This comprehensive inspection took place on 21 September and was unannounced. Vermont House provides accommodation for up to nine people who require support with personal care and who have a learning disability and/ or autism spectrum disorder. At the time of our visit five people lived at the home.
Prior to this inspection we received information that people were not supported safely and they did not have enough food to eat.
We checked and found enough staff were on duty during our visit to keep people safe and meet their support needs. The provider's recruitment procedures minimised the risks to people safety. Some staff had left their employment at the home since our last inspection. There were three staff vacancies at the home at the time of our visit and plans were in place to recruit new staff to the vacant positions. New staff were provided with effective support when they first started work.
Staff understood their responsibilities to care for people effectively in line with their wishes. Records showed a programme of regular training supported staff to keep their skills and knowledge up to date. People thought staff had the skills and knowledge they needed to provide the care and support they required.
Staff assisted people to plan food menus and we saw a variety of foods which people enjoyed were available to them. Staff demonstrated a good understanding of people’s dietary needs.
The home had 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 home was last inspected on 26 August 2016. At that focused inspection we and rated the service 'Requires improvement ' in ‘Safe.’ We identified checks that took place in relation to the fire safety at the home did not occur at the frequency the registered provider had specified. Also, the way people’s medicines were managed was not consistently safe. We found during this visit the required improvements had been made.
A variety of effective systems were in place to monitor the quality of the home. Since our last inspection the frequency of the checks in relation to fire safety at the home had increased. This assured the provider people and the staff were kept as safe as possible if a fire was to occur. Staff had completed fire safety training to improve their understanding of fire safety. Improvements had also been made to the level of information recorded to inform staff and the emergency services of the support people required to evacuate the building safely.
Since our last inspection improvements had been made to how medicines including PRN medicines were managed and administered. The frequency of medicine checks had also increased. This meant people had received their medicines when they needed them. However, medication errors had occurred since our last inspection. Action had been taken to reduce the risk of further errors occurring; staff had also completed further training to increase their knowledge and confidence to administer medicines correctly.
People felt safe living at the home and procedures were in place to protect them from harm. Staff had competed safeguarding adults training and were knowledgeable about the risks associated with people's care. Records showed the management team knew how to correctly report safeguarding concerns which meant any allegations of abuse could be investigated.
Risk assessments and management plans were in place and contained clear guidance to support staff to manage risks. However, some staff felt under pressure as they had found dealing with recent incidents of challenging behaviour difficult.
The provider and the management team were aware of the challenges staff faced and had taken positive actions in an attempt to improve the wellbeing of the staff. Analysis of the incidents had been completed and the information was used was to hold 'behavioural workshops' with the staff which included new techniques and approaches they could use to support them to manage people's behaviour.
An out of office on- call system was in place which meant staff could speak with a member of the management team at this time if they needed support.
The home worked in partnership with local health and social care professionals. This meant people who lived at the home received the appropriate support to meet their needs.
People told us the staff were caring and we saw there was as relaxed atmosphere at the home. Staff knew the people they supported well and were responsive to their needs. People were offered choices and staff understood people’s different communication styles. The provider and the management team promoted equality land diversity at the home. We saw people’s right to privacy was respected by the staff team and people were supported to maintain their independence.
People had personalised care plans and had planned their care in partnership with the staff which met their personal goals and care needs. People were supported to take part in social activities which they enjoyed. People were encouraged to maintain relationships important to them and there were no restrictions on visiting times.
People knew how to make a complaint and told us they felt confident to make a complaint if they wanted to. Weekly meetings took place for people at the home to be involved in decisions about the home. Annual quality questionnaires were also sent to people to gather their views on the service. Action was taken if improvements were required.
People were happy with how the home was run. Overall, staff felt supported by their managers and we saw good communication between them and their managers during our visit. Staff confirmed they had opportunities to attend staff meetings and contribute their ideas to the running of the home. The provider had a system in place to identify good care and encourage all staff to develop their skills to improve the service.
The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Consent to care was sought in line with legislation and guidance. Mental capacity assessments had been completed and where people had been assessed as not having capacity, best interest decision meetings had taken place and the outcomes were clearly recorded.