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 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 CQC which looks at the overall quality of the service.
United Response – 1 St Alphege Road is a care home provides accommodation and personal care for five people who need support with their mental health. Four people live in the main house and one person has separate accommodation in the grounds of the service.
This was an unannounced inspection. The service met all of the regulations we inspected against at our last inspection on 27 November 2013. During this visit, we met all of the people who used the service and were able to have conversations with four of them. We spoke with three care staff, the registered manager and a specialist nurse who was visiting the 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.. After the inspection we spoke with a relative and received information from other community specialists who were involved in supporting the people using the service.
We observed people as they engaged in activities and relaxed at the service. Staff supported people in a discreet, friendly and reassuring manner. Staff knocked on people’s doors before entering their rooms and had understanding of people’s needs. Some people were preparing and cooking their own meals and some were supported by staff in the kitchen.
People had an allocated keyworker who were involved in their assessments and reviews. A key worker was a member of staff who co-ordinates a person’s care and support and promotes continuity. Potential risks to people were identified and managed. Throughout the inspection people were treated with kindness and respect. Everyone told us their privacy was respected and they were able to make choices about their day to day lives.
Safeguarding procedures keep people safe from harm. All of the people told us they felt safe in the home; and if they had any concerns, they were confident these would be quickly addressed by their key-worker or by the registered manager.
There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed. A satisfactory system of recruitment was in place to ensure that the staff employed to support people were fit to do so. Staff were appropriately trained and skilled and provided care in a safe environment. The staff also completed extra training when people’s needs changed to ensure that they were up to date. The care provided to people was safe and effective and met peoples’ needs.
People received their medicines safely and when they needed them and they were monitored for any side effects. At the time of the inspection the service was not monitoring the temperature at which drugs were stored. The registered manager immediately rectified this.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under Act and the Safeguards (DoLS). The registered manager told us that they had not found it necessary to apply for a Deprivation of Liberty Safeguards authorisation for anyone to date.
Each person who used the service had a care plan which was personal to them and that they been involved in writing. We looked at four care plans. Two of the care plans we looked at did not record all the up to date information needed to make sure staff had guidance and information to care and support people in the way that suited them best. Some information had been removed from the plans and was not easily assessible.
People felt that they were listened to and were involved in planning all aspects of their care and support. Meetings were organised for people so that they had the opportunity to communicate what mattered to them. They were supported by a stable and consistent staff team who knew them well. Local community health and social care specialists had regular meetings comprising of people who use the service and care staff so that people’s care and support could be reviewed.
People were offered and received a balanced and healthy diet. They were able to choose what they wanted to eat and when they wanted to eat it. People’s rooms were personalised and furnished with their own things.
The registered manager and the area manager assessed and monitored the quality of care consistently. The service encouraged feedback from people and families, which they used to make improvements to the service.