We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was unannounced and planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by the Care Quality Commission, which looks at the overall quality of the service. Where we have found breaches you can see what action we told the provider to take at the back of the full version of the report.
Accommodation and personal care is provided at this location for up to 17 adults with physical and/or learning disabilities. At our inspection there were 16 people with physical disabilities living at the home.
There is a registered manager in post at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
We found that the law relating to infection prevention, the management of medicines and monitoring the quality and safety of people’s care was not being met. Not all areas of the home were clean or hygienic and people’s medicines were not always safely stored or recorded. Regular checks of the quality and safety of people’s care were made, but they were not sufficient to fully protect people against the risks of acquiring a health associated infection or from risks associated with the unsafe use and management of medicines.
People told us that they were happy and felt safe living in the home and knew who they could speak with if they had any concerns about their care and safety, or that of others.
Staff understood and met people’s care needs. They usually followed the provider’s aims and values for people’s care, choice and rights, but did not always maintain confidentiality for people’s care.
Staff followed the Mental Capacity Act 2005 (MCA) to obtain people’s consent for their care and to ensure that important decisions about people’s care were made in their best interests when required. The MCA is a law providing a system of assessment and decision making to protect people who do not have capacity to give consent themselves. People were protected against unnecessary restrictions to their liberty and staff had a basic understanding of the Deprivation of Liberty Safeguards (DoLS). This is a law that requires assessment and authorisation if a person lacks mental capacity and needs to have their freedom restricted to keep them safe. There were no people either subject to, or requiring authorisation for this at our inspection.
Risks to people’s safety and their health needs were shown in their written care plans and effectively managed. Staff understood people’s health needs and people were supported to maintain good health and to access health care services when required. When necessary, staff sought advice for people’s care from relevant health and social care professionals and staff followed their instructions from this where required.
People received the care they needed and were satisfied with the food and drinks provided. People received the support they needed for their nutrition in a way that promoted their independence and enjoyment. They were also supported to maintain their hobbies and interests and contacts with families and friends. People’s care plans reflected their individual needs, choices and preferences and were regularly reviewed with them and their representatives where appropriate. Staff knew how to communicate with people in the way that met with their needs and preferences.
There were robust procedures for the recruitment of staff and volunteers, who were trained, supported and supervised. Staff understood their roles and responsibilities and knew how to report any concerns they may have about people’s care or safety. Sufficient care staff were provided and action was being taken to recruit additional staff to improve catering, laundry and domestic arrangements at the home.
Staff and people using the service were positive about the management of the home. They were asked for their views about the care provided and were kept informed about any changes or improvements to be made from this. Improvements in progress at our inspection included, to ensure people’s confidentiality and that all people knew how to complain; development of food menus for healthier eating and to increase people’s opportunities to access the local and wider community.