26 January 2017
During a routine inspection
The provider’s care service is based on site and is designed to enable and facilitate the delivery of personal care and other support to people living at Campbell place now or when they need it in the future. The service is registered to provide personal care to older people, people living with dementia, people with a learning disability or autistic spectrum disorder, people with a sensory impairment or mental health condition, people with an eating disorder, younger adults and people with a physical disability. At the time of our inspection they were providing the regulated activity of personal care to 32 people.
People living at Campbell place had the use of communal facilities such as a restaurant, a shared lounge with a piano, games and a TV, access to a shared garden and a garden room and library. A bathroom was available with an assisted bath should a person require this. All flats had wet rooms for their own use. There were also treatment rooms used by a visiting hairdresser and chiropodist. The scheme had secure access and a staffed reception area.
The service had a registered manager. 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. At the time of our inspection the registered manager was managing three of the provider’s services which were located close together.
People told us they were cared for safely by the provider’s staff. Staff had completed training in safeguarding adults from abuse and appropriate actions had been taken by staff and managers when concerns about people’s safety had been raised.
Staff we spoke with understood the risks that people experienced and took the appropriate actions to ensure people received safe and appropriate care. Information about risks to people were communicated effectively to ensure people were supported safely.
There were sufficient suitably qualified staff available to meet people’s needs. People confirmed they received the care as agreed with the provider. On occasion, people did not receive their care at their preferred times due to unplanned staff absence. The registered manager had taken action to improve this for people by highlighting with the staff the importance of good notice for absence which enabled them to plan staff cover more effectively.
People were protected from the employment of unsuitable staff because the provider carried out the relevant checks to ensure staff were recruited safely. The recruitment process helped ensure staff were suitable for their role. Staff had access to induction and on-going training, supervision and appraisal. This ensured staff had the skills and knowledge to support people safely and effectively.
People’s medicines were managed safely by appropriately trained staff and the provider monitored the administration of people’s medicines through regular checks and audits.
People told us staff supported them to be as independent as they were able to be. People’s legal rights were upheld because the provider’s staff understood the principles of the Mental Capacity Act 2005 (MCA). Where appropriate the provider sought confirmation of the legal authority other people held to make decisions on behalf of a person. This is important to ensure people were protected from inappropriate and unlawful decision making.
People we spoke with who were supported with their meals and drinks told us they were satisfied with the support they received. Risks to people from poor hydration and nutrition were assessed and monitored to ensure people’s nutrition needs were met in line with their preferences. People spoke highly of the quality and choice of food provided for them.
People told us they received care from healthcare professionals as required. The provider’s staff supported people with their healthcare needs by providing care following guidance from other healthcare professionals. Staff communicated effectively about people’s day to day health care needs and any changes to their needs.
People told us they received care from kind and compassionate staff who treated them with dignity and respect. People experienced positive relationships with staff who understood their needs and preferences. People spoke highly of the provider’s staff and valued their relationships with them.
People and their relatives were given support when making decisions about their preferences for end of life care. Where necessary, people and staff were supported by palliative care specialists. Services and equipment were provided as and when needed. People’s relatives told us their loved one was cared for by staff with kindness and compassion towards the end of their life.
Records showed that people’s care, and support needs were set out in a care plan that described what staff needed to do to make sure personalised care was provided. Care plans were based on an assessment of people’s needs and detailed people’s preferred routines and how they wished to be cared for and supported.
Activities were provided in the communal areas of the building or on an individual basis if agreed as part of a person’s care package. People spoke positively about the activities on offer and valued the companionship and stimulation these provided for them.
People and their relatives knew how to make a complaint. The provider had a process in place to investigate and respond to complaints and concerns and we saw complaints made had been managed in line with these procedures.
People’s feedback about the management of the service was good. The registered manager and team leader promoted an open and inclusive culture in the home. People had access to management staff on site and told us managers listened to them and acted on their concerns.
Staff spoke positively about the leadership and management and told us they were encouraged to speak up if they had concerns. There was a culture of learning from mistakes and errors which enabled staff to feel confident in discussing these with managers. This promoted people’s safety because staff were prepared to learn from mistakes and supported to prevent a reoccurrence.
The registered manager had failed to submit statutory notifications to us about some safeguarding incidents as they had not fully understood this process. This is important to ensure we have information about any risks to the safety of people using the service so we can monitor the safety of the service people received. People had not been placed at risk because the local authority safeguarding team had been notified and appropriate actions had been taken to keep people safe. The registered manager submitted these notifications promptly following the inspections and we were assured these would be submitted as required and monitored in the future. More time was required to embed this into practice.
The provider had a quality assurance system in place and this was used to drive improvements to the service. People, relatives, staff and other professionals were asked for their feedback about the quality of the service and this was acted on. A programme of audits was carried out by the registered manager, team leader and the provider. These audits assessed and monitored the quality of the service being delivered and identified actions for improvements which were completed.