Background to this inspection
Updated
17 April 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector.
Service and service type:
Care Management Group - Smitham Downs 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 home did not have a registered manager at the time of the inspection. There was a new manager who was due to apply to register. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced.
What we did:
We reviewed information we had received about the service since the last inspection in August 2016. This included details about incidents the provider must notify us about. Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements.
People living at Smitham Downs Road were unable to fully share with us their views of the service. We therefore used observations and spent time with people and staff to help us understand their experiences. We also reviewed three people’s care records to see how their care and support was provided.
The acting manager and previous registered manager were available to help with the inspection and we spoke with four members of staff. We checked recruitment records for three staff members and training and supervision arrangements for the staff team. We looked around the premises and at records for the management of the service including quality assurance systems, audits and health and safety records. We reviewed how medicines were managed and the records relating to this.
Following our inspection, we spoke with three people’s relatives to ask their views about the service. The registered manager also sent us information we requested. This included service improvement plans, the most recent health and safety audit, training information and a summary of incidents/ accidents. The manager also sent us a copy of the local authority’s report following their quality monitoring visit in October 2018.
Updated
17 April 2019
About the service: Care Management Group - Smitham Downs Road provides personal care and support for up to nine adults with learning disabilities or autism. Since our last inspection, everyone who previously lived in the home had moved to another service owned by the provider. At the time of this inspection six people were using the service.
People’s experience of using this service: At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.
Smitham Downs Road had undergone complete refurbishment and redecoration since we last inspected. The provider had managed this in such a way to accommodate the needs of new people moving to the service. This included making sure people’s bedrooms were furnished according to their needs and choices before they moved in.
People needs were fully assessed before moving to the home so the provider knew whether they could meet the person's needs. Risks to people’s health and wellbeing were understood and staff had the information they needed to support people and keep them safe. Care plans were personalised to reflect individual needs and preferences. People’s needs were regularly monitored and reviewed and staff responded appropriately to changes in people's needs or circumstances.
People were protected from abuse and discrimination. Staff were trained to recognise signs of potential abuse and how to manage and report any situations in which people may be at risk. The provider followed safe recruitment practice to make sure staff were suitable to work in a care setting.
There were enough staff with the right skills and knowledge to meet people’s needs. Staff training included supporting people who presented behaviours that could result in harming themselves or others. Staff also learnt how to communicate effectively with people in their preferred ways, for example, where people did not use verbal communication.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff treated people with dignity and respect. People decided how they spent their time and staff respected their choices and independence. Information was made available in accessible formats to help people who needed support with communication. People took part in activities they liked or had an interest in and staff supported people to try new ones.
People received the care and treatment they needed to maintain their health and wellbeing. They had access to appropriate health, social and medical support when it was needed. Medicines were managed safely and people received their medicines as prescribed.
People maintained relationships with those that mattered to them. People and their relatives had opportunities to share their views and the provider listened to their feedback. Relatives knew how to raise concerns and told us they would be confident to do so. Arrangements were in place to monitor, investigate and respond to complaints.
There was an inclusive culture at the service where staff felt listened to and supported. The new manager showed effective leadership and knew what was working well and what needed improving in the home. Staff and relatives told us the manager had made positive changes since joining.
The provider had good oversight of the service and used effective systems to monitor quality and safety, keep checks on standards and develop the service. Where improvements were needed or lessons learnt, action was taken to make the necessary changes.
At the time of the provider’s registration, the care service had not been developed and designed in line with the values that underpin the 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. However, we found care was provided in line with these principles and values. People received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: At the last inspection the service was rated Good. (Report published September 2016)
Why we inspected: This was a planned inspection to check the service remained Good.
Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection schedule or sooner if required.