Archived: Royal Mencap Society - 1-2 Broadstone Close

1-2 Broadstone close is a residential care home that can accommodate up to nine people with learning disabilities and autism. Eight people were using the service. The service is located in two adjoining houses adapted for the purpose. Accommodation is provided across two floors and people had access to a garden at the rear of the house.

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

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 support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 were protected from the risk of abuse, and staff were knowledgeable about how to recognise and report concerns of abuse. There were systems in place to protect people from the risk of harm and abuse, and people, relatives and staff felt confident to raise concerns about unsafe care. People were supported to be as independent as possible whilst remaining safe. Key information about people's care needs was available to staff in the event of an emergency.

People were supported to have a varied and balanced diet. People were encouraged to participate in the planning and cooking of meals. They had access to a range of health and social care professionals for advice, treatment and support. Staff monitored people's health and well-being effectively and responded quickly to any concerns.

Staff were recruited in a safe way. The provider took steps to ensure checks were undertaken to ensure potential staff were suitable to work with people needing care. Staff received regular supervision and had checks on their knowledge and skills. They also received an induction and training in a range of skills the provider felt necessary to meet the needs of people at the service.

People were supported by staff who routinely promoted privacy and dignity.

Staff had a good understanding of people, their likes and dislikes. There was sufficient staff to ensure people could access activities of their choice. This area had improved since the last inspection where they were rated as requires improvement.

Medicines were managed, stored, administered and disposed of safely. Staff received training and ongoing skills assessments that enabled them to be confident in supporting people with medicines.

There was an open culture focussed on continual learning and improvement. The service continued to be well led and benefitted from clear and consistent leadership. The registered manager was praised by people, their relatives and staff, for their positive and supportive approach and their prompt resolution of issues. Systems were in place to monitor the quality of care provided and continuously improve the service. The management team and staff engaged well with other services and had developed positive relationships.

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 9 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Royal Mencap Society - 1-2 Broadstone Close on our website at www.cqc.org.uk.

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.

1-2 Broadstone Close is two semi-detached houses which are joined together with an internal adjoining corridor. Although 1-2 Broadstone Close is registered as one service with the Care Quality Commission, people living there consider them as two separate houses and treat them as such. Four people live at 1 Broadstone Close, and five people live at 2 Broadstone Close. The service is registered to accommodate nine people for nursing or personal care. The service does not provide nursing care. Nine people were living there at the time of our inspection. The service provides support to people who have learning disabilities.

The service had a registered manager in post at the time of our inspection. 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.

There was not always enough staff to support people at times when they needed. People, relatives and health and social care professionals felt there were occasions where additional support should be available to ensure people’s needs were met.

People had mixed views about the amount of support they had to take part in activities in the home and the local community. Staff were not consistently recording what support was offered, and what actually happened. The provider could not assure themselves people were being encouraged and supported to take part in a range of activities and hobbies that were meaningful to them.

People were protected from the risk of abuse, and staff were knowledgeable about how to recognise and report concerns of abuse. There were systems in place to protect people from the risk of harm and abuse, and people, relatives and staff felt confident to raise concerns about unsafe care. People were supported to be as independent as possible whilst remaining safe. Key information about people’s care needs was available to staff in the event of an emergency.

Staff were recruited in a safe way. The provider took steps to ensure checks were undertaken to ensure that potential staff were suitable to work with people needing care. Staff received regular supervision and had checks on their knowledge and skills. They also received an induction and training in a range of skills the provider felt necessary to meet the needs of people at the service. Staff received training and ongoing supervision to ensure that their skills, attitudes and values met the provider’s requirements.

Medicines were managed, stored, administered and disposed of safely. Staff received training and ongoing skills assessments that enabled them to be confident in supporting people with medicines.

People consented to care and support in many aspects of their daily lives, and were encouraged to make their own choices. Appropriate arrangements were in place to assess whether people were able to consent to their care, where this was needed. The provider met the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). This ensured people’s care was provided lawfully, and they had their rights respected.

People were supported to have a varied and balanced diet. People were encouraged to participate in the planning and cooking of meals. They had access to a range of health and social care professionals for advice, treatment and support. Staff monitored people’s health and well-being effectively, and responded quickly to any concerns.

People felt cared for by staff who treated them with kindness, dignity and respect. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care, and were confident the provider would take action where needed. The provider had a complaints procedure to ensure issues with quality of care were addressed. People were involved as much as possible in planning and reviewing their own care, and had access to independent advocacy to support them to do this.

There were systems in place to monitor the quality of the service. There were checks in place to ensure the service was of good quality, and the provider could demonstrate where improvements had been identified and made. However, the quality monitoring had not identified issues with staffing levels, and the potential impact on people’s quality of life. The registered manager understood their responsibilities, and CQC was appropriately notified of events as required.

People using the service appeared relaxed and interacted with staff members in a positive way, some were occupied with cooking activities and others watching the television. Of the people that commented one person told us 'I like to watch the football, England won the other night' and 'They (the staff) asked me to go shopping today, I like to go but not in that rain'.

We observed staff talking with and assisting people throughout the time of our visit, this was done with the peoples' privacy and dignity in mind and showed the staffs' awareness of peoples individual support needs.

We looked at areas of care planning, nutrition, medicine administration staff support and at the general safety around the home, and found the home was compliant in all those areas.

We found people experienced care, treatment and support that met their needs and protected their rights. One person told us that the 'staff are nice and look after me well.' Another person told us that 'staff were very nice. I have no problems." A member of staff told us that they were 'proud to work here. I enjoy working with the service users and it is a nice home to work in.'

We found people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We found people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We also found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.