Peel House can provide accommodation and personal care for up to eight people with complex learning and physical needs. This is the first inspection since changes in the registration of the provider. The inspection visit was unannounced and took place on 17 February 2016. At the time of our visit eight people were living at the service. A registered manager was 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.
We saw people welcome staff attention and responded in a positive manner towards staff. Members of staff were knowledgeable about the procedures for safeguarding vulnerable adults from abuse.
Systems to manage risk were in place. Members of staff knew the actions needed to minimise the risks. For example, regular repositioning of people at risk of pressure ulcers and how meals must be served to people at risk of choking. Risk assessments and support guidance were combined and action plans informed staff on the measures in place to maintain people’s safety.
Staff said the staffing levels were appropriate to meet people’s needs and to support people with a range of activities.
Safe systems of medicine management were in place. Members of staff were competent to administer medicines. Medicine administration record charts were signed by the staff to indicate the medicines administered. Protocols were developed for medicines to be administered “when required” which gave staff guidance on administering the medicines consistently as needed by the person.
Staff attended training to develop their skills and they were supported to perform their role and responsibilities.
People were enabled to make decisions and staff knew how people made choices. Applications for authorisation of restrictions under the deprivation of liberty safeguards (DoLS) were made for people subject to continuous supervisions. Mental Capacity Act 2005 (MCA) assessments were not in place for specific assessments such as bed sides and audio monitoring systems. The registered manager said DoLS applications to authorise these restrictions had been made.
We observed good interactions between people and staff. We saw staff took prompt action when they noticed people making attempts to gain attention for refreshments by eye pointing.
Staff said gaining people’s trust helped them develop relationships. We saw staff use their knowledge of the person to provide care and treatment in people’s preferred manner.
Quality assurance systems were developed, which included the views of relatives and external professionals. Where shortfalls were identified, action plans were devised to make improvements. For example improving the frequency of one to one meetings with staff to help them with their roles and responsibilities.