This inspection took place on 8 December 2015 and was unannounced.
Jean Marshall House is part of The Outlook Foundation, a charity which provides accommodation, and/or personal care and training for young adults with mild to moderate learning disabilities. This was a supported living scheme where people live in their own home under a tenancy agreement. People received personal care or social support in order to promote their independence. The support provided was tailored to meet people’s individual needs and enable the person to be as autonomous and independent as possible. Jean Marshall House has up to eight people living in the service and is registered to provide personal care. People have en-suite accommodation and a range of communal facilities they can use. The service is situated in a residential area with easy access to local amenities, transport links and the city centre.
The Outlook Foundation has three services in Brighton and Hove. It used its own transport that staff across the foundations services use to get people to and from any activities. The Outlook Foundation also had a learning centre which provided an educational and training facility to promote people’s independence, and which people can use to help develop their life skills.
The service had a registered manager, who was present throughout the inspection, who has been in their current post for a number of years and knew the service well. 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.
People were cared for by staff who had not all been recruited through safe procedures. Recruitment checks such as two written references had not always been received prior to new staff working in the service. This is an area that requires improvement.
People's individual care and support needs were assessed before they moved into the service. Care and support provided was personalised and based on the identified needs of each individual. People were supported to develop their life skills and increase their independence. People, where possible, were supported to move onto further accommodation where they could be more independent, for example into their own flat. People’s care and support plans and risk assessments were detailed and reviewed regularly. People told us they had felt involved and listened to.
Where people were unable to make decisions for themselves the service had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.
People told us they felt safe. One person told us, “The team we’ve got now is excellent I love them to bits I feel safe and confident to talk to them.” They knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to. One person told us, “There is always someone to go to.” There were systems in place to assess and manage risks and to provide safe and effective care.
People were supported to eat a healthy and nutritious diet.
People had access to health care professionals. They had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. There were procedures in place to ensure the safe administration of medicines. People were supported to take their medicines and increase their independence within a risk management framework.
There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. The number of staff on duty had enabled people to be supported to attend educational courses, participate in voluntary work and in social activities. One person told us, “The staff are fantastic they have been there for us from day one. We often have a take away with the staff once a week and I’m very happy.” Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.
Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the registered manager, who they described as very approachable.
People and their representatives were asked to complete a satisfaction questionnaire and we could see the actions which had been completed following the comments received. People had the opportunity to attend regular ‘residents meetings’. The registered manager told us that staff carried out a range of internal audits, and records confirmed this. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of this report.