28 November 2017
During a routine inspection
The service is a care home that provides care and accommodation for up to eight people with a physical disability and cognitive brain impairment caused after an accident, stroke or by cerebral palsy. Cerebral palsy is a lifelong condition that affects movement and co-ordination. At the time of our inspection there were eight people using the service. The accommodation was situated over three floors. A lift was used for people to access different floors in the service.
A registered manager was employed at the service. 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 not available for this inspection. However, the deputy manager and provider's group manager were on site and assisted the inspection process.
The provider trained staff so that they understood their responsibilities to protect people from harm. Staff were encouraged and supported to raise any concerns they may have.
The provider offered an inclusive service. They had policies about Equality, Diversity and Human Rights.
The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
The provider was consistent in measuring the quality of people’s experiences and continued to work at putting people at the heart of the service.
The quality outcomes promoted in the providers policies and procedures were monitored by the management in the service. Audits undertaken were based on cause and effect learning analysis, to improve quality. All staff understood their roles in meeting the expected quality levels and staff were empowered to challenge poor practice. The provider shared their learning with other services in the provider group of care homes.
People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health.
We observed and people described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered.
Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected. Some people employed their own external care staff for some activities. We observed people being consulted about their care and staff being flexible to requests made by people to change routines and activities.
Incidents and accidents were recorded and checked by the provider to see what steps could be taken to prevent these happening again. Staff were trained about the safe management of people with behaviours that may harm themselves or others.
Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The provider recruited staff with relevant experience and the right attitude to work with people who had physical disabilities and cognitive impairment. New staff and existing staff were given an induction and on-going training which included information specific to the people’s needs in the service.
People, their relatives and health care professionals had the opportunity to share their views about the service either face-to-face, by telephone, or by using formal feedback forms.
Staff assessed people as individuals so that they understood how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed within the service, both to individual people and for the wider risk from the environment. Staff understood the steps to be taken to minimise risk when they were identified. The provider’s policies and management plans were implemented by staff to protect people from harm.
Meals were suitable for people’s individual dietary needs and met their preferences. People were supported to eat and drink according to their assessed needs. Staff supported people to maintain a balanced diet and monitor their nutritional health.
Staff received supervision and attended meetings that assisted them in maintaining their skills and knowledge of social care.
The premises and equipment in it were regularly maintained and serviced to minimise risks to people’s safety.
Management systems were in use to minimise the risks from the spread of infection and keep the service clean and odour free.