This inspection was carried out on 2 January 2019 and was unannounced. Fiveways 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. Fiveways is registered to provide accommodation and personal care for up to five people who have a learning disability and other complex needs. Fiveways is on the outskirts of Whitstable and is close to local transport and amenities. Five people were living at the service at the time of inspection and each had their own personalised bedroom. People had access to a communal lounge, conservatory, kitchen, laundry room, sensory room, two bathrooms, a wet room and toilet.
The care service 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.
There was a registered manager in post, and present 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.
At the last inspection on 8 June 2016 the service was rated 'Good' in all key questions. At this inspection, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and have now rated the service ‘Requires Improvement’.
Checks and audits were in place, but has not been successful in identifying the concerns we identified during this inspection. The registered manager had not completed checks on new staff working at the service, and therefore did not identify issues with staff recruitment. Medicine audits failed to identify issues with medicines reconciliations.
We found that medicines management was not consistently safe. Staff failed to react when three people missed three days of medicines. Accidents and incidents were reported, but action was always not taken or clearly documented to minimise the risk of it reoccurring.
Staff knew how to safeguard people from potential harm and abuse. Staff had received a full induction, and had access to on-going training and supervision. The service was clean, well maintained and fit for purpose.
People told us, and we observed there to be sufficient staff numbers to keep people safe, and meet their needs. Risks to people had been identified and minimised where possible.
People were supported to be involved in meal planning and food preparation. People were supported to take part in meaningful activities, and encouraged to live healthier lives.
People’s needs had been assessed, and staff worked with best practice guidance. Staff knew people well, and could identify when their needs changed, and organised for input from healthcare professionals.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People are 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 support this practice.
People told us they were treated with kindness, respect and compassion. We observed staff interactions with people, and saw a mutual respect between people and staff. Staff supported people to be as independent as possible, including supporting them to take positive risks.
People received personalised care specific to their needs. People told us they choose how they spent their time.
People were supported to express their views and be involved in decisions about their care and support. People told us they understood how to complain.
People told us they were happy living at the service. People told us the staff and registered manager were the best things about living at the service. Staff told us they were well supported in their roles. There were systems in place to improve the quality of the service, including completing quality assurance questionnaires. However, the overarching results of this had yet to be analysed by the provider.
The registered manager had submitted statutory notifications as required, and was displaying their CQC rating within the service.
You can see what action we told the provider to take at the back of the report.