21 June 2016
During a routine inspection
The service offers overnight respite breaks within a homely environment. Personalised support and care is provided for each individual. The service supports people to take part in activities at the location and out in the community including arts and crafts, music and singing, dance, keep fit, cookery and computers. The service is closely linked with the nearby day centre for people with learning disabilities.
At the time of the inspection, there was 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 location was last inspected under the 2010 Regulations on 23 January 2014, where the five outcomes we inspected were compliant. This is the first inspection of the location under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People were not able to tell us themselves they felt safe at 9 Allenby Road. However, we observed that people were supported in a safe way. Staff we spoke with were knowledgeable of how to act if abuse occurred and how to report this to managers or other authorities.
Proper maintenance of the premises and grounds was evident. The registered manager was knowledgeable about risks from the building and completed assessments and coordinated repairs to effectively prevent harm to people. Repairs were completed by external contractors and some minor delays occurred whilst waiting for their attendance.
The service had robust recruitment procedures and detailed personnel files. The provider needed to improve their collection of enhanced criminal records disclosures for new staff before they commenced. We met with the provider who assured us they would, which they later confirmed in writing had occurred. We observed staffing levels met people’s needs. People were often out of the building attending activities like the day centre, and staff who stayed on site performed other functions like cleaning and shopping.
Medicines were safely managed. This was not confirmed by regular audits of pharmacists as people did not stay for long periods of time. However, we examined the handling of people’s medicines during our inspection and found that people were safe from harm. We advised the provider to seek guidance and support to ensure people’s medicines records were checked at each subsequent admission.
Infection prevention and control practices were satisfactory. The service was clean and tidy but staff handwashing practices required some improvement. After the inspection, the provider sent us confirmation this was complete.
Staff training, supervision and performance development was effective. Induction programmes and training was evident, but some competency checks and repetition of training was needed to ensure the best effective care. The provider sent us information after the inspection which demonstrated they listened to our findings and took action to ensure staff had the continued knowledge and skills to perform their roles.
The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA). Better recording of the information about people’s ability to consent was necessary to ensure the service complied with the MCA codes of practice. The service demonstrated that, where necessary, authorisations were recorded to deprive people of their liberty for various decisions.
People received nutritious food which they enjoyed. Hydration was offered to people to ensure they did not become dehydrated. People assisted with shopping and cooking and had the right to choose their own meals.
We observed staff were caring and friendly. As staff had worked with most people over an extended period of time, they had come to know each person better. This was reflected in the care that people received in an ongoing way. People had the right to choose or refuse and this was respected by staff. We saw people’s privacy and dignity was respected during daily hygiene practices.
Responsive care was provided to people. Their wishes, preferences, likes and dislikes were considered and accommodated. Staff knew about the complaints procedure and people had the ability to complain. There were no complaints since our last inspection, although the registered manager and service manager had the knowledge and skills to investigate if a complaint was raised.
The workplace culture at 9 Allenby Road was good. Management was stable at the service and there was a low staff turnover. Staff described a positive place to work and care for people. Staff told us they enjoyed their roles and found management approachable and reasonable. The registered manager, service manager and nominated individual were knowledgeable about quality care and accountable in their roles.
As a result of the inspection and our findings, the provider decided to apply to us to carry out nursing care at the service. We will assess their application and make a decision within a given timeframe.