Archived: 8 Chestnut Road

Updated 1 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an announced inspection which was completed on 26 and 29 April 2016. The inspection was completed by one adult social care inspector. The previous inspection was completed in February 2013 there were no breaches of regulation at that time. This service had been dormant for over 12 months in 2014 until the present person moved to the home in June 2015.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make.

We reviewed the information included in the PIR along with information we held about the home. This included notifications, which is information about important events which the service is required to send us by law.

We contacted four health and social care professionals to obtain their views on the service and how it was being managed. This included professionals from the local community learning disability team and a consultant psychiatrist.

During the inspection we looked at the care records for the one person living at the service and records relating to the running of the home. This included staffing rotas, policies and procedures, quality checks that had been completed, supervision and training information for staff. We spoke with two members of staff and the operations manager and the registered manager in person, and two members of staff by telephone. We also contacted another service to speak with staff there that provided support to the staff by telephone

We spent time speaking with the person living at 8 Chestnut Road. Records relating to the recruitment of staff were held at the main Milestone Trust office so we were unable to check on this occasion. Before the inspection we contacted a relative by telephone to ask about their experience of the care and support the person received.

Updated 1 June 2016

8 Chestnuts provides accommodation and personal care for up to five people who have a learning disability. There was one person accommodated at the time of the inspection. This was an announced inspection, which meant the staff and provider knew we would be visiting. This was because there were often times when there was no one at the service as they were out and about in the community. This inspection took place on the 26 and 29 April 2016.

There was a registered manager in post who also worked at another registered home which was part of Milestone Trust. 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 had delegated the day to day management responsibility to a team leader.

Due to the nature of the service and that only one person was living in the home at the time of the inspection. We have not included our evidence in the main body of the report to protect the confidentiality of the person. The full report has been shared with the provider.

The person benefited from a service that was tailored to their individual care and support needs. Staff supported the person throughout the day and night on a one to one basis. Staff felt isolated. External support systems that were provided were not as effective as they should have been in supporting the staff remotely. The person’s behavioural care plan requires more information to guide staff to meet the person’s needs consistently.

The person was protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these procedures. Systems were in place to ensure the person was safe. These included risk management, checks on the environment and safe recruitment processes. Staff knew what to do to keep the person safe.

A care plan was in place that clearly described how the person wanted to be supported. This was tailored to the person. Care was effective and responsive to person’s changing needs. The person had access to healthcare professionals when they became unwell or required specialist advice. The person received their medicines safely.

The person’s rights were upheld and they were involved in decisions about their care and support. Where decisions were more complex these had been discussed with relatives and other health care professionals to ensure it was in the person’s best interest. Staff were knowledgeable about legislation to protect people in relation to making decisions and safeguards in respect of deprivation of liberty safeguards. An appropriate application had been made in respect of these safeguards ensuring the person was protected.

Staff had received appropriate training to support the person living at the service. Staff were supported in their role and received regular supervisions. Supervisions are where a member of staff meets with a senior manager to discuss their role, performance and training needs.

Systems were in place to ensure that any complaints were responded to. The person’s views were sought through an annual survey and through monthly meetings.

The staff, the team leader and a representative from Milestones Trust completed regular checks on the systems that were in operation in the home to ensure they were effective.

The person was provided with an effective, caring and responsive service that was well led. The organisation’s values and philosophy were clearly explained to staff.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.