Background to this inspection
Updated
22 November 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 one inspector.
Service and service type
1 Hamilton Road is a 'care home'. People in care homes receive accommodation and their care as a 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
This inspection was unannounced.
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 met one of the people using the service. Neither person was able to tell us about their experience of the care provided. We spoke with six members of staff including the registered manager, service manager, team leader, two care and support workers, and an administration member of staff. We spoke with an independent advocate who was visiting a person using the service.
We reviewed a range of records. This included both people’s care records and medication records. We looked at staff records in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from two professionals who regularly visit the service.
Updated
22 November 2019
About the service
1 Hamilton Road is a residential care home providing personal care and support for up to two adults who have complex support needs including learning disabilities and / or autism. The home accommodates two people in one adapted building, each person having a separate flat with adapted facilities.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
There were a range of systems in place to assess and monitor the quality and safety of the service. However, these had not always been effective in mitigating identified risks. Safeguarding and staff recruitment processes were not as effective and robust as they should be.
There was a positive, inclusive culture and ethos within the service. The registered manager and staff engaged well with people using the service, their relatives, and external stakeholders.
Staff we spoke with were friendly and caring and treated people with respect.
People’s medicines were stored and well managed to ensure their safe and proper use.
People’s needs were assessed and care and support plans were person-centred and reviewed.
Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.
Records showed people received regular and on-going health checks and support to attend appointments. People's health care needs were monitored and any changes in their health or well-being prompted a referral to their GP or other health care professionals.
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.
Staff demonstrated a good knowledge of people’s individual needs and preferences regarding their support. People were supported and encouraged to be involved in making decisions about their care and support.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 18 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection significant improvement had been made but had not been sustained in all areas and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.