The Regard Partnership Limited - 225 London Road

About the service

The Regard Partnership Limited – 225 London Road is a ‘care home’ that provides care and support for up to 6 people. All the people who live at Kneller Road have a learning disability or autistic spectrum disorder. There were 6 people living there at the time of the inspection.

CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

The service people received was safe for them to live in and staff to work in. The quality of the service was regularly reviewed, and changes made to improve people’s care and support as required. This was in a manner that best suited people. Within the home, well-established working partnerships promoted people’s participation and reduced their danger of social isolation.

Right Care

There were appropriately recruited and trained staff, in sufficient numbers to support people to live safely, whilst enjoying their lives. Any risks to people and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. Trained staff safely administered people’s medicines.

Right culture

The home had a positive, open, and honest culture with leadership and management that was clearly identifiable and transparent. Staff understood and followed the provider’s vision and values which were clearly defined. Staff were aware of their responsibilities, accountability and happy to take responsibility and report any concerns they may have.

Rating at last inspection

The last rating for this service was Good (published 10 January 2019).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Regard Partnership Limited – 225 London Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The provider was following best practice guidance to prevent visitors to the home spreading COVID-19 infection. The provider enabled residents to keep in touch with family members and people's friends through regular phone calls, emails and video conferencing.

Staff had successfully adhered to infection control and COVID policies so that no challenges or difficulties had been experienced throughout the pandemic in relation to staffing in this service.

All visitors were asked to complete COVID-19 lateral flow test. All visiting professionals on the national testing programme were asked to show proof of their recent COVID-19 negative test. On entry all staff and visitors were provided with Personal Protective Equipment (PPE). This was to ensure the safety of staff and

people.

People were supported to see their family in the garden during summer and markings were done in the garden to ensure social distancing.

The home had multiple clean areas for staff to don and doff (put on and take off) PPE.

Our observations during the inspection confirmed staff were adhering to PPE and Infection Control guidance.

The provider had ensured residents who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing.

Further information is in the detailed findings below.

225 London Road 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. At the time of inspection there were five people living in the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service was provided 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.

At our last inspection in June 2016 we rated the service Good. At this inspection, we found the service had remained Good.

The home was well decorated and adapted to meet people’s needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff on display.

None of the people who lived at the home were able to communicate using ordinary verbal conversation. However, most people could respond to direct questions with a “yes” or “no” answer and used other forms of communication such as basic sign language or sounds which the staff knew how to interpret.

People gave us positive feedback about the home and their satisfaction with care staff and did this through their interaction with staff and the ease with which they moved about the home and exercised choice throughout the inspection.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff told us they received the support and training they needed to help them do their jobs well. The managers were proactive in ensuring staff completed training relevant to the needs of people living at the service. This included specialist training to enable staff to care for people with particular needs.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely and people received their medicines as prescribed, with accurate records available to show which medicines people had received. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

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

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced. Relatives told us they felt able to speak to the registered manager or any of the staff team at any time if they needed help and assistance.

The newly-appointed registered manager and an established staff team were committed to providing high quality person centred care and support. This ethos was central to how the service operated. The service was flexible and responsive to changes in people’s needs and individual family circumstances. The service had a stable and consistent staff team who had people’s wellbeing at heart.

Further information is in the detailed findings below.

The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of a lounge area and dining room. There was a private garden at the rear of the property.

There was a registered manager in post, and they were at the home at the time of our 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 home was well decorated and adapted to meet people’s needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and staff.

People who were able to communicate with us gave us positive feedback about the home and the caring nature of staff. Other people were able to demonstrate in other ways that they felt safe and cared for at the home, for example through their interaction with staff.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in these decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

Staff helped people to keep healthy and well, they supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely, and people received their medicines as prescribed. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may have been restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced.

Our review on the 09 December 2013 showed that the provider was meeting the standards. We checked two records. These had been reviewed and amended to show the date of the weekly audit and the date the medication audit occurred. Staff had been reminded not to leave medication keys in the medication cabinet and storage of half dose drugs had been discontinued. We were advised of the new process for storing half dose tablets which included the use of a correctly labelled dossett box.

The records we reviewed for all three people living at the home were complete and comprehensive. The registered manager informed us that all outstanding actions and work had been completed and that staff had been reminded of the importance of keeping the medication cabinet locked at all times.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People were not always protected against the risks associated with medicines because the arrangements the provider had in place were not always being followed. Some practices were unsafe and some medication was stored loose and could not be clearly identified.

We spoke with three staff who gave details about the training they had completed within the last year and this included moving and handling, first aid, fire safety and medication management, which meant that staff were addressing their on-going learning needs.

Three staff we spoke with told us about how they would support someone who made a complaint or raised matters of concern. They each described the main features of the complaints policy including listening to and acknowledging people's concerns.