Staff said they enjoyed working at the service and they received good support from the registered manager. There was an out of hours on call system in operation that ensured management support and advice was always available when staff needed it.

We found arrangements were in place for obtaining people’s consent to treatment and care, and for acting in people’s best interests. People experienced care and treatment that met their needs and kept them safe. They were protected from the risks of unsafe premises and there were enough staff to meet their needs. A system was in place for monitoring the quality and safety of the service people received.

We were able to speak with the majority of people living at the home.

However all were challenged with regard to their communication therefore

observation was used during this inspection.

The home was warm, clean and had a relaxed and friendly atmosphere.

There was a support worker and a home leader on duty with the registered manager supervising.

Observation and interviews showed us that staff were kind and respected their privacy.

We observed staff supporting people in a friendly and professional way and saw that

people were being offered choice with regard to menus, activities and care preferences.

People who use the service seemed positive about the care and treatment they received at

the home.

Interviews with staff and care plans also told us they had good access to health care

professionals such as doctors, district nurses, dentists and speech and language therapists.

People who use the service indicated to us that they felt safe at the home. They told us

they had no concerns about their care.