Next Steps Mental Health Levensulme

Updated 23 January 2019

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 4 December 2018. We gave the service 24 hours’ notice of the inspection visit because it is a small home supporting people with mental health issues. We needed to be sure someone would be in and to give the home time to inform and support people before our visit. One inspector completed the inspection.

Before our inspection the provider completed a provider information return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we held about the service. We looked at the statutory notifications the home had sent us. A statutory notification is information about important events, which the provider is required to send to us by law.

We contacted the local authority safeguarding and commissioning teams. The feedback we received was positive about the service. We also contacted Manchester Healthwatch who did not have any information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection we spoke with four people who used the service and observed people and staff interactions in communal areas of the home. We also spoke with three members of care staff, the registered manager and the two directors of the provider.

We looked at records relating to the management of the service such as the staffing rotas, policies, incident and accident records, three staff recruitment files, training records, two care files, meeting minutes and auditing systems.

Updated 23 January 2019

This inspection took place on 4 December 2018. This was the first inspection of Next Steps Mental Health Levensulme (known as Next Steps) since first registering with the Care Quality Commission (CQC) in December 2017.

Next Steps 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.

Next Steps is registered for up to five people with mental health needs. The house has a shared lounge, dining room, bathroom and kitchen. Each person has their own bedroom. There were five people living at the home at the time of our inspection, with one person being short term whilst a more independent supported living home was identified.

The service has been 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 living at Next Steps can live as ordinary a life as any citizen.

The service had two managers registered with the CQC. One registered manager was one of the directors who had set up the home and one had been registered since to manage the home on a day to day basis. A registered manager is a person who has registered with the 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.

Clear, person centred care plans and risk assessments were in place to identify people’s needs and provide guidance for staff in how to support people to meet these needs. Care plans gave details about people’s mental health needs and provided strategies and distraction techniques for each person. People were supported to take positive risks where appropriate and to increase their independence. Care plans and risk assessments were regularly reviewed to ensure they were current.

People were involved in agreeing their care and support. They met with their key worker each month to discuss their support and what they were happy or unhappy with. Goals were agreed and reviewed.

The service was working within the principles of the Mental Capacity Act (2005). Capacity assessments and best interest decision meetings were seen in people’s care files.

Staff were knowledgeable about people’s needs and how to support them to minimise their anxiety levels. Staff told us they enjoyed working at the service and felt well supported by the registered manager, nurses and directors. Regular supervisions and team meetings were held.

Staff received the training they needed to fulfil their role. Training courses were used alongside micro-teach sessions within supervisions and team days to discuss the support strategies being used.

There were sufficient staff on duty to meet people’s assessed needs. A recruitment system was in place to ensure staff were suitable for working with vulnerable people.

People were supported to access their local community and to maintain their independence where possible. They were encouraged to complete any tasks they could do for themselves.

People’s health, nutritional and dietary needs were being met by the service. Other professionals, for example psychiatry services, were involved in supporting people and the service where needed.

A quality assurance system was in place at the service. The registered manager and directors completed checks for medicines, finances, care plans, the environment and health and safety.

All incidents were reviewed by the manager to identify any patterns in the incidents. Where applicable following serious incidents de-brief meetings were held with the staff involved to review the incident and to review how people were supported to try to reduce the risk of further incidents occurring.

Medicines were administered as prescribed. The director introduced a separate chart for staff to record when they had applied any prescribed topical creams. Protocols were in place for the use of medicines that were not administered regularly, although some required more detail of the signs that the person needed the as required medicine to be administered.

The service sought the views of the staff and relatives through annual surveys. The staff survey responses had been positive and the registered manager had followed up any comments made in the survey. Regular residents’ meetings were held.

The home was visibly clean with no malodours. Equipment was maintained in line with national guidelines.