Background to this inspection
Updated
9 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Mencap, 16 Lumley Road 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be staff at the service to speak with us.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
People had complex communication and support needs. We spoke to all six people and observed their experience of living at 16 Lumley Road. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who found it difficult to talk to us. We spoke with five members of staff including the registered manager and care staff. We spoke with two relatives.
We reviewed a range of records. This included four people’s care plans and multiple medication records. We looked at two staff files in relation to recruitments and supervision. A variety of records relating to the management of the service, including policies, procedures and audit processes. We pathway tracked two people. This is where we check that the records for people match the care and support they receive from staff.
After the inspection
We continued to seek clarification from the registered manager to validate the evidence we found. We spoke to one relative and three professionals who regularly visit the service.
Updated
9 October 2019
About the service
Mencap at 16 Lumley Road, Horley is a residential home providing personal care for up to six people. At the time of the inspection there were six people living at the service. People living at 16 Lumley Road were, older people, with learning disabilities.
16 Lumley Road is a house with two floors. Bedrooms were on the first floor and the ground floor had communal living areas and an office. The home had a garden which people could use.
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 outcomes for people using the service reflected the principles of Registering the Right Support by promoting choice, control, independence and inclusion. People’s support focussed on them having opportunities to maintain relationships, engage in activities of their choice and maintain their independence.
People were not always able to tell us they felt safe however we observed staff interacting with people. People were relaxed and responded to staff by smiling and talking. Staff knew people well, they knew their support and communication needs. Risk assessments were in place specific to people’s needs.
There were enough staff to meet people’s daily needs and staff were recruited safely. Agency staff were occasionally used but they were given an induction and were only used if they had the right skills. The home was clean and safe. A relative said, “The environment is very good. It’s always spotless.” Medicines were stored, provided and disposed of safely.
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.
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 had received relevant training to suit the needs of people. This included mental capacity and challenging behaviour and safeguarding. People’s nutritional needs were met and people could choose their own weekly menu. People received regular support from health and social care professionals.
Staff were caring and attentive to people. A relative told us, “They couldn’t be anywhere better, they’re absolutely brilliant.” Staff knew people well and we observed positive relationships between staff and people. People’s privacy, dignity and independence were promoted. A member of staff said, “They are six very different people with very different needs.”
The support people received was person-centred and focussed on their needs. Care plans were regularly reviewed with people, relatives, professionals and staff all involved. People had a routine of different activities each week according to their wishes and interests. Strong links with the local community had been established.
The registered manager was well thought of and everyone told us the service was well led. Most audit processes were carried out centrally but local audits were managed regarding medicines, accidents, incidents and training. Feedback was sought from people and staff and regular meetings were held.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Good. (Report published 4 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.