Archived: Southdown Housing Association - 3a Grosvenor Road

3a Grosvenor Road is a residential care home providing personal care and support for up to three adults with learning disabilities or autistic spectrum disorder. There were two people living there are the time of the inspection. The care home had two bedrooms downstairs and a self- contained flat upstairs with a large accessible garden.

People’s experience of using this service and what we found

There was a lack of consistency in how the service was managed and led. Staff had not always been well supported and the provider’s systems for monitoring quality had not always identified shortfalls in the management of the service. There were not always sufficient staff with the skills needed to support people with complex needs. The provider told us that Covid-19 had caused many challenges which contributed to these issues. They had taken action to make improvements, including with staffing levels. Staff told us this had already made a difference.

People were supported in a personalised way and were leading full and busy lives. A relative said “People have a good quality of life. It’s a homely atmosphere, it’s not clinical, it feels like their home.” Staff were knowledgeable about people’s needs and supported them to be as independent as possible. Staff had undertaken training that was relevant to the needs of people they were supporting. Support plans and risk assessments were detailed and had been reviewed regularly and when people’s needs had changed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of Safe, Effective and Well led, the service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence. People were supported to access the local community and staff were focussed on providing choice and enabling independence.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. Support was highly personalised and reflected people’s individual needs and preferences.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Staff described an ethos of supporting people to maximise their quality of life and used positive behaviour support to increase confidence and reduce restrictions on their freedom.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 November 2016).

Why we inspected

This focussed inspection was prompted in part due to concerns received about the safety and management of the service. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-Led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service is Requires Improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider had taken action to mitigate the risks but changes were not yet fully embedded and sustained. Please see the Safe and Well -Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 3a Grosvenor Road on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The last inspection of the service was carried out on 6 January 2014. No concerns were identified with the care being provided to people at that inspection.

3a Grosvenor Road provides accommodation and support with personal care for up to three adults. The home specialises in providing care to adults who have a learning disability. The home is staffed 24 hours a day.

At the time of our inspection there were three people living at the home. The people we met with had very complex needs and were not able to tell us about their experiences of life at the home. We therefore used our observations of care and our discussions with staff to help form our judgements.

There was 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.

People were supported by a caring staff team who knew them well. Staff morale was good and there was a happy and relaxed atmosphere in the home. In a recent satisfaction survey a relative commented “[Name of person] is very lucky to be looked after by the staff at Grosvenor Road” and “The observation and care is brilliant.”

Routines in the home were flexible and were based around the needs and preferences of the people who lived there. People were able to plan their day with staff and they were supported to access social and leisure activities in the home and local community.

The home was a safe place for people. There were sufficient staff to meet people’s needs. Staff understood people’s needs and provided the care and support they needed.

Staff knew how to recognise and report abuse. They had received training in safeguarding adults from abuse and they knew the procedures to follow if they had concerns.

People’s health care needs were monitored and met. People received good support from health and social care professionals. Staff were skilled at communicating with people, especially if people were unable to communicate verbally.

People were unable to look after their own medicines. Staff made sure medicines were stored securely and there were sufficient supplies of medicines. People received their medicines when they needed them.

People were always asked for their consent before staff assisted them with any tasks and staff knew the procedures to follow to make sure people’s legal and human rights were protected.

There were effective systems in place to monitor and improve the quality of the service provided.

One person who uses the service told us 'I am going on holiday in June and I go every year, I like it here'.

Staff we spoke with enjoyed working at 3a Grosvenor Road. One person told us 'we are a great team and communicate well'. Another member of staff told us 'we give great 1:1 support to the people who live here'. If staff needed support or development they felt their manager was approachable and helpful.

Comments from a recent relative survey read 'I find the staff are always helpful, keen to please and very polite'. Another comment read 'I could not wish for anything better for my brother, staff are excellent and he always seems very happy'.

We also looked at support plans, risk assessments, staff records and surveys.

Two people that did express an opinion, indicated to us that they were happy living in the home, that they liked the staff supporting them and had choices in what they wanted to do.

There were processes in place to support people to make informed choices about their care and support wherever possible.

Each person living in the home had a detailed plan of care in place that included people's individual needs and wishes and also recorded people's physical and emotional healthcare needs.

The home's staff worked with a variety of healthcare professionals including mental health and the learning disability teams and referrals were promptly made to specialist services where relevant.

We spoke with staff and reviewed records which showed us that people were protected from abuse and their care was planned and delivered in a safe manner.

Comments we received from a family member included. 'All I can say is two words, brilliant and excellent. They know X well and he knows them. They keep me up to date with everything and bring him half way so that we are able to meet.'

Another family member told us. 'I would give the staff ten out of ten, there is a stable staff team and they are dedicated and experienced.'