Archived: Royal Mencap Society - 9-10 Jutland Place

Royal Mencap Society - 9-10 Jutland Place is a care home without nursing registered to accommodate up to 8 people with a learning disability and/or autism spectrum conditions. There were 7 people living at the home at the time of our inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

People’s care was provided in a safe, clean, and well-maintained environment. Staff managed risks well to keep people safe. People’s medicines were managed safely and staff supported people to access healthcare services when they needed them.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests and to achieve their goals. Staff supported people to take part in activities, to access their community, and to maintain relationships with their families.

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.

Right care

There were enough staff available to meet people’s needs and keep them safe. Staff understood their responsibilities in protecting people from abuse and knew how to report any concerns they had. The provider’s recruitment procedures helped ensure only suitable staff were employed. People were supported by consistent staff who knew their needs well. Relatives told us the home was a family-oriented and supportive environment which their family members enjoyed.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. People were supported to be as independent as possible and to develop and maintain skills. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right culture

The manager and assistant manager promoted a culture in which staff valued people’s individuality and protected their rights. The views of people who lived at the home, their relatives and staff were sought and listened to. Staff knew people well and were responsive to their needs and wishes.

Staff felt well-supported and had opportunities to contribute to the development of the service. Monitoring systems were effective in keeping people safe and ensuring they received good quality care. The manager and staff had established effective relationships with other professionals involved in people’s care.

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 16 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

9-10 Jutland Place provides accommodation, care and support for a maximum of eight adults with learning disabilities. There were seven people living at the home at the time of our inspection.

9-10 Jutland Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post who was on leave 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 and associated Regulations about how the service is run.

At our last inspection in January 2016 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.

Why the service is rated good:

There were always enough staff available to keep people safe and meet their needs. Staff understood their responsibilities regarding keeping people safe from abuse and knew how to report any concerns they had. The provider’s recruitment procedures helped ensure that only suitable staff were employed.

Staff had assessed the risks people faced and implemented measures to keep them as safe as possible whilst living the life they chose. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Accidents and incidents were recorded and monitored. Medicines were stored, managed and administered safely. Staff kept the home clean and hygienic and maintained appropriate standards of infection control.

Staff had the training and support they needed to do their jobs. This meant they had the skills and knowledge to provide effective care. Staff had opportunities to discuss their professional development and to achieve further, relevant qualifications.

People’s needs had been assessed to ensure staff had the skills to provide their care. Staff supported people to stay healthy and to obtain treatment if they needed it. Information about people’s needs had been recorded for medical staff should the person require admission to hospital. People’s needs were met by the layout and design of the premises.

Restrictions were only imposed upon people where these were authorised and necessary to keep them safe. 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 supported this practice. If a person lacked capacity to make a decision, relevant people had been involved in the decision-making process to ensure the outcome reflected the person’s best interests.

People’s nutritional needs had been assessed and any dietary needs recorded in their care plans. Risk assessments had been carried out to identify any risks related to eating and drinking. People were involved in choosing the menu. Staff struck an appropriate balance between enabling choice and promoting a balanced diet.

People received their care from kind and caring staff with whom they had established positive relationships. Staff treated people with respect and maintained their privacy and dignity. Confidential information was stored securely and only accessible to appropriate people. People were supported to maintain relationships with their friends and families. Staff encouraged people to be independent and to be involved in the day-to-day life of the home.

Care and support was personalised to meet people’s individual needs. People’s needs and wishes were reviewed regularly and relatives’ contributions to reviews were encouraged and valued. People had opportunities to take part in activities and to be involved in their local community. There were appropriate procedures for managing complaints and people were confident any concerns they had would be taken seriously.

The registered manager provided good leadership for the service and led by example in their approach and practice. Staff valued the support provided by the registered manager and worked well as a team. There was an open culture at the home in which people, relatives and staff felt able to speak up and share their views.

Quality monitoring systems were effective in ensuring that people received safe, well-planned care. Key areas of the service were audited regularly and any actions needed to improve included in the home’s continuous improvement plan. The registered manager and staff had developed effective relationships with professionals involved in people’s care to ensure they received the care they needed.

Further information is in the detailed findings below.

The inspection took place on 8 and 15 January 2016. The first visit was unannounced. Due to the small size of this service, the inspection was carried out by one inspector.

There was 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 and associated Regulations about how the service is run.

People were kept safe because staff understood their responsibilities should they suspect abuse was taking place and knew how to report any concerns they had. Risks to people’s safety had been assessed and measures had been put in place to mitigate these risks. There were plans in place to ensure that people’s care would not be interrupted in the event of an emergency.

