Archived: Care Management Group - 17 Heathcote Road

17 Heathcote Road is owned by Care Management Group (CMG). The organisation provides 24-hour care and support for up to nine people who live in their own flats in a building which is owned by CMG. People’s flats have en-suite and cooking facilities and there are a variety of communal areas for people to use. At the time of the inspection eight people were using the service.

The building design fitted into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going from the house.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

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.

People were supported to live their life the way they wanted. This was done through identification and management of risks, so they could take part in activities they enjoyed and live as independently as possible. Staffing levels were based on the needs of people and changed as required to ensure people had the support they needed, at the time they wanted it. People were supported to manage their own medicines in a safe way or were given support if needed. Accidents and incidents were reviewed by people and staff to understand what had happened and then minimise the risk of a repeat occurrence.

People were supported and given guidance on healthy eating and drinking choices. Staff received appropriate training and supervision to ensure they understood people’s needs and could support them effectively. Staff worked well as a team to ensure they gave effective support to people and give them access to healthcare professionals and other outside support agencies. People's needs were assessed before they started using the service, with the identification of clear goals and aspirations people wanted to achieve.

People told us they felt respected by the staff, and they were given the freedom and independence to live their life the way they wanted. Staff knew people as individuals, and good working relationships had been developed between people and staff. The staff team ensured the values of promoting choice, control, independence and inclusion were followed throughout the service. People were supported to achieve their agreed goals and be safe.

Systems were in place to monitor the quality and safety of the service. Feedback was welcomed and used to make improvements to the service. The registered manager, staff and provider were keen to drive improvement that would impact positively on people's lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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.

The inspection took place on 3 October 2016 and was unannounced.

There was a registered manager in post, and they were at the service at the time of our inspection. 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.

This is a supported living service that aims to give people the confidence and skills to live independently. Staff understood to achieve that, people had to be supported to make decisions on their own and be able to understand the consequences of each choice. Throughout our inspection staff helped people to do this, by being available to talk, and spend time discussing issues people had in their lives. The service had a servicely feel and reflected the interests and lives of the people who lived there. There was positive feedback about the service and caring nature of staff from people who live here.

People were safe at 17 Heathcote Road. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. People were involved in these decisions because staff took the time to explain to them in a way they could understand.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the service. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People were supported to manage their own medicines where possible. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. These procedures were regularly discussed with people to ensure they knew how to respond in an emergency. An alternative location for people to stay was also identified in case the service could not be used for a time.

If people did not have the capacity to understand or consent to a decision the staff understood the requirements of the Mental Capacity Act (2005). Appropriate assessments of people’s ability to make decisions for themselves had been completed. Staff asked people for their permission before they provided support.

Where people’s liberty may need to be restricted to keep them safe, the staff understood the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected. No one had, or needed a DoLS at the time of our inspection.

People were supported to choose healthy options for what they ate and drank and how they led their lives. Staff respected people’s choice to make decisions for themselves.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment. People’s health was seen to improve due to the care and support staff gave.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff talking with them and showing interest in what people were doing. People looked relaxed and happy with the staff. People could have visitors from family and friends whenever they wanted.

Support plans were based around the individual preferences of people as well as their medical needs. People were very involved in how their support was planned and given. Support plans gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans.

People knew how to make a complaint. The policy was in an easy to read format to help people and relatives know how to make a complaint if they wished. Complaints received since our last inspection had been dealt with in an appropriate manner. Staff knew how to respond to a complaint should one be received.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the service. The registered manager had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were analysed and used to improve the care provided to people. The senior management from the provider regularly visited the service to give people and staff an opportunity to talk to them, and to ensure a good standard of care was being provided to people.

People were living in a caring, safe, clean service, and had effective and responsive support from the staff. The registered manager led the service well and worked with the provider and staff team to give a good quality of life to people. A person said, “The staff are friendly, helpful and understanding. They are all such nice people.”

Most of the people we spoke with said they liked living there. Staff were seen to interact well with people. For example by having conversations with them about how they were and the activities they were doing that day. People appeared relaxed and happy.

We saw that systems were in place to ensure staff worked with the consent of people. One person said 'They listen to what I say and don't make me do anything I don't want to.'

People who used the service had been involved in the planning of care. We saw that risks had been assessed and action taken to protect the welfare and safety of people.

We looked around the house and saw that it was clean and tidy. People who used the service told us they were happy with the standards of cleanliness.

We saw that the manager carried out appropriate checks when they employed staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

All the people we spoke with said they knew how to raise a complaint. Most said that they had never felt the need to complain, but if they did they thought the manager would listen to what they said and take action.

One person told us that "This is the best home ever, staff understand me.' Another said 'Staff respect me.' We saw staff treated people with respect, for example by asking permission before showing us care plans.

People received care and welfare that met their needs. A person using the service told us 'We can choose what support we want." Feedback from a relative said 'Care Management Group have been absolutely life changing for my relative.'

People using the service told us they felt safe with staff. Staff we spoke with were able to identify signs of abuse and knew the actions to take.

The provider had a system in-place for matching staff levels to meet people's needs. One person told us 'I couldn't wish for a better staff team.'

The staff we spoke to told us they felt supported to do their job. One staff member told us 'I love it here and look forward to coming to work everyday.' Another staff member said 'They are really hot on training here, we definitely get enough training.'

The provider was regularly assessing and monitoring the quality of the service they provided.