463

Updated 3 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

463 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, nurse, support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people’s care and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with two relatives following the inspection for their feedback on the support provided by the service.

Updated 3 October 2019

About the service

463 is a small residential home providing personal and nursing care to seven young adults who have a life limiting condition. 463 is a fully adapted home in a residential area of Manchester.

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

People said they enjoyed living at 463 and they felt safe. They said the staff were supportive, kind and respectful. Relatives were also positive about the support their relative received.

People were supported to maintain their health and nutrition. Clear information about people’s health conditions and guidance for staff to follow if they became unwell was included in the care files. Referrals were made to medical professionals when required. People received their medicines as prescribed.

Staff knew where people required a modified diet; however, they did not always record when they added a thickener to fluids to reduce the risk of choking. A record form was implemented for thickeners following our inspection.

People’s support needs and any potential risks were assessed and guidance provided on how to support people and manage the known risks. People had the support they needed and were encouraged to be independent in the tasks they could do for themselves.

Where required, people’s communication needs were assessed and communication passports were in place to identify the potential meanings of the vocalisations and gestures used.

Staff were safely recruited and received the training and support to undertake their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People said staff offered them advice and then they were able to make their own choices.

The registered manager had oversight of the service through a combination being visible, speaking with people and staff, checking paperwork weekly or monthly and annual audits for medicines and infection control.

Incidents were recorded and reviewed to ensure actions had been taken to reduce the risk of a re-occurrence.

People continued to access 463’s sister organisation, Francis House Children’s Hospice for respite care. Trained staff at the hospice supported people in making advanced decisions for the end of their life; however, this information was not available for the staff team at 463.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 25 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.