This inspection took place on 13 and 14 July 2017 and was unannounced on the first day. At our last inspection in June 2015 we rated this service “good”. At this inspection we found the service remained “good.” Miranda House provides an extra care service for up to 20 older people who live in self-contained flats over three floors within the building with a single secure entrance. Each flat contains a lounge, bedroom, kitchen and walk-in shower. There are also shared bathrooms on each floor, and the ground floor contains a staff office and a shared lounge with a kitchen. There is a small courtyard outside. At the time of our inspection there were 16 people living in the service and four flats were vacant.
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 our previous inspection we made a recommendation about how the provider developed policies and procedures around mental capacity. At this inspection we found the provider had acted on our recommendation to improve policies and training relating to mental capacity, but had highlighted the need to provide better evidence that people had consented to their care and support when they were unable to write. We have made a recommendation about this. Staff continued to receive suitable training and supervision to carry out their roles.
The provider had measures in place to monitor people’s views of the service and had acted on these. For example implementing a more detailed programme of activities included a weekly Sunday roast. People spoke of being treated well by care workers and commented positively on the cleanliness of the building.
People’s care was planned and delivered in a way that met their needs, and people received additional support as required. We saw that people received support to maintain good health and people’s weights were monitored, with action taken to address weight loss. People’s plans contained extensive information about peoples’ life histories and preferences, and regular reviews and keyworking sessions were used to ensure that people’s needs were still met.
The provider had systems in place to address and manage risks to people, in areas such as mobility and social isolation. The building was kept secure, and staffing levels were suitable to meet people’s needs. People were able to call for assistance from staff who were available 24 hours a day.
People received support where required to receive their medicines safely, and the provider had systems in place to detect possible errors or issues with medicines. The provider had suitable safeguarding measures in place to protect people from abuse and to investigate where allegations had taken place.
Managers carried out checks to ensure that standards of care remained good, and were working with local organisations to improve the service people received.