Next Steps

Updated 12 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We carried out this inspection on 17 January 2018 and it was announced. The inspection team consisted of two adult social care inspectors.

The provider had completed a Provider Information Return (PIR) prior to our inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information that we held about the service including notifications. A notification is information about important events which the service is required to send us by law.

We contacted the local authority commissioning and safeguarding teams as well as the local healthwatch board and the local authority infection control team. There were no comments made about Next Steps.

Healthwatch is an organisation responsible for ensuring the voice of users of health and care services are heard by those commissioning, delivering and regulating services.

During the inspection we observed interactions between staff and people who used the service within the communal lounge and we looked at people’s bedrooms and the dining and kitchen areas. We spoke with two staff members, the registered manager and the registered provider, a student nurse and a pharmacist. We spoke with four people who used the service. We looked at records relating to the service. This included two care records, three staff personnel files, daily record notes, medication administration records (MAR), staffing rotas, training and supervision records, minutes from staff and house meetings, maintenance records, quality assurance systems, incidents and accidents records, policies and procedures and compliments and complaints records.

Updated 12 April 2018

We carried out this inspection on 17 January 2018. We gave the service 24 hours’ notice that we were planning to inspect due to the service being small and ensuring people were at the service. The inspection team consisted of two adult social care inspectors. This was the first inspection of this service since being registered with the Care Quality Commission (CQC).

Next Steps is registered to provide accommodation for people who require personal or nursing care and treatment of disease, disorder or injury.

Next Steps is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Next Steps is registered to provide accommodation to four people in a house over two floors. There were three people living at the service on the day of inspection and a fourth person was trialling the service over a number of days to ensure that their needs could be met.

There was 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 2008 and associated Regulations about how the service is run.

Staff had a clear understanding about their role and responsibilities in protecting people they supported from abuse. Staff were able to identity signs and symptoms of potential abuse and report them appropriately.

Robust policies and procedures were in place to help ensure the suitability of staff employed at the service.

There were sufficient staff deployed to meet the needs of people who lived at the service. Staff were provided with appropriate training in subjects such as mental capacity, fire, psychosis, infection control and first aid. Staff were given regular supervision.

Medicines were stored, recorded and administered safely.

Care plans were person centred and reflected people’s needs and included goals and aspirations that people would like to achieve. People and their families or representatives were involved in the planning of care. People were encouraged to make their own decisions about their care and staff followed legislation designed to protect people’s rights. Mental capacity assessments and deprivation of liberty safeguards were in place.

Risk assessments were detailed and people were encouraged to be involved in the planning of risk assessments to assist in keeping people safe.

Accidents and incidents were clearly documented and actions taken were reviewed and any learning documented.

Staff were aware how to protect people from the risk of infection and there were policies and procedures in place for the management of infection control.

People were encouraged to plan their own meals and cook with support. Nutrition was monitored for those at risk of malnutrition.

We observed kind and person centred interactions with people who lived at Next Steps and staff members. The staff members knew the people well and put people at ease while we were inspecting the service.

People made choices in how they wished to spend their day. We saw that people were supported to attended football sessions and go shopping and see families and friends.

The registered manager and the registered provider were visible within the service. They promoted an open and honest culture for working which was fair and supportive to all staff. Staff felt supported in their roles and were complimentary of the registered manager and registered provider.

We saw that there were systems in place for monitoring and addressing any complaints received. The service documented where improvements and outcomes were identified and any learning from the complaint.

There were a number of audits in place to monitor the performance of the service. Both the registered manager and registered provider had complete oversight of the service and were completely involved in all aspects of the management of the service.

The environment was suitable for the people who lived at Next Steps; it was clean and homely and had communal areas as well as each person having their own private bedroom.