Archived: Royal Mencap Society - 16 Lumley Road

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.

16 Lumley Road is a care home for up to six people with a learning disability or people living on the autistic spectrum. When we inspected the service, six people were living there. The service had a registered manager who had been in post for 21 years. 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.

People using the service and their relatives told us people were cared for safely in the service. The provider had systems to protect people that staff knew about and followed.

There were enough staff to support people and the provider carried out checks to make sure new staff were suitable to work in the service. Staff received the training they needed to support people, they treated people with kindness and patience and people did not have to wait for support from staff.

People were able to choose where they spent their time and they told us they enjoyed the activities and holidays they went on and the food provided in the service. People took part in a range of activities in the home and the local community, both with staff support and alone if they were able to go out independently. The provider produced care plans in formats people could understand and involved people and their relatives in planning the support people received.

People had access to the healthcare services they needed and received the medicines they needed safely.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). We saw no examples of people being deprived of their liberty unlawfully.

The service had a registered manager who had worked in the service for a number of years. The provider and registered manager had systems to monitor quality in the service and make improvements.

The provider encouraged people using the service and their relatives to comment on the care and support people received.

Our observations of staff practice showed that people were receiving effective, safe and appropriate care, which was designed to meet their specific needs. We saw that people felt comfortable in approaching staff and asking for assistance. People were relaxed and content in their surroundings. Staff engaged positively with people using the service to encourage them to communicate their consent, wishes and choices.

Three people we spoke with told us that they were happy with the care and support they received. One person told us, 'I feel like my home and I am happy living here.' Another person said, "I like it here and staff are nice."

People told us that staff treated them with respect and promoted their privacy. They told us they felt they would be listened to if they raised any concerns.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

People were protected from the risks of inadequate nutrition and dehydration.

Staff told us that they have received regular training and that they felt confident to carry out their roles and meet the needs of people using the service.

We found that the provider had a system in place to monitor the quality of the service they provided and we found that people were generally satisfied with the care and treatment they received.

All of the people who live at the home were very positive about the service they receive, as were the staff about the provider and the training and support they had received.

The people who used the service confirmed that they were able to make choices about their lives and that they wanted to live at the home. One had a job and another went out alone nearly every day. We observed processes for decision-making as well as care plans, policies and procedures and risk assessments.

There was a safeguarding policy and the staff we spoke to were fully aware of this and described what they would do if they felt they needed to report something. The people who lived at the service also told us that they would be able to report their concerns or make complaints if necessary. Records were complete and up to date. We saw an accessible complaints procedure and residents handbook in their bedrooms.

Having assessed the evidence we considered the service demonstrated how it met the safety and care needs of the people living in the home.