28 March 2012
During a routine inspection
We used a number of different methods to help us understand the experience of people using the service, because the people using the service had complex needs, which meant they were not able to fully express their views.
We spent time observing staff interaction with people. We also asked questions of the manager and staff who were on duty. The Operations manager for the organisation also came and spoke to us during our visit.
We looked at people's care records and spoke to relatives and health care professionals following the visit.
During our visit some concern was raised by the staff team about changes to the service and a lack of information about these changes being provided to people who live in the home. We spoke to the manager about these concerns and also spoke to Social Services following our visit to find out if they had any comment to make about these concerns that staff had raised. We found that the provider had not fully taken into account people's rights when making decisions about their care and living arrangements.
Since the visit we have spoken to Plymouth Social Services and the specialist Learning Disablity services who have confirmed that they had met with the Operations manager for Quality Lifestyles Limited and agreed an action plan to ensure that any decisions regarding the service are made in the best interests of each individual concerned. The Care Quality Commission has been provided with a copy of this action plan, which incldes ' Best Interest and Independent Advocacy meetings and discussion with people who use the service and their relatives.
We saw that staff were able to communicate with people using various methods including some sign language and a understanding of people's behaviour, mood and body language.
We saw that risk was understood and managed; for example, the risk from choking. We found that appropriate advice was sought from external healthcare professionals such as physiotherapy and Speech and Language therapy. People's health needs were well met.
We found that people engaged in a range of activities inside and outside the home. One person said that they enjoy a music group and records that we looked at confirmed that this is a regular planned activity. The staff we spoke to were familiar with the activities people enjoy and were able to show us how they document and monitor this information.
People's intimate care was provided in private and they were treated with respect.
One person said that the staff were 'kind and caring, and help me when I have any difficulty getting dressed'
The staff were able to tell us about different types of abuse and what they needed to do to ensure people were kept safe.
We spoke to the manager about safeguarding people who use the service. We found that the manager had limited understanding about the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS) particularly in relation to issues relating to restraint and peoples rights.
Staff we spoke to said that on a day to day basis they felt well supported by their colleagues and the manager. However, all the staff we spoke to said that they did not feel fully informed about changes taking place in the home. Two of the staff we spoke to said that they felt the low moral amongst the staff team and lack of information about changes taking place in the home could have a detrimental affect on people living in the home.