Archived: 185 Herbert Road

Updated 24 November 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.

This inspection took place on 18 and 19 September 2018 and was unannounced. One inspector and an inspection manager inspected on the 18 September 2018. The inspector returned to the service on 19 September April 2018 to complete the inspection.

Before the inspection we looked at all the information we held about the service. This information included the statutory notifications that the service sent to the Care Quality Commission. A notification is information about important events that the service is required to send us by law. The provider had completed a Provider Information Return (PIR). 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. We also contacted the commissioners and the local authority safeguarding team for their feedback about the service. We used this information to help inform our inspection planning.

During our inspection we spent time observing the support being provided to people. We spoke with two members of staff, the service manager, the area manager, and the head of operation. We looked at two people’s care records and four staff records. We also looked at records related to the management of the service such as the administration of medicines, accidents and incidents reports, Deprivation of Liberty Safeguards (DoLS) authorisations, health and safety records, and the provider’s policies and procedures.

Updated 24 November 2018

This inspection took place on 18 and 19 September 2018 and was unannounced.

185 Herbert Road is a care home, provides accommodation for people who require nursing or personal care for up to three adults who have a range of needs including learning disabilities. At the time of the inspection the home was providing care and support to three people.

185 Herbert Road is managed by the provider, Medstar Domiciliary Care Services Limited, since its registration in September 2017. This is their first inspection.

The service did not have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 current manager told us that the previous registered manager left the service in April 2018, and that they joined the service as a manager, two months before our inspection. The head of operations said that the current manager, is in the process of making an application to CQC to become a registered manager. However, their application was not received at CQC.

We found four breaches of the fundamental standards and regulations. The care service has been fully 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. The premises were not safe. The fire alarm and the fire doors did not confirm to the fire safety standards, sofa in the communal area was not fire rated and the emergency lighting was insufficient. The service was not free from offensive odours. The provider did not manage accidents and incidents effectively to reduce the possibility of reoccurrence. Medicines were not managed safely. The decoration and other adaptations to the premises did not help to meet people’s needs. The provider’s quality assurance system and process to assess and monitor the quality of the care people received were not effective. The provider had not notified CQC where Deprivation of Liberty Safeguards (DoLS) had been authorised for people as required, so that where needed, CQC can take follow-up action.

You can see what action we told the provider to take at the back of the full version of the report.

The service had clear procedures to support staff to recognise and respond to abuse. The manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks.

The provider carried out comprehensive background checks of staff before they started working and there were enough staff to support to people. The service had arrangements to deal with emergencies.

The provider trained staff to support people and meet their needs. The provider supported staff through regular supervision and appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff understood their responsibility under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff assessed people’s nutritional needs and supported them to maintain a balanced diet. Staff supported people to access the healthcare services they required, and monitored their healthcare appointments. The manager and staff liaised with external health and social care professionals to meet people’s needs.

Staff involved health and social care professionals and relatives where appropriate in the assessment. However, Health and social care professionals Staff considered people’s choices, health and social care needs, and their general wellbeing. However, there was no evidence to suggest that people with profound needs were involved in their care planning and review process and this required improvement.

Staff supported people in a way which was kind, caring, and respectful. However, comments from staff that were not respectful and this required improvement. Staff protected people’s privacy and dignity.

People were supported to maintain relationships with people that mattered to them. People's needs were reviewed and monitored on a regular basis. The provider had a policy and procedure about managing complaints and to provide end-of-life support to people. Staff felt supported by the manager. The service worked effectively with health and social care professionals, and commissioners.