Archived: The Octagon

The Octagon provides accommodation for people requiring personal care who have a learning disability. At the time of this inspection the service was providing accommodation and personal care to six people with learning disabilities and other complex needs.

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.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests.

People's experience of using this service:

People were safe and supported by a staff team who knew them well. Staff were able to recognise potential signs of abuse and the registered manager was aware of the process to follow should an allegation be made. People received appropriate support to receive their medicines when they needed them. Risks to people were assessed and plans were in place to help keep people safe.

People were protected from the risks associated with the control and spread of infection and the accommodation was suitable to provide a homely environment.

Staff understood, and protected people's rights and people were treated as individuals. People were encouraged to be as independent as they were able. Staff worked effectively with health and social care professionals to ensure people’s needs were met.

People had opportunities to engage in activities that were of interest to them.

There were enough staff to meet people’s needs. Staff were well supported and well trained. People told us that staff were kind and people were supported with respect and understanding.

There was a complaints procedure in place which was also available in an easy read format. Staff knew people well, meaning they could tell when someone was unhappy or uncomfortable.

Regular audits of the service showed people received good outcomes and a safe and well managed service. The management team were approachable and proactive to ensure the service met the needs of the people they supported. The service had good community links that promoted inclusion.

Rating at last inspection:

The service was rated Good at the last inspection in November 2016 (published January 2017).

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Octagon on our website at www.cqc.org.uk.

The Octagon provides accommodation for people requiring personal care who may have a learning disability. At the time of the inspection there were 6 people living at the service.

There was a registered manager in post. 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.

People were supported by a staff team who knew how to keep people safe from the risk of harm and abuse. People were kept safe as potential risks had been assessed and staff were working in ways to reduce these risks. People were supported by sufficient numbers of staff who had been recruited safely. People received their medicines as prescribed from suitably trained staff.

People received care and support from an appropriately trained staff team. People were asked for their consent to care and support and the principles of the Mental Capacity Act 2005 were followed. People’s capacity was being assessed where appropriate, and where required, decisions were being made in the best interests of people.

People were provided with the appropriate support to eat and drink and were offered choices. People were supported by staff who understood and catered for their specific dietary needs.

People were supported to maintain their health and staff appropriately sought healthcare professional’s advice where there were concerns about people’s health and wellbeing.

People were treated with kindness and respect. People’s privacy, dignity and independence was promoted and people were supported to maintain relationships that were important to them.

People’s individual care needs and preferences were understood and met. Staff knew people’s care needs well and supported them appropriately. People and their relatives were involved in the planning and review of their care. The provider had a complaints process in place to ensure complaints were appropriately investigated.

The management of the service had been inconsistent and as such staff did not always feel supported or well communicated with, and there was low staff morale.

People and their relatives were provided with opportunities to give feedback on the service. The registered manager had systems and processes in place to monitor and analyse the quality of the service, and they used information from quality checks to drive improvement.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

Safeguarding procedures were in place. Staff and managers were aware of how to safeguard people and the actions they should take if they had any concerns.

Some people could not make complex decisions about their care. Multi-disciplinary meetings were held to make decisions about people's care. This made sure that actions were taken in a person's best interest and their rights were upheld.

The service had a risk management system in place. This made sure that people still had choices about their lifestyle but were not placed at unnecessary risk.

The provider had a recruitment process that made sure staff were appropriate to work with people and that they received induction training to provide care in a safe way.

Is the service effective?

Plans of care were in place that identified people's needs. Some elements of the plans of care were not up to date due to people's rapidly changing needs. This had not impacted on people's care as staff knew people well and liaised closely together to ensure that care remained appropriate and met people's needs.

Staff took account of people's wishes and their previous lifestyle to ensure that care was provided in the way people preferred.

Is the service caring?

When we spoke with staff it was very clear that they genuinely cared for the people they supported. Some staff had worked with people for many years and were very keen to provide care in the way they wanted and to improve their quality of life.

People's preferences and lifestyle wishes were recorded and acted upon. If people had spiritual needs the staff ensured these were responded to.

Comments from relatives included: 'The staff are very good with my relative. They are wonderful' and '[The staff] do a marvellous job'.

Relatives had the opportunity to complete an annual satisfaction survey. People who received the service could take part in regular meetings. Where improvements or omissions to the service were identified these were acted upon.

Is the service responsive?

People who received a service were given an easy read complaints procedure. This was not provided to relatives and the manager told us they would ensure a copy was provided. Complaints and concerns made to the manager were acted upon promptly. A complaint made directly to the provider had not been dealt with promptly although action was taken locally by the service.

Is the service well led?

Relatives and professionals had seen good improvements in the service since the current managers had worked at the service.

The service had a number of quality assurance processes to monitor and check the service. Action was taken when shortfalls were found although these were not always fully recorded. The checks and audits in place had led to an improvement in the quality of care people received.