7 June 2017
During a routine inspection
Number Six is a respite service providing residential care and one-to-one support for up to one young adult with a learning disability at a time. It is a small, two-bedroomed terraced house not far from the centre of Slaithwaite village. Since the service was registered in 2013 a total of 15 people have received respite care. At the time of this inspection four people were using the service on a weekly or monthly basis for up to two nights at a time.
Number Six was last inspected in December 2014. At that time it was rated as ‘Good’ in all of our five key questions.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 this inspection we found breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014 relating to safe care and treatment, consent, staffing, good governance and fit and proper persons employed. You can see what action we have told the provider to take at the back of the full version of the report.
Record-keeping for medicines management and administration required improvement. Support workers could describe the medicines people needed and when they should be administered.
Not all aspects of the building had been checked for health and safety. The gas safety certificate had expired shortly before the inspection and the building’s fire risk assessment had not been reviewed since 2013.
People chose the support workers they wanted to provide their one-to-one support when they used Number Six for respite. Recruitment records for the service were incomplete.
Support workers had received the training they needed to support people effectively; however, they did not receive regular supervision or annual appraisal. This was noted at the last inspection in December 2014.
Support workers told us they did not think every person had capacity to make all of their own decisions. People’s care records made no reference to their capacity (or otherwise) to consent to the care and treatment they received at Number Six. This included considerations around people’s freedom and liberty.
The service used information provided by people’s relatives and carers as the support plan for each person to guide staff as to the needs of the person. They had not formulated support plans with the people who used the service to ensure plans of care reflected the person’s personal preferences Records showed, and relatives told us, people received support that was person-centred.
The registered manager did not complete audits to monitor the service for safety and quality in order to drive quality improvement.
At the time of this inspection the registered manager was away on a trip of more than 28 consecutive days. They had not informed CQC of this, as is required by the Care Quality Commission (Registration) Regulations 2009.
We recommended the registered manager refreshed their knowledge with respect to the requirements to notify CQC of incidents and changes at the service.
No complaints had been made to the service since the last inspection in December 2014. Relatives told us they felt able to speak to managers about any concerns they might have. People did not have access to an easy to read version of the provider’s complaints policy.
People’s relatives told us they felt their family members were safe at Number Six. Staff members could describe how to recognise and report abuse.
Risks to people had been assessed and control measures put in place, although we did identify one person with a medical condition who did not have support plans in place to guide staff. People were supported to take risks in order to have new experiences and maximise their independence.
People were supported to eat the foods they enjoyed at Number Six. They were encouraged to shop for and cook food with staff, and often went out for meals.
Number Six had been adapted to suit the people who used the service for respite care. We found it to be very homely and welcoming.
People told us they liked their support workers. Their relatives said staff were kind and caring, and helped support their family members to be as independent as they could be.
Support workers could describe people well as individuals. They knew what people liked and disliked and what made them happy. Support workers consulted the person before each period of respite to find out what activities they wanted to do.
People chose the activities they wanted to do when they were at Number Six. Records showed people often went out for walks, to eat, to shop, went to the cinema and went bowling.
Relatives told us they liked the updates they received from support workers about their family member when they were using the respite service.
Staff had regular meetings with managers at Number Six. Records showed they discussed good practice and ideas to improve the service. Staff supported people according to the provider’s vision and values for the service.