This inspection took place on the 27 and 29 September 2016 and was unannounced. Richardson Court provides accommodation and support for up to six people who may have a learning disability or autistic spectrum disorder. Some people display behaviour which may challenge others. At the time of the inspection six people were living at the service. Richardson Court was last inspected on 19 August 2015 where two breaches of our regulations were identified, an overall rating of requires improvement was given at that inspection. The provider had resolved the issues raised at the previous inspection which were no longer a concern at this inspection.
Each person had a single room; some rooms had en-suite facilities. People had access to shared bathrooms, kitchen, laundry room, dining room, and a large communal lounge. There was a well maintained, secure garden and outside area that people could access freely. There was off street parking within the grounds.
The service did not have a registered manager in post. 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. The registered manager had de-registered with the Commission in February 2016; the provider had appointed a manager to manage the service in March 2016. They had submitted an application to register with the Care Quality Commission (CQC) at the time of our inspection. The manager was present throughout the inspection.
Risks to people were not always managed safely, this put people at potential risk of harm. Paint had been left in a person’s bedroom and portable, electric fires used in peoples rooms were unguarded and had not been risk assessed.
Regular supervisions had not been established for all staff, the manager had not checked the competency of a staff member who worked alone.
There were enough staff to meet people’s immediate needs, agency staff and the manager covered any gaps in the rota. The provider was in the process of recruiting more staff.
Appropriate checks were made to keep people safe. Safety checks had been made regularly on equipment and the environment.
The manager had good oversight of monitoring people’s support needs. People had behavioural guidelines in their care plans to help staff manage incidents. When incidents occurred the manager and staff discussed how things could change to improve outcomes for people.
Staff had a good understanding of how to keep people safe. Contact names and numbers of who to contact within the service and outside of the service were available should concerns about people’s safety need to be raised.
There were safe processes for storing, administering and returning medicines. Medicines were administered by trained staff. Regular audits were conducted on medicines to check errors had not occurred.
Staff had appropriate training and experience to support people with their individual needs and demonstrated a clear understanding of the people who lived there.
New staff underwent an induction which prepared them for their role and did not work unsupervised until assessed as competent to do so. Safe and robust recruitment process were in place to ensure people were supported by appropriately checked staff.
The service was good at responding to people who needed help to manage their health needs. People were supported to access outside health professionals.
The manager had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). People were offered advocacy services and the service had taken the appropriate steps to meet the requirements of the legislation.
People had choice around their food and drink and could choose alternative meal options when they wished. People with individual dietary requirements were catered for and advice was sought from healthcare professionals to help people to manage this.
Staff demonstrated caring attitudes towards people and showed concern for people’s welfare. People’s choices were respected and staff spent time engaging people in communication in their preferred way. When people required to be supported with their anxieties staff did this in a patient and compassionate manner. People felt confident and comfortable in their home and staff were easily approachable.
People were supported in a person centred and individual way. People’s care files were written in an easy read format which included pictures to help people understand its content. Each person had a key worker who regularly reviewed if the person’s current needs were being met or had changed.
People were helped to make complaints and staff supported people who were unable to use the easy read complaints policy by understanding what their body language meant if they were unhappy.
The service had been without a registered manager since February 2016 which is a requirement of the provider’s registration with the Commission; the manager had been in post since March 2016 and had applied for their registration with the Commission.
The manager understood the key challenges of the service and had started to make changes to improve the service people received. Staff said they felt well supported by the manager and commented that the service had improved since their appointment.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.