Background to this inspection
Updated
17 January 2019
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.
This inspection took place on 15 November 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because it is a small service and we needed to be sure that people and staff would be in. The inspection team consisted of three inspectors.
This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.
Before the inspection we reviewed information we held about the service including previous inspection reports, any notifications, (a notification is information about important events which the service is required to send to us by law) and any complaints that we had received. The provider had submitted a Provider Information Return (PIR) before the inspection. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This enabled us to ensure that we were addressing any potential areas of concern at the inspection.
As people had difficulties in verbal communication, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We 'pathway tracked' two of the people living at the home. Pathway tracking means we looked at people's care documentation in depth and made observations of the support they were given. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care. We also spoke with one relative of a person who used the service. We spoke with two members of staff and the registered manager and spoke with other staff on duty during the inspection. We looked at a range of documents including policies and procedures, care records for four people and other documents such as safeguarding, incident and accident records, medication records and quality assurance information. We reviewed staff records including recruitment, supervision and training information as well as team meeting minutes and we looked at the provider’s management systems.
The last inspection on 21 August 2017 identified four breaches of the regulations.
Updated
17 January 2019
The inspection took place on 15 November 2018 and was announced. 52 Mill Lane provides accommodation and personal care for up to five adults with severe learning disabilities and physical needs. The house is situated in a residential area of Hove with some shops nearby. The house has been adapted for the needs of the people who live there. Accommodation is arranged on the ground floor, with offices for staff on the first floor.
52 Mill Lane is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home had a 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.
The last inspection on 21 August 2017 identified four breaches of regulations and rated the service as requires improvement. We asked the provider to complete an action plan to show what they would do, and by when, to make improvements. At this inspection on 15 November 2018, we found that staff had followed the action plan and the overall rating for the service had improved to Good.
People were living with a range of complex needs. Risks to people had been identified, assessed and managed. Care plans were comprehensive and provided clear guidance which was being followed by staff to keep people safe. There were enough staff with suitable skills and experience.
Staff understood their responsibilities for safeguarding people from abuse. People were receiving their medicines safely. The home was clean and staff protected people by the prevention and control of infection. Monitoring of incidents and accidents ensured that lessons were learned and improvements were made when things went wrong.
Staff received the training and support they needed to care for people. They understood their responsibilities to gain people’s consent for care and treatment. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were receiving the support they needed to have enough to eat and drink. Staff ensured that people had access to the health care services they needed. The home had adaptations that supported people’s independence and met their individual needs. The home 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.
People were supported by staff who knew them well. Staff were kind and caring and respected people’s dignity and privacy. A relative told us, “The staff are very good. They create a great atmosphere at the place, people are happy there.”
People were supported to be involved in decisions about their care and support. Staff were effective in supporting people with their communication needs.
People were receiving a personalised service and staff were focussed on enriching people’s quality of life. People were leading full and active lives according to their interests and preferences.
Staff were responsive when people’s needs changed and reviewed risk assessments and care plans regularly. Staff were responsive to complaints and feedback.
Management systems and processes were robust and improvements had been made to meet all breaches of regulation that were identified at the last inspection on 21 August 2017. The registered manager provided clear leadership and staff spoke highly of the management of the home. Staff understood their roles and responsibilities and described positive working relationships and good communication both internally and with external agencies.