Portland Road

Updated 5 July 2017

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 home, and to provide a rating for the home under the Care Act 2014.

The inspection took place on the 24 November 2015 and was unannounced. The inspection team consisted of two Inspectors.

On the day of the inspection, we spoke with four people that lived at the home, the registered manager, the deputy manager, four care staff and the intern. We also sought feedback from senior management and three mental health professionals after the inspection. Before the inspection, we checked the information that we held about the home and the provider. This included previous inspection reports and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the home. A notification is information about important events which the home is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used the PIR to help us focus on specific areas of practice during the inspection. Portland Road was last inspected in November 2013 when no concerns were identified.

During the inspection we reviewed the records of the home. These included staff training records and procedures, audits, six staff files along with information in regards to the upkeep of the premises. We also looked at all six care plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at Portland Road. This is when we looked at their care documentation in depth and obtained their views on how they found living at Portland Road. It is an important part of our inspection, as it allowed us to capture information about a selected group of people receiving care.

Updated 5 July 2017

We inspected Portland Road on the 24 November 2015. Portland Road is a mental health care home which can accommodate up to nine people. On the day of our inspection, eight people were living at the home. The age range of people varied from 28 – 80 years old. Predominately people required support with their mental health needs; support was also needed in relation to substance misuse, anxiety and physical health care needs.

Portland Road belongs to the provider Brighton Housing Trust and falls under the ‘Archway Project’. The ‘Archway Project’ is part of the accommodation strategy for Brighton and Hove City Council for people with mental health needs. It helps bridge the gap between hospital and community and forms part of the pathway to help people move towards more independent living. The provider operates two registered care homes and three supported living units.’

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The delivery of care at Portland Road was built on the promotion of mental health recovery. Supporting people to move forward, increase independence and improve independent living skills. People told us they appreciated the level of support they received and clearly understood the ethos of the service. One person told us how the calm atmosphere where they could gradually get better and be able to move on. Another person told us, “It’s a safe and trusting place to be.”

Person centred care was central to the ethos and every day practices at the service. Staff were dedicated and compassionate about engaging with people to empower them to be involved in planning their own support. Staff used innovative and individual ways of involving people so that they felt consulted, empowered, listened to and valued. Staff worked in partnership with people to empower them to achieve their goal and support people to move on to a more independent lifestyle. Creative methods were used for people to engage in meaningful individual activities that enhanced their lives.

Co-production (developing the service in an equal and reciprocal relationship between staff and people) was at the heart of the service. The provider, management team and staff were committed to involving people with the overall running of the service, from staff induction, policies, procedures and budgets. A client representative had been nominated who was actively involved in house meetings and soon to meet the creative director of Brighton Housing Trust. External healthcare professionals spoke highly of the home. One mental health professional told us, “They work with a number of our clients who have severe and enduring mental health problems in a very caring and flexible way. There communication is very good. They work flexibly and responsively with clients and manage risks very well. The staff team appear very calm capable and co-operative and are able to manage significant levels of distress and behavioural disturbance.”

The leadership sought out creative ways to provide a personalised service and had achieved outstanding results through the promotion of co-production and client involvement. The service was part of Psychologically Informed Environment (PIE) pilot and recognised the impact of the environment on people. The positive impact of this approach meant the some people had started to engage more with staff and their own recovery. Client steering groups and focus groups had been organised. These provided a forum for people to be actively involved in the design and running of the service.

A person centred approach to safeguarding was adopted. Staff worked in partnership with people to safeguarding themselves whilst empowering people to take positive risks. Harm minimisation was utilised as an approach to managing risk. One staff member told us, “When people have abused substances, we create a safe space where they can talk to us and explore what happened.”

The home was welcoming, friendly and calm. People were relaxed, engaged with people around them or enjoying activities within the home or out in the town. People were empowered by the management team to be very much a part of the inspection. We were shown round by people and also joined people for their daily coffee morning. One person told us, “This is a very nice place to be.”

The management team were passionate and creative in their approach to ensure staff were kept up to date with training and recognised the importance of a strong skilled workforce. There were named champions in various areas such as health and safety and first aid within the service who actively motivated and supported staff to ensure people were provided with a quality service. People were also actively encouraged to become champions and one person was the ‘client’ champion for health and safety’.

Staff worked in a variety of ways to improve outcomes for individuals. Each person had an individual key-worker who they met on a weekly basis. Staff were dedicated to ensuring key-working sessions met the need of the person and promoted their wellbeing. Key-working sessions were often creative with staff engaging with people doing various activities. One person told us, “We do a variety of things during our sessions. I really enjoy them.”

There was strong emphasis on continual improvement and best practice which benefited people and staff. There were robust systems to assure quality and identify any potential improvements to the service. This meant people benefited from a constantly improving service that they were at the heart of. A robust service improvement plan was in place and part of the improvement plan involved a student social worker joining the team in January 2016 for their social work placement,

The recovery model was fully utilised and people were supported to achieve their individual goals. Staff also recognised when people’s mental health may be deteriorating and the signs and triggers to look for. People confirmed that staff had an excellent understanding of their needs and they felt confident in the skills of staff. The management team were always thinking one step ahead and how they could improve their practice. In line with the model of recovery, staff were completing WRAPs (Wellness Recovery Action Plan). These considered what the person would want to happen in the event of their mental health deteriorating.

Engagement with the local community was encouraged by the provider and staff were actively involved in building further links with the community and encouraging people to engage with other services outside of the service. To promote meaningful activities and reduce the risk of social isolation, staff worked in partnership with external agencies. The role of the intern and volunteer at the service also promoted social engagement.