Archived: 87 Church Road

87 Church Road could accommodate up to eight people. People who live at the home have learning and physical disabilities. At the time of our inspection 5 people were living in the home. Everyone had their own bedroom and had access to a large dining room, conservatory and lounge. People could also access a large secure garden.

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We found the following examples of good practice.

• Since the onset of the pandemic, there had been no confirmed or suspected cases of people using the service having contracted COVID-19, at the time of this review. Staff were being tested weekly. Individual assessments and best interest decisions had been made about COVID testing for people who use the service.

• Staff greeted visitors at the entrance to the home and took their temperature and ensured they were wearing the correct Personal Protective Equipment (PPE). Arrangements for visiting were displayed clearly so health and social care professionals, friends and family knew what was expected of them to keep people safe. Visitors had to leave their contact details as part of a track and trace and complete a health declaration. There was a supply of masks available at the entrance to the home for visitors and a good system of meeting and escorting to an area of the home to enable hand washing to maintain people's safety.

• There were separate zoned areas for putting on and removing Personal Protective Equipment (PPE), and suitable arrangements for their disposal. There was hand sanitizer, gloves and aprons placed in four areas of the home for ease of access.

• The environment had been adapted by moving furniture to enable social distancing. Clear signage was in place reminding staff and people about how many people could safely be in each room. For example, only two people either two staff or a member of staff and a person being supported could be in the kitchen at one time to enable social distancing.

• The service used creative ways to ensure activities were still offered to people living in the service. This included accessing the community following government guidance. Each person had a detailed and individual risk assessment. Sunflower lanyards and exemption cards were used by people who were unable to wear a face mask when in the community. An activity co-ordinator was supporting people to make Halloween decorations. Daily activities were organised for people to help with their wellbeing.

• People were supported to see their families outside of the service in open spaces to reduce the risk of infection. People were supported to observe social distancing whilst meeting with their families. Where there was a risk of people not understanding social distancing window visits had been organised.

• The provider and registered manager had ensured that staff had up to date information to keep people and staff safe. The organisation had been responsive and set up a COVID team of senior managers that supported staff and offered up to date guidance and advice including monitoring any risks to the service and ensuring there was enough PPE available. At the height of the pandemic there was daily communication from the team as guidance changed.

• All staff had received additional infection prevention and control training, and training in RESTORE2 was underway. This training provides a framework for staff to recognise the early signs of a person’s health deteriorating meaning health intervention could be sought quicker.

• There were clear policies, procedures, quality assurance checks and contingency plans in place in respect of managing the pandemic and keeping people and staff safe.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People received support from staff who were kind and caring. People were positive about the care they received and spoke in positive terms about the staff. Our observations showed that staff were kind and respectful. People’s independence was encouraged.

People were able to take part in a range of activities according to their own needs and interest. This included support to meet religious or spiritual needs. People were able to make complaints when they had them and these were responded to. There was a complaints procedure produced in a format suited to people’s communication needs.

People were safe. Staff understood their responsibility to protect people from the risk of abuse and had received training in this. People received safe support with their medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People’s health needs were effectively met. People were supported to see healthcare professionals when they needed to.

The service was well led. There was a registered manager in place supported by an assistant team leader. There were systems in place to monitor the quality and safety of the service.

Further information is in the detailed findings below

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People were cared for in a clean and safe environment. The main doors to the building were secure and the garden was contained. There were enough staff on duty to meet the needs of the people who used the service. This included the registered manager and all staff had received relevant training in order to carry out their roles.

We saw that staff ensured people's personal safety was maintained by assisting them with activities when required. We saw that people's care plans detailed where their safety might be at risk, and what staff should do to prevent this.

CQC monitors the operation of the Deprivation of Liberty safeguards which applies to care homes. We were informed by the manager of one application that had been submitted in order to assist one person with the acquisition of a new wheelchair. This assessment had been completed in line with the provider's procedures.

Is the service effective?

People who were able to communicate with us were able to confirm that they were happy and well looked after. All of the people that we saw were clean, well dressed and were comfortable and well cared for. This was evidenced by observing people's facial expressions and body language.

Staff told us that had received training relevant to their role and we saw evidence of this. This was further confirmed during scenario conversations with staff. It was clear when we spoke with staff and from the interactions that we observed that staff fully understood people's care needs and that they knew them well. We saw this when we observed staff helping one person with a drink.

Is the service caring?

All of the staff that we saw and spoke with were kind and attentive to people's needs. They spoke gently to people and gave people time to respond. The atmosphere was calm and unhurried and we saw that people were encouraged to be as independent as possible. One member of staff told us "I love the atmosphere here, it's like a big family" and another member of staff told us "I love being here to help people". On the day of our inspection, five people were returning from a holiday with staff. One person told us, with help from staff that they had enjoyed the time away, particularly the hotel entertainment.

Is the service responsive?

The records that we looked at confirmed that people's individual care needs and preferences had been recorded and that care had been planned accordingly.

We saw that activities were planned for people in accordance with their personal choices and that these were offered as individual activities or as part of a group.

We saw that people were encouraged to maintain relationships with friends and relatives and we heard from staff how trips had been planned for people in order to make this happen.

Is the service well-led?

The manager and the staff understood the principles of quality assurance and we saw evidence of audits and surveys that had been undertaken in the past twelve months. We saw minutes of staff meetings that showed that staff regularly discussed ways of improving the service they provided for people. As an example we saw that garden maintenance had been discussed in order to improve the environment for people.

The individuals living at 87 Church Road have a learning disability and some complex needs. This meant that it was difficult to fully seek their views as many of the individuals used non verbal communication. We saw that people looked well cared for and appeared happy and relaxed in the company of staff.

People were supported to be involved in decisions about their care, more complex decisions were made within the legal framework. This ensured that decisions made in the best interest of the person involved other professionals.

People's care and welfare needs were being met. This included health and personal care. The provider stored, managed and administered medication safely. We observed medication being audited and administered safely.

All the people we spoke with indicated they were happy with the staff. The provider made sure that thorough recruitment checks were made on all staff before they were employed.

We spoke to a visitor, they told us that they visited on a weekly basis and had no concerns about the care and support given to their daughter. They told us 'staff here are wonderful, they do a marvellous job and my daughter is well looked after'.

People's ability to consent to their care or treatment had been assessed and recorded, where people required support for more complex decisions advice would be sought.

When we visited 87 Church Road in February this year we reported that improvements were needed for recording within care plans and risk assessments. We found at this inspection that out of the four people's records we looked at, three people's care plans and risk assessments had not been reviewed or updated since August 2011 and therefore it was unclear whether the information recorded was up to date.

Appropriate arrangements were in place in relation to the handling and administration of medicine and medicines were kept safely. Clear procedures were in place to support people to raise concerns about their care and the service they received.