18 October 2017
During a routine inspection
The home was designed to provide a transitional service with a view towards moving people on to more independent living. This is sometimes termed a ‘Reablement Model’ as people were generally expected to stay up to two years, or less depending on their needs. This intent has changed somewhat as only one person is currently undertaking reablement. The registered manager was working with the local authority on future planning needs.
This was an unannounced inspection that took place on 18 October 2017. At the last inspection in June 2015, the service was rated as Good. At this inspection we found the service remained Good. We judged that the domain 'Responsive' was no longer outstanding because the previous outstanding elements of reablement work were no longer being carried out to the same extent in the home.
The service had a registered manager who also managed a domiciliary care service, Living for Life, which provides support to people living with learning disability in the community. 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 registered manager was suitably qualified and experienced to manage the service.
Staff had received training on ensuring people were kept free from harm and abuse. They were confident in management dealing with any issues appropriately. Staff knew how to contact outside agencies if necessary.
Good risk assessments and emergency planning were in place. Accidents and incidents monitoring was in place but there had been no recent issues in the home.
We saw that staffing levels were usually suitable to meet the assessed needs of people in the service. An extra member of staff was in place in the house because there was a problem with assistive technology. The registered manager had also increased staffing levels so that people could be taken out to activities more often.
Staff recruitment was thorough with all checks completed before new staff had access to vulnerable people. The organisation had robust disciplinary procedures in place.
Medicines were managed appropriately. People had their medicines reviewed by their GP and specialist health care providers.
Staff were trained in infection control and supported people in their own environment. The home was clean and orderly on the day of the inspection.
Staff were supported to develop appropriately. Staff told us they were keen to learn and we saw that induction, training, appraisal and supervision helped them to give good levels of care and support.
Staff received good levels of training around principles of care in relation to people living with a learning disability and/or autism. Restraint had not been used in this service. Consent was sought, where possible. The manager and the local authority worked together to ensure the service operated within the Mental Capacity Act 2005
People were supported to get good health care support from their own GP, specialist nurses and consultants. Staff worked with people to support and encourage them to visit dentists and other health care providers.
Staff we spoke to displayed a caring attitude. They understood how to support people and help them maintain their dignity and privacy. Staff showed both empathy and respect for people living a learning disability or with autism. People in the service had access to advocates. Staff understood the values and culture of the organisation.
Everyone supported by the service had been appropriately assessed. Each person had a person centred plan that staff followed closely. New plans had been put in place that were comprehensive yet were easy to follow.
People were encouraged to go out and to engage, where possible, with age and ability appropriate activities and social events. Staff were aware of how difficult this was for some people and planning for activities was done with care and consideration.
Complaint procedures were in place. There had been no complaints received about the service.
The service had a suitably experienced and qualified registered manager and she delegated the day-to-day running of the service to a senior support worker. Some changes were underway to introduce another senior support worker to the home. Staff understood the scheme of delegation.
There was a suitable quality monitoring system in place and regular audits and analysis undertaken. The registered manager was developing a plan for the future of the service. Suitable record keeping was in place.