Archived: Psychiatric Rehabilitation Association - 44 & 60 Chesterfield Gardens

We previously inspected the service on 30 August 2013 and the service was found to be meeting the standards inspected.

Whilst there was a registered manager at the service, the registered manager was away from work so there were temporary management arrangements in place. One staff member was temporarily promoted to supervise the home. The provider had also appointed a temporary service manager the week of the inspection who would oversee the running of the home, though was not based at the service.

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.

People living at the service told us they felt safe. People told us they found the staff caring and we witnessed kind interactions between staff and people living at the service on the day of the inspection.

Staff recruitment was not always safe as the provider could not evidence references had been applied for.

Although there were risk assessments in place which were updated regularly, they did not cover all the risks identified in the care plans and care records. Also, we found some were generic in nature so did not offer specific advise to staff in managing risks identified. Care plans were in place and had been updated regularly.

Staff supervision, appraisal and training took place.

We found medicines were stored and administered safely. However, not all staff were aware of the side effects of medicines.

The service was clean throughout and food was labelled and sealed hygienically. Accidents and incidents were recorded but we could not always evidence learning had taken place as a result, and was shared with the staff team.

We checked the system for managing people’s money. Receipts were available to show expenditure and there were spot checks of funds against records. There was a lack of evidence to explain the authority the service had to manage people’s money.

We noted one practice by the registered manager that lacked understanding of consent in relation to one person living at the service.

Some people living at the service told us they thought there was not always enough staff to support them. The provider told us agency staff were to be employed to fill any vacancies on the rota following the inspection, and they would review how staff were deployed across the houses.

Food was plentiful and people had an opportunity to choose the menu. People prepared their own breakfast and lunch if they were able, and staff cooked the evening meal.

People had some opportunities to be involved in their care through key worker sessions, and we saw that outings took place that had been chosen by people living at the service.

Fire drills took place regularly and there were checks of the premises for health and safety risks. There were some minor repairs required to the building and the décor was dated in some areas. Some furniture needed replacing in the communal areas.

We found breaches of the regulations in relation to staff recruitment, consent, risk assessments and governance of the service.

We have also made a recommendation in relation to personalisation of care records.

You can see what action we told the provider to take at the back of the full version of the report.

People who use the service were positive about the care and treatment they received at the home. They confirmed that staff assisted them when they needed support with their care and that staff were very helpful. People also told us they had good access to health care professionals such as doctors, district nurses, dentists and mental health professionals.

We spoke to people about safety. They told us that they felt safe and that if anything ever happened they would be happy to speak to the manager.

We saw that medicines were obtained, stored, administered and disposed of in a safe appropriate manner.

Staff were supported in their training. All staff that we spoke with said that they were happy with the training they received. Rota's showed that the provider had taken measures to ensure that there was always enough staff on duty to provide an effective, safe service.

We found that all areas of risk had been appropriately assessed and that the provider carried out regular checks and reviews of their risk assessments.

Policies and procedures were comprehensive and appropriate to ensure the service delivery was safe and appropriate for the people who used this service.

We noted an improvement in the storage of medicines in the home, and the recording of people's prescribed injections. Staff told us that they had received appropriate training and supervision, and had training resources available regarding diabetes, mental health and mental capacity.

A significant improvement had been made regarding the home environment in both houses, for the comfort of people living at the home.