Background to this inspection
Updated
1 May 2018
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 service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 14 March 2018 and was unannounced. The inspection team consisted of two inspectors.
People could not communicate verbally with us so we observed care and support for extended periods in the home. We spoke with two relatives in the home and contacted a further three by telephone after the inspection visit. We also spoke with the area manager, deputy manager, registered nurse and five support workers. The registered manager was absent on the day of the inspection but we telephoned them afterwards to ask them further questions to help us make a judgement about the quality of the service provided.
We observed care and support, including the mealtime experience and looked around the home. We looked at three people’s care records and other records such as medication records, meeting notes, accident and incident reports, training records and maintenance records.
Before visiting the home we reviewed the information we held about the service which included notifications sent to us by the provider. We contacted the local authority commissioning and safeguarding teams to ask for their views of the service. We spoke with one health professional who works with the service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
Updated
1 May 2018
The inspection took place on 14 March 2018 and was unannounced. This was the service’s first inspection since the care provider changed in 2016. Turning Point – West Lane 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.
Turning Point – West Lane accommodates 12 people in one adapted building. The building is split into two units, each accommodating six people. On the day of the inspection 12 people were living in the home.
The service was currently transitioning from a nursing home to a supported living model of care. This demonstrated the service was being developed and redesigned 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.
A registered manager was in place. 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.
Overall, people were protected from abuse living in the home. Systems were in place in order for concerns to be raised and investigated to help keep people safe. We made a recommendation regarding the creation of personal spending plans to help ensure there was a clear evidence that spending decisions were made in people’s best interests.
Risks to people’s health and safety were assessed and clear and detailed care plans created to help ensure staff provided safe care. Staff were knowledgeable about the people they supported and how to keep them safe. Incidents and accidents were reported, investigated and lessons learnt to improve safety.
People received their medicines when they needed them and appropriate records were kept to demonstrate safe systems were in place.
The premises was clean and tidy and suitable for its intended purpose. The building was well maintained.
There were enough staff deployed to ensure people received timely support. Staff were recruited safely to help ensure they were of suitable character to work with vulnerable people. Staff received a range of training and support relevant to their role, caring for people with learning disabilities.
People’s nutritional needs were assessed and plans of care put in place to help ensure their needs were met. People had access to a range of food and drink in line with their preferences and needs.
The service was compliant with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, the principals of the Mental Capacity Act (MCA) were followed and decisions were made in people’s best interests. The service involved people in decision making to the maximum extent possible.
The service worked with a range of health professionals to help ensure people’s healthcare needs were met. Technology was used by the service to help meet people’s needs.
Staff were kind and caring and treated people with a high level of dignity and respect. Staff knew people well and were dedicated in providing personalised care and support.
Staff used individual techniques to communicate with people. This included interpreting body language and using pictures to help people make choices.
People’s care needs were assessed and a range of clear and person centred care plans put in place. These were regularly reviewed to ensure people’s support goals were current and relevant.
People received a good range of activities which met their individual needs and preferences. People’s feedback about activities was regularly sought.
A system was in place to log, record and learn from any complaints received about the service.
We found a visible and person centred culture within the home, with staff dedicated to ensuring people’s support needs were met. Staff worked well together and we found a pleasant atmosphere within the home.
A range of checks were undertaken by the service to ensure it was operating to a high standard. The findings of these checks were used to make further improvements to the service.
The service utilised internal and external specialists to ensure that they kept up-to-date with the latest best practice guidance. This helped ensure effective and appropriate support was provided.