Archived: Shalom

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

A registered manager was employed by the service and was present during 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.

We observed staff interacting with people in a kind and caring manner, involving people in choices around their daily living. Staff sought permission before providing care and support and made sure people knew what was happening at all times.

People looked relaxed and comfortable in the company of staff and did not hesitate to seek support and assistance when required.

Staff continued to monitor people’s physical and emotional wellbeing and ensured support was in place to meet their changing needs. Each person had a health action plan which described their health care needs. Where necessary, staff contacted health and social care professionals for guidance and support. People’s medicines were managed and administered safely.

Staff received training in how to recognise and report abuse. All staff were clear about how to report any concerns they had. Staff we spoke with were confident that any concerns raised would be fully investigated to ensure people were protected from the risk of harm or abuse.

People had access to food and drink throughout the day and were supported to eat their preferred food choices. Where people chose not to eat the menu options available alternatives were offered.

Staff told us they felt supported in their roles. Staff said they received appropriate training to have the correct knowledge and skills to meet people’s needs.

There were enough staff deployed to fully meet people’s health and social care needs. The registered manager and provider had systems in place to ensure safe recruitment practices were followed.

The registered manager had systems in place to monitor the quality of the service provided. The service worked in conjunction with other health professionals to support people to access additional support and services where needed.

Further information is in the detailed findings below.

The inspection took place on 01 February 2016. This was an unannounced inspection. During our last inspection in June 2014 we found the provider had satisfied the legal requirements in all of the areas that we looked at.

A registered manager was employed by 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 were supported by kind, caring staff who knew them well and understood their care and support needs. Relatives spoke positively about the care and support their family member received. They felt people had developed caring relationships with staff. People were supported to take part in social activities both within the home and community.

People were supported to maintain relationships with people that mattered to them. Relatives were kept informed of their loved ones health and well-being and any changes in their needs.

People were kept safe by staff who recognised signs of potential harm or abuse and knew what to do when safeguarding concerns were raised. Staff felt confident concerns raised would be listened to and acted upon by the registered manager and deputy manager.

People were supported to have sufficient to eat and drink and maintain a balanced diet that promoted healthy eating. People had access to dietary and nutritional specialists to help meet their assessed needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place for the safe management of medicines. People received their medicines as prescribed by staff that were trained to do so. Referrals were made to relevant health professionals when needed and each person had a health action plan in place.

Staff told us they felt supported by both management and colleagues. Staff received training as required by the provider and regular supervision to enable them to meet people’s needs.

There were enough staff deployed to fully meet people’s health and social care needs. The registered manager and provider had systems in place to ensure safe recruitment practices were followed.

Staff and the registered manager had an understanding of the Mental Capacity Act (2005).

Staff were knowledgeable about the rights of people to make their own choices and decisions. This was reflected in the way staff supported and encouraged people to make decisions when delivering care and support.

Staff understood their roles and responsibilities in relation to infection control and hygiene. During our inspection we saw the home was clean, tidy and free from odours.

The provider and registered manager had systems in place to monitor the quality of service. Relatives of people using the service were encouraged to share their views on the care and support their family member received.

There were systems in place to respond to any emergencies. Staff had access to a 24 hour on call system to enable them to seek advice in an emergency. People had personal emergency evacuation plans in place in the event of an emergency such as fire.

As part of this inspection we spoke with three relatives, a visiting healthcare professional, the registered manager, the deputy manager and two care staff.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at.

Is the service safe?

People who lived at Shalom were unable to tell us what they thought about the support and care provided. We spoke with three relatives who told us that they had confidence in the staff supporting their family member. They felt that their family member was also safe whilst living at the home.

Care plans provided guidance for staff on how to meet people's needs in a way which minimised the risk for the individual. Where people were at risk, staff followed effective risk management policies and procedures to protect the person. This ensured that staff were able to support people whilst respecting their dignity and protecting their rights.

There was a member of senior staff available on-call in case emergencies arose.

Recruitment practices were safe and thorough. Staff had received supervision and undertaken training in the safeguarding of vulnerable people. This ensured that staff were able to identify unsafe practices and take appropriate action to resolve them.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications have been submitted, appropriate policies and procedures were in place. Relevant staff had received training on understanding when an application should be made and how to submit one.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

The home had access to an advocacy service if people needed it. This meant that when required people could access additional support. Relatives we spoke with told us that they were involved in planning their family member's care.

People's care and welfare needs were assessed. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Relatives told us that they were happy with the care that had been delivered and that their family member's needs had been met. Staff had received training to meet the needs of the people they were supporting.

Is the service caring?

We observed that people were supported by attentive and caring staff. We saw that care workers showed patience and gave encouragement when supporting people.

We saw that staff showed concern for people's well-being. Staff knew the people they were caring for and supporting, including their preferences and personal histories.

People who lived at Shalom were unable to tell us what they thought about the support and care provided. We spoke with three relatives. We asked for their opinion about the staff and how they supported their family member. They all said they were happy with the care and support received by their family member.

Is the service responsive?

People regularly attended a range of activities both in and outside the service. The home had its own adapted vehicle which helped people to remain involved in their local community.

The service worked well with other agencies, health professionals and family members to make sure people received consistent care. Records contained details of appointments with health professionals and any outcomes. We saw that referrals were made to the appropriate health services when people's needs changed.

Relatives we spoke with confirmed staff would always contact the appropriate health professional if their family member required an appointment.

Is the service well-led?

The service worked well with other agencies, health professionals and family members to make sure people received consistent care. We spoke with a visiting healthcare professional who spoke positively about working with the home.

Staff had a good understanding of the ethos of the home and what was required of them.

The home had quality assurance processes in place. People and their representatives were asked for their feedback on the service they received. Relatives we spoke confirmed they knew how to make a complaint if they were not happy with services provided. One relative told us that they were quite happy to raise any concerns they had with the manager or other staff members. Any concerns raised were dealt with quickly and they were always informed of any outcomes.

After our visit, we spoke to three relatives of people who used the service. All were complimentary about the service their son or daughter received.

People were relaxed in their surroundings and looked well supported. They were encouraged to participate in varied social activities in relation to their individual needs and preferences. Staff interacted with people in a friendly manner as they went about their work.

There was an emphasis on people receiving healthy, balanced meals of their choice. Staff supported people to eat in a sensitive and attentive manner. They were aware of people's nutritional needs and would report any concerns to the GP.

The home was homely, clean and safe. Bedrooms were personalised and reflected people's individual interests and preferences. Systems such as clear procedures, audits and staff training were in place to minimise the risk of infection.

People had detailed support plans, which identified their needs and the assistance they required. Other records demonstrated the range of management systems within the home. Records were organised and stored appropriately.

As part of this inspection, shortly after our visit we contacted a relative who told us they were 'very satisfied with the care and support provided.' They told us staff kept them informed of anything relevant regarding the health and welfare of their relative. They said 'the staff are caring and experienced and know my relative very well. I am confident any concerns would be dealt with promptly and effectively.'

Records we saw showed the home liaised with community health services. Staff kept full notes of changes in person's wellbeing and requested medical attention for people in a timely way. We observed staff provided care and support in line with people's care plans.

Staff told us they worked well together, communication between staff was good and they enjoyed going to work.