The inspection of The Conkers took place on 18 September 2017 and on 4 October 2017. We previously inspected the service on 26 March 2015 and was rated Good overall and in all five domains.The Conkers is registered to provide accommodation and personal care for up to seven people with learning disabilities and other complex health needs. The home is a one storey, purpose-built building with a separate garden. There are private bedrooms with en-suite facilities, a communal lounge, a sensory/small lounge room, a communal kitchen/dining room, a communal bathroom and a separate laundry/domestic room. There were seven people living at the home at the time of this inspection.
The home had a registered manager in place. 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.
During this inspection, we identified that the service was breaching regulations related with safe care and treatment. The medicine room was not secure and there were inaccuracies in the transcribing of how medicines should be taken in the medicine management records. Controlled drugs were not overseen in line with organisational policy.
Staff had been recruited safely and there were sufficient numbers of staff employed to keep people safe.
Risks had been assessed relating to social and leisure activities. Measures had been introduced to reduce risks and to enable people to be as independent as possible.
Regular safety assessments by competent people had been carried out such as those relating to gas, electric, water safety, hoist and sling use.
Staff had received induction and mandatory training. There were outstanding requirements for annual staff update training and the staff training matrix was not up to date.
Staff received regular appraisals and supervision.
Staff demonstrated a thorough understanding of the Mental Capacity Act 2005. Mental capacity assessments had been completed for people who lacked capacity to make decisions and choices.
People were supported with their nutrition and hydration needs. Electronic equipment was used to help support people to choose their meals. It was observed that meal times were a pleasant and enjoyable experience for people.
We saw staff were passionate about providing a supportive environment and were knowledgeable with regards to people’s individual requirements.
Relatives were involved with changes to people’s care and were kept up to date.
Daily record folders containing private and confidential information were kept in the communal area and not secured.
Care plans included a person centred life plan which detailed people’s likes and dislikes, personal routines and mobility capabilities. Staff were very skilled in supporting people to maintain their independence by being knowledgeable about a person’s need.
Regular audits took place within the home although issues with the medicines management had not been picked up by these quality processes.
Staff knew their duties and roles in caring for people and felt supported by their manager.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.