Archived: 185 Herbert Road

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.