This inspection took place on 1 and 3 December 2014 and was unannounced. The service met the regulations we inspected at the last inspection which took place on 21 November 2013.
Trevelyan Road provides accommodation and support for up to four males with a history of mental health needs. It is situated in a residential area of Tooting with good access to local shops and transport links.
There was a registered manager 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 home is arranged over three floors with a lounge, kitchen/dining area, toilet and a bedroom on the ground floor, two bedrooms and a bathroom on the first floor and one bedroom on the third floor. There is an accessible garden to the rear of the property.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 during this inspection. We found that the provider was not meeting some of the requirements of the law in relation to meeting people’s individual care needs, supporting staff, how complaints and concerns were handled and how they monitored the quality of service provided. You can see what action we told the provider to take at the back of the full version of the report.
Care plans for people using the service were not always effective in capturing the required information and supporting people to achieve positive outcomes. People’s individual support needs were not being recorded in a way that was easy to follow which meant that people were at risk of not always receiving support that met their needs.
Although staff had attended some training, there was no evidence of training that had been delivered to staff in relation to supporting people with mental health needs and in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
Although meetings were held with people using the service, we saw that concerns raised were not always followed up or assigned to staff to look into. Therefore the provider did not ensure that people’s concerns were followed up.
The provider did not have an effective way of monitoring the quality of service provided to people, either through formal feedback methods or through quality assurance audits. We identified shortfalls in reporting significant events to the Care Quality Commission (CQC) as required.
There was an open door culture at the service. We observed people coming into the manager’s office throughout our inspection wanting to speak with him. Staff told us that the manager was very supportive and easy to talk to.
People told us they enjoyed living at the home and that staff treated them with respect. We saw that there was a friendly relaxed atmosphere at the home with people and staff spending time in the lounge together. People told us they felt safe living at the home.
People were able to go out during the day by themselves or with staff. Some people were restricted from leaving the home at certain times or without a support worker. Where this was done the decision to restrict them had been taken lawfully and in their interests.
Staff administered medicines safely. Although staff recorded and completed medicine administration record (MAR) charts correctly, we saw in some instances that appropriate action was not always taken when people refused their medicines. We have made a recommendation to the provider about this.
People told us they felt supported by staff and that there were enough staff members to meet their needs. Staff told us they were content working at the home and felt that they received good training to help them meet people’s needs.
People had access to healthcare services and received on-going healthcare support, for example, through their GP. Referrals were made to other professionals if the need arose. People met with their psychiatrist and their mental health needs were reviewed by their psychiatrist and the community mental health and learning disability team.
People told us they enjoyed the food at the home and had no concerns. People were encouraged to help staff in preparing meals, so that they could become more independent. During our inspection, we saw that people were given choice and independence in aspects of their daily living such as activities and household chores.