This inspection was unannounced and took place on the 8, 11 and 12 January 2016.
17 Flaxfield Road is a residential care home which provides residential care for up to five adults with mild to moderate learning disabilities. The care home comprised of two floors with its own secure garden and was within walking distance of Basingstoke town centre. At the time of the inspection five people were using the service.
17 Flaxfield Road has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Relatives of people using the service told us they felt their family members were kept safe. Support workers understood and followed the provider’s guidance to enable them to recognise and address any safeguarding concerns about people.
People’s safety was promoted because risks that may cause them harm had been identified and managed. People were assisted by support workers who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.
Recruitment procedures were completed to ensure people were protected from the employment of unsuitable support workers. New support workers induction training was followed by a period of time working with experienced colleagues to ensure they had the skills and confidence required to support people safely. There were sufficient support workers employed to ensure that people’s individual needs were met.
Contingency plans were in place to ensure the safe delivery of people’s care in the event of adverse situations such as large scale resident or support worker sickness and fire or floods. Fire drills were documented, understood by support workers and practiced to ensure people were kept safe.
People were protected from the unsafe administration of medicines. Support workers responsible for administering medicines had received training to ensure people’s medicines were administered, stored and disposed of correctly. Support workers skills in medicines management were regularly reviewed by the manager to ensure they remained competent to continue.
People, where possible, were supported by support workers to make their own decisions. Support workers were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005. The service worked with people and support workers when required to assess people’s capacity to make specific decisions for themselves. Support workers sought people’s consent before delivering care and support. Documentation showed people’s decisions to receive care had been appropriately assessed, respected and documented.
The service encouraged people to attend a weekly ‘Speakeasy’ advocacy session which provides independent advice to people. This enabled people to access independent advice and support if they required it as well as encouraging people to speak about things that mattered to them.
Support workers received an effective induction into working at 17 Flaxfield Road and completed the provider’s mandatory training to ensure that they had the skills and knowledge required to support people effectively.
People were supported to eat and drink enough to maintain a balanced diet. We saw that people were able to choose their meals and they enjoyed what was provided. Records showed people’s food and drink preferences were documented in their care plans and were understood by support workers. People at risk of choking received personalised health care professional assessments and recommendations made were followed by support workers to ensure their needs were being met.
People’s health needs were met as the support workers and the registered manager promptly engaged with healthcare agencies and professionals to ensure people’s identified health care needs were met and to maintain people’s safety and welfare.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications had been submitted to
the relevant supervisory body to ensure people were not being unlawfully restricted.
Support workers had taken time to develop close relationships with the people they were assisting. Support workers actively promoted people’s independence and sought activities and work placements to ensure their continued development. Support worker demonstrated in every interaction that they knew and understood the needs of the people they were supporting. Relatives told us they were happy with the care provided. The registered manager and support workers were able to identify and discuss the importance of maintaining people’s dignity and privacy at all times. People were encouraged and supported by support workers to make choices about their care including how they spent their day within the home or in the community.
People had care plans which were personalised to their needs and wishes. They contained detailed information to assist support workers to provide care in a manner that respected each person’s individual requirements and promoted treating people with dignity.
Relatives knew how to complain and told us they would do so if required. Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way. Relatives and support workers were encouraged to provide feedback on the quality of the service during regular meetings with support workers and the registered manager. Information was made available in alternative formats to allow people receiving the service to provide their feedback or complaints.
The provider’s values of care were communicated to people and understood by support workers. Relatives told us and we saw these standards were evidenced in the way that care was delivered.
The registered manager and support workers promoted a culture which focused on providing individuals with the opportunities to live their lives as independent members of the community. People were assisted by support workers who encouraged them to raise concerns with them and the registered manager. The provider had a routine and regular monitoring quality monitoring process in place to assess the quality of the service being provided.
The registered manager had informed the CQC of notifiable incidents which occurred at the service allowing the CQC to monitor that appropriate action was taken to keep people safe.
Relatives told us and we saw that the home had a confident registered manager and support workers told us they felt supported by the registered manager.