This inspection took place on 10 October 2016 and was announced.16 Crompton Street is a residential service which provides accommodation and personal care for a maximum of seven people. At the time of the inspection three people were living at the service.
A registered manager was not in post. However the manager of the service was in the process of applying to become the registered manager. The manager was unavailable on the day of the 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.
The provider had implemented an approach to quality monitoring which was appropriate for the size of the service. However, these processes had failed to identify issues relating to the completion of essential safety checks and missing references.
We have made a recommendation about this.
The service had processes to monitor safety and employed external contractors to service and check; gas safety, electrical safety and fire equipment. We saw that checks had been completed in each area within the previous 12 months.
Risk to the people living at the service was appropriately assessed and recorded in care records. Each risk assessment focused on maximising the person’s independence while safely managing any risks and had been recently reviewed. People told us they were involved in decisions about care and taking risks.
Medicines were safely stored and administered. However the service did not have an effective procedure in place to monitor stock levels.
Staff had the skills and knowledge to meet the needs of the people living at the service. Staff were required to complete a programme of training which included; first aid, administration of medicines, people handling and adult safeguarding. The training matrix provided indicated that all training required by the provider was up to date.
The people living at the service were actively involved in choices about food and drink and had free access to the kitchen. We were told that they were being supported to be more independent with shopping and food preparation.
People living at the service were supported to maintain good health by accessing a range of community services. We were told that they had a GP, optician and dentist and had regular check-ups. We saw evidence of this in care records. We also saw evidence of health action plans which detailed a range of healthcare needs and other important information.
Throughout the inspection we observed staff interacting with the people living at the service in a manner which was compassionate and caring. We saw that staff spoke regularly with the people living at the service. They explained what they were doing and discussed their needs and activities. Staff knew the care needs of the people well.
We saw that people had choice and control over their lives and that staff responded to them expressing choice in a positive and supportive manner. With the exception of the administration of medicines, it was clear that the provision of care was not task-led and did not adhere to a fixed timetable.
Information was provided in a way that made it easier for people to understand. Staff took time to re-word things when people didn’t initially understand. We saw that some important information, for example consent documents, were produced in plain English and made use of images to support people’s understanding.
Privacy and dignity were protected and promoted by staff. Staff spoke with respect about the people living at the service and promoted their dignity in practical ways. Each person had a lock on their bedroom door for additional privacy and security. All confidential information was stored securely in an office within the service.
We saw from our observations that the people living at the service were involved in discussions about care on a day to day basis. We also saw evidence that people were actively involved in regular reviews of their care. Each person had a monthly ‘keyworker’ review which was signed by the person and the staff member.
The people living at the service were supported to follow their interests and an activities file was maintained which included photographs and comments from people living at the service. Activities were also discussed and planned at regular ‘service user’ meetings.
The service had been developed with input from the people living there and the staff team. Communication between staff and the manager was open and regular. We saw evidence that staff meetings had taken place regularly. Information relating to people living at the service and developments had been shared at the meetings.
Staff were clearly motivated to do their jobs and enjoyed working at the service. Staff understood their roles and demonstrated that they knew what was expected of them.
Records indicated that notifications of important events had been submitted to the Care Quality Commission appropriately. Safeguarding referrals to the local authority had been made in an appropriate and timely manner.