This service provides accommodation with personal care to three people with learning disabilities. This service was last inspected in December 2013 and all standards inspected were met.A registered manager was in post but at the time of the inspection was on an extended period of leave. We were informed about the absence and the arrangements for the day to day management of the home. We were told the area manager was to take over line management responsibilities. 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.
The three people we spoke with said they felt safe living at the home and the staff made them feel secure. Members of staff knew the types of abuse and the responsibility placed on them to report allegations of abuse.
Risks were assessed and action plans developed to minimise the risk. Members of staff were knowledgeable about the actions they must take where risks were identified. For example epilepsy and for self-administration of medicines.
People said they had the attention they needed but there were staff shortages. Staff said the relief staff used were known to people. The area manager said during the registered manager’s absence, relief staff were being used to cover these hours.
Safe systems of medicines were in place. Staff supported people who were able to take control of their management of medicines which included ordering, storing and administration. Members of staff signed medicine administration records to indicate the medicines administered. Protocols which gave staff guidance on administering homely remedies such as pain relief from a stock supply were in place. The medicine cabinet was located in the bathroom and although there were checks of temperature of the cabinet, it was not taken at the time the shower was being used. This meant the temperature could be above the recommended levels.
Staff said they had an induction when they started work for the organisation. They said the induction took six months to complete and included shadowing more experienced staff. There was essential training set by the provider which the staff attended and included safeguarding of vulnerable adults from abuse, medicine and epilepsy. However, relief staff said they did not have refresher training to update their knowledge and skills.
People told us they made their own decisions about their care and treatment. Where there were concerns about people’s ability to make specific decisions Mental Capacity Act (MCA) 2005 assessments were undertaken. People were not subject to continuous supervision in the home and within the community.
People said they prepared their breakfast and their lunch, they made decisions about the menus and staff prepared the evening meal. We saw people make their lunch and refreshments and discuss with staff the evening meal to be prepared.
A record of healthcare visits was maintained. Health action plans were developed on how people were to be supported with their health care needs. People told us the staff knew how to meet their needs and were supported with their on-going healthcare. They said they were independent and needed minimal support from the staff with personal care
People told us their rights were respected by the staff. For example, staff knocked on their bedroom doors before entering. Staff gave us examples to describe how they respected people’s privacy and dignity.
Support plans described the person’s ability to manage their care for themselves and on how staff were to assist the person to meet their needs. Daily routines described how people spent their day in the home and the activities participated in. People knew information about them was kept. They said discussions on how staff were to support them took place.
People said they approached the staff with concerns. There were no complaints received at the home since the last inspection.
The views of people were gathered during tenant meetings. People told us they participated in daily living skills such as cleaning and vacuuming. They said one day per week was allocated for them to clean their bedrooms and they were assigned specific areas of the home to clean. For example, vacuuming the lounge.
Systems were in place to gather people's views during house meetings. Quality assurance arrangements in place ensured people's safety and well-being. Systems and processes were used to assess, monitor and improve the quality, safety and welfare of people. There were systems of auditing which ensured people received appropriate care and treatment.