The Inspection was carried out on Thursday 5th November 2015 and was unannounced.
This home provided accommodation and personal care for up to two people with learning disabilities, autism and people who may harm themselves or others. The accommodation was spread over three floors giving people plenty of personal space and shared areas. One bedroom had en-suite shower facilities.
There was a registered manager employed at the home. 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.
The registered manager was unable to devote enough time to the management and leadership of the service. Suitable support mechanisms for the registered manager were not followed by the provider to ensure they were carrying out their responsibilities in meeting the requirements of the Health and Social Care Act 2008 and associated Regulations.
General environmental risk assessments were in place but had not been regularly reviewed. People, including staff and visitors, may not be protected from potential risks around the home.
The provider did not have robust auditing systems and processes in place to check the quality of the service provided. Ensuring safe and effective practices and systems are being followed is a responsibility of the provider. Action may not be taken when changes or improvements were needed to keep people safe or to meet the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People and their relatives told us and indicated they felt safe. There was an up to date safeguarding adult’s procedure and policy in place. The staff demonstrated they had a good understanding of what abuse is and how they would act if they suspected abuse was taking place.
People received support from staff with taking prescribed medicines. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.
Recruitment practices were safe and effective. Checks were carried out to make sure staff were suitable to work with people who needed care and support. Staff had received an induction when they were first employed and were supported by the manager in one to one and informal meetings.
The staff had the skills and knowledge in order to carry out their duties effectively and had received adequate training.
Staff supported people with their nutrition, hydration and health care needs. They encouraged healthy choices of food as well as giving people choice and support to make healthy decisions in this area.
Individual care was planned and delivered with the full involvement of people, their relatives and relevant others
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager and staff showed that they understood the Mental Capacity Act 2005 and DoLS. The registered manager understood their responsibilities as Mental Capacity assessments and decisions made in people’s best interest were recorded.
People’s needs were assessed before moving into the service with involvement from relatives, health professionals and the person’s funding authority. Care plans contained detailed person centred information and guidance. All aspects of a person’s health, social and personal care needs to enable staff to meet their individual requirements were included. People were encouraged and supported to engage in activities within the service and in the community.
Potential risks to people in their everyday lives had been individually identified and had been assessed in relation to the impact that it may have.
The staff knew people very well, including their personal histories and interests. We observed them being respectful and caring when speaking about or to people. There was a relaxed and friendly atmosphere in the home and there was a good rapport between people and staff. People’s privacy and dignity were respected by a team who understood how important this was to a person’s wellbeing.
Systems were in place for people or their relatives to raise their concerns or complaints.
People, relatives and professionals had been asked for their views of the service provided
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.