Archived: Henshaws Society for Blind People - 45 Yew Tree Lane

Updated 13 January 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 13 and 14 September 2016. We did not give advance notice of our arrival on the first day. The inspection team on the first day was an adult social care Inspector, and a specialist advisor, who had expertise in working with young people with sensory disabilities. On the second day the Inspector returned to complete the inspection and give feedback.

Before the inspection we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR along with other information we held about the service, including notifications received from the service and information from other sources.

We contacted the contract officer of Manchester City Council for information about the council’s recent monitoring visits. They had not made any recent visits.

We talked with and observed the five people using the service, and talked with one visiting relative, five members of staff and the registered manager and deputy manager, and a district nurse. We also talked by telephone with two relatives of people living in the home, and received emails from them.

We looked at four care records, two medicine administration records, five staff files, and staff rotas, staff meeting notes and other information. We requested some information be sent to us, namely training records, which however we did not receive.

Updated 13 January 2017

This inspection took place over two days on 13 and 14 September 2016. The first day was unannounced, which meant the service did not know we were coming. The second day was by arrangement.

The previous inspection took place on 10 September 2014. At that inspection we found the service was meeting the regulations we looked at.

Henshaws Society for Blind People (Henshaws) runs a home for up to six people at 45 Yew Tree Lane, in Northern Moor in south Manchester. There were five people living in the home at the date of the inspection. The people living there were young men who mostly had a visual impairment, and also had other complex care needs. They each had a bedroom, and shared a communal living area and dining area.

At the date of this inspection the registered manager was just about to leave, after six years in post. There was a process ongoing to appoint a new registered manager. 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 found an allegation of abuse which had been investigated internally but had not been reported as a safeguarding incident.

We found the home was a safe environment for people with visual impairment, three of whom could walk around the house freely. We pointed out a couple of trip hazards.

At the time of this inspection there was someone living in the home on a temporary basis with a view to a permanent placement. His needs and abilities were different from those of the other people in the home. The behaviour that partly resulted from the inability to meet this person’s needs at the service had caused the others to become inhibited about moving around.

Staffing levels were appropriate to meet the basic care needs of people living at the home however at times more staff were needed to support people with their planned activities. One person required one to one support which meant there were fewer staff available for activities with the others. When there was one fewer staff working, as happened on the first morning of our inspection, activities had to be cancelled.

There had been no staff recruited from outside Henshaws for three years. This created the benefit of continuity but also the risk of staff being too comfortable in their routines.

Medicines were ordered, stored, administered and recorded in safe ways. However we found improvements were needed because the instructions for PRN or ‘as required’ medicines needed to be clearer, and the cabinet for controlled drugs needed to be made secure.

Fire precautions were in place and equipment was serviced. There were individual plans for evacuation, but the person who had arrived in July 2016 did not yet have one in place.

We were told that training took place but there was no record of training available, so the provider was unable to demonstrate that all staff training was up to date. We requested the training record be forwarded to us after the inspection but did not receive it. This was a breach of the regulation regarding training of staff. There were some records of supervision but not of annual appraisals.

The service was applying the Mental Capacity Act 2005 (MCA) and had carried out mental capacity assessments on all the people living in the home. Applications under the Deprivation of Liberty Safeguards (DoLS) had recently been made for four people, but not for one person on respite, although he had been in the home for two months. This was a breach of the regulation relating to protecting people from an unlawful deprivation of liberty.

Food was cooked by staff. We did not see people involved in helping to prepare meals. The menus were similar from one week to the next. People’s diets were monitored.

The service ensured that people were registered with a GP and kept appointments with medical professionals.

The view of families and professionals was that the home was a very caring environment. Staff were most often kind to the people they were supporting. People were encouraged to be independent, although that had been affected by the current situation in the home.

People received appropriate help with their personal care. People got up quite late in the mornings, but this was their choice (except for one person). Those who could took part in chores around the home.

Confidentiality of people’s personal information was respected.

Care records were very detailed to the extent that it was difficult to find specific information in them. There was some obsolete information. We found little evidence that people had been involved in the writing or review of their own care plans.

One person was not receiving much attention or stimulation even though he was receiving one to one support. He spent a long time in bed in the morning and also in the afternoon. Staff appeared uncertain how to respond to or help him manage any behaviours that challenged staff and others. This was a breach of the regulation relating to meeting people’s needs. We considered that the impact on others in the home represented a breach of the regulation relating to respect and dignity.

Activities did take place although on the day of our visit they were cancelled due to staff sickness. Some people engaged in a variety of activities each week, others less so. There had been a holiday in September 2015 and another one was being planned. One family member expressed the view there were fewer activities than they expected. This was a further breach of the regulation relating to meeting people’s needs.

There was a complaints policy and log. A recent complaint had not been recorded, but had received a detailed response.

The registered manager of the service was about to leave and be replaced. The staff were nearly all long –serving and offered consistency of care.

The aim of the provider organisation was to enable people with visual or other disabilities to exceed expectations. We found this was the aim of the service, but that there were times when people were sitting listening to the TV with no purposeful activity.

The registered manager told us that lessons had recently been learned about a poor pre-admission assessment process. However, the decision had impacted on the quality of life in the home. Along with examples of poor records, this was a breach of the regulation relating to good governance.

There was a range of audits carried out. Reviews and audits of care plans needed to be more thorough and address the content of the care plans. Staff from the provider visited to carry out assessments.

Staff meetings took place. The minutes suggested that these were used as a means of reminding staff of their duties and obligations. It was less clear they were an opportunity for staff to raise issues themselves.

We found breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of the full version of the report.