There were enough staff on duty to keep people safe and meet their needs. The provider’s recruitment procedures helped ensure that only suitable staff were employed. People’s medicines were managed safely.

People received their care from a consistent staff team who knew their needs well. Staff were well supported through supervision and appraisal and had opportunities to discuss their professional development. All staff had attended a comprehensive induction and had access to relevant, ongoing training. Staff were motivated and had a commitment to providing high quality care and support. They said morale was good and they worked well together as a team.

The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Applications for DoLS authorisations had been submitted where restrictions were imposed to keep people safe. Staff understood the importance of gaining people’s consent to their care and people’s best interests had been considered when they needed support to make decisions.

Staff enabled people to make informed choices about what they ate and supported them to maintain a balanced diet. People were supported to maintain good health and to obtain treatment when they needed it. The service had effective relationships with healthcare professionals which ensured that people received the care and treatment they needed.

Staff were kind and caring. They treated people with respect and supported them in a way that maintained their privacy and dignity. Staff made sure people had the information they needed to make informed choices and to understand information that was important to them. Relatives told us their family members received high quality care from caring staff. Staff promoted people’s involvement in their local community. People had opportunities to take part in social events and activities and were supported to maintain relationships with their friends and families.

People received personalised care and support based on their individual needs. Staff shared information about people’s needs effectively to ensure that care was being provided in a consistent way. People’s needs and wishes were reviewed regularly and relatives’ contributions to reviews were encouraged and valued.

The registered manager provided good leadership for the service and led by example in their approach to supporting people. The registered manager encouraged the input of people, their relatives, staff and other stakeholders in developing and improving the service. Staff told us the registered manager encouraged staff to think creatively about how support could be provided in a way that best met people’s needs. The provider had effective systems of quality monitoring, which helped ensure that all areas of the service were working well and records were up to date.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

' Is the service safe?

People were cared for in a safe, clean, homely environment. There were enough staff on duty to meet people's needs and staff had access to on-call management support 24 hours a day. Care plans demonstrated that people's healthcare needs were addressed and that people had access to medical advice and treatment when they needed it. Staff carried out regular checks to ensure that people were cared for in a safe environment and risk assessments had been carried out to identify and manage any risks to people.

' Is the service effective?

People told us that they could make choices about how they spent their time and that they had opportunities to take part in activities they enjoyed. People said that staff helped them arrange a medical appointment if they felt unwell and accompanied them to appointments.

Guidance was provided for staff in the way people preferred their care and support to be delivered. Staff communicated important information about people's needs effectively and provided care and support in a consistent way. People were supported to access their local community and to maintain relationships with their friends and families.

Records, including care records, were well organised and up to date. There were clear standard operating procedures in place, which were known and understood by staff.

' Is the service caring?

People told us that staff were available when they needed them and that they provided good support. One person told us, 'I like all the staff here' and another said that they enjoyed going out with staff.

All the staff on duty had worked with the people living at the home for some time and knew their needs well. This meant that people received consistent care from staff who understood their needs. We observed that staff engaged positively with people who used the service and treated them with respect. Staff were observant of people's needs and provided support promptly when it was required.

' Is the service responsive?

People's needs had been assessed before they began to use the service to ensure that the home was suitable for them. People received a personalised service based on their individual needs and preferences. People's needs were reviewed regularly and the provider responded appropriately if their needs changed.

The provider sought the advice of other health and social care professionals when appropriate to ensure that people received the care and treatment they needed.

People told us that they were consulted about the home's menu and that they enjoyed the food provided at the home. They said that they could have alternatives to the menu if they wished. People told us that they enjoyed eating out and that they were able to invite their friends and families for meals at the home if they wished.

' Is the service well-led?

The registered manager had been in post for a number of years and provided good leadership to the staff team. Staff had a good understanding of the ethos of the home and had access to the training they needed to do their jobs. Staff said they were well supported by the manager and had opportunities to discuss their professional development needs.

The provider had developed systems to monitor the quality of the service, including seeking the views of people living at the home and other stakeholders. The service was also monitored by the local authority quality assurance team. We found that the provider took action to address any shortfalls identified through this process.

People's healthcare needs were monitored and they were supported to access treatment or specialist input when they needed it. We found that staff managed the recording, administration, and disposal of medication appropriately. Records of the care, support and treatment people received were accurate and up to date.

Staff received the training, supervision and support they needed to do their jobs. The staff team shared important information effectively to ensure that they were aware of any changes in people's needs or the way in which their support should be provided. The staff we spoke with told us that the manager encouraged them to contribute their views about how the experience of people who used the service could be improved.