Archived: Royal Mencap Society - 45 Park Road

Royal Mencap Society 45 Park Road is a residential care home providing personal care to people with a learning disability and autism. The service can support up to eight people. At the time of this inspection five people were living at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using this service and what we found

The registered manager and provider had an improved oversight of the service and had acted to address issues identified during our last inspection.

Environmental risks had been addressed, to ensure these did not pose a risk to people.

Accident and incident reports were reviewed by the registered manager to ensure lessons learned were identified and measures put in place to reduce risks to people. People’s falls risk assessments had been reviewed, and the service had liaised with professionals about people’s falls risk.

Risks to people in the event of a fire had been reduced as there were enough staff to support people to safely leave the service in the event of a fire. A fire risk assessment had been undertaken and actions addressed.

Systems and processes had been implemented to enable the service to identify risks relating to the storage of medicines, use of bedrails, falls from height and scalding.

Rating at last inspection

The last rating for this service was requires improvement (published 27 November 2019).

Following our last inspection, we served a warning notice on the provider. We required the service to be compliant with Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by 28 November 2019.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Royal Mencap Society - 45 Park Road on our website at www.cqc.org.uk.

Royal Mencap Society 45 Park Road is a residential care home providing personal care to seven people with a learning disability and autism. The service can support up to eight people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Systems and processes had not identified where there were concerns with the safety of the home environment or people’s equipment. Risk assessments had not been completed for all areas of risk to identify measures that could be put in place to reduce people’s risks and keep them safe from harm. Some accidents and incident reports had not been reviewed to identify learning.

The registered manager had been absent for a period, this had impacted on the governance within the service as staff were not easily able to identify where information relating to the delivery of the regulated activity was stored. Legally required notifications were not always submitted to the CQC.

The service had identified improvements needed to the living environment. However, there had been a delay in undertaking improvements to the building and décor. We saw areas of damp, damaged flooring and walls and communal areas needing redecoration. We received feedback that the carpets had not been replaced for some time.

Decision specific mental capacity assessments and best interest decisions had not been undertaken. However, we found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were not always enough staff available to support everyone to be able to access community activities at the time they wished. However, staff knew people well and enjoyed supporting people to engage in their hobbies and interests. Care plans were person centred and pictorial, so people could be involved in planning and reviewing their care plans. The service planned to implement end of life care plans and provide end of life training for staff.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent

Staff knew how to recognise, and report suspected abuse. Staff had been safely recruited and people received their medicines on time. Staff had a good knowledge of infection controls requirements and had access to personal protective equipment.

People told us they were happy with the food available and were able to choose what they wanted to eat and drink. Staff contacted health professionals as needed and had received specific training to meet people’s individual needs. Staff received an induction before they started work with the service and felt well supported by the management team.

People were supported by staff that were kind and caring and treated them as if they were a member of their family. Staff respected people’s privacy and dignity and involved them in decisions about their care.

The service understood their requirements in relation to duty of candour and were open and honest with us during our inspection. They worked with partner agencies such as commissioners and healthcare professionals to meet the needs of the people living at the service. There had been no complaints. People and relatives knew how to complain and told us, they felt confident action would be taken should they complain.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 29 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to people safety, consent and quality assurance systems and processes.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated them with respect, kindness and dignity.

People had plans of care in place that were focused on them as individuals. This allowed staff to provide consistent support in line with people’s personal preferences. People and their relatives felt they could raise a concern and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the home. People, their relatives and staff told us that they felt confident that they could approach the manager and that they would listen. There were quality assurance systems in place to monitor and review the quality of the service that was provided.

We looked at numerous records including people's care records, staff records, medication records and records in relation to the management of the service.

Our observations showed that people were comfortable, well kempt and were being cared for in a pleasant environment. People's bedrooms had been decorated according to their personal tastes. The provider may find it useful to note that a few areas of the home were starting to look dated, a bathroom was in need of some minor maintenance and part of the garden area was overgrown.

We found that people's independence and community involvement had been promoted by the service and we saw that staff treated people with dignity and respect and had a good understanding of their needs. Staff we spoke with were positive about their roles and demonstrated a good rapport with people using the service.

People who used the service were positive about the care and support they received.

We looked at the records of four people who used the service and found care had been planned and delivered appropriately with regard to people's health, safety and welfare.

There were appropriate arrangements in place for the obtaining and administration of medication.

Staff had been appropriately screened to ensure they were appropriate to work with vulnerable people and had received a thorough induction.

There was an appropriate complaints handling process in place and arrangements were in place to support people with making a complaint.

The people using the service told us they were happy living there. One person told us, "I am happy living here. I like the staff. They are nice people. I went to the football last week." We observed that people had the choice of what activities to undertake and saw that they had the freedom to choose what to eat and where to go. One person using the service commented that, "I have no worries living here. I'm happy here."

The staff working at the service described a very open style of management and felt that they were adequately trained and developed in their roles. One staff member told us, "I love the home. I like working for the manager and I love the residents. It's my day off today and I'm here so what does that tell you." All of the staff we spoke to were positive about working at the home and they all said they understood the needs of the people they were caring for. Another staff member who had worked at the home for nine years said, "I love it. That's why I'm still here."

We spoke to the friend of someone who had been using the service since it had opened. They were complimentary about the care being provided and told us, "I've found the staff very, very good. They are very loving and very kind."