Archived: 136 Warminster Road - SHSC Respite Service

An unannounced inspection visit to Warminster Road took place on 13 November 2014.

Warminster Road provides short stay respite accommodation for adults with learning difficulties. The service has five registered beds. Two beds are located in ‘136a Warminster Road’ which is a detached house. The remaining three beds are located within ‘House 3’ which is within a shared, on-site, neighbouring property.

The service was last inspected by the Care Quality Commission (CQC) in February 2014 and was found to be meeting regulations relating to consent to care and treatment, care and welfare of people who use services, staffing, assessing and monitoring the quality of service provision and complaints.

As well as speaking with each person using the service, we also undertook a number of informal observations in order to see how staff interacted with people and see how care was provided. This was because some people accessing the service had communication difficulties and were not always able to verbally communicate their experience of the service to us. We also telephoned the relatives of four people on 14 and 17 November 2014 in order to gain their views about the service.

During our inspection visit we spoke with the team leader and with the registered manager. 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. We spoke with four support workers by telephone on 14 November 2014.

Our inspection identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report

Our check of medication records identified that medicines were not always safely managed and recorded. This meant that people accessing the service may not be protected against the risks associated with the unsafe management of medication.

Our review care plans highlighted some gaps and inconsistencies about records at Warminster Road. Our findings made it difficult to establish whether some plans were current and accurately reflected people’s needs. Whilst there was no evidence to suggest that these shortfalls had negatively impacted upon people, the lack of information, review and recording within some key documents meant that people may not be protected against the risks of receiving inappropriate care and treatment.

Whilst detailed checks took place in relation to health and safety and the premises, we identified that audits relating to key areas of practice did not take place. For example, the shortfalls identified during our inspection in relation to medicines and records had not been identified or highlighted by an internal auditing system.

Observations throughout our inspection demonstrated that people were supported safely by staff who knew their individual needs and preferences. Conversations with staff and our observations showed us that staff offered and involved people in a range of day to day decisions and adapted the way they communicated to meet the needs of the person they were supporting. People were treated with dignity and respect throughout our inspection and staff were aware of people’s differing cultural and religious needs.

Relatives we contacted following our inspection were confident that their family members were safe when staying at Warminster Road. Our conversations with staff and our review of records demonstrated that staff identified safeguarding issues and followed local procedures in order to safeguard people. Appropriate systems were in place to safeguard and manage people‘s finances.

Staff were appropriately vetted to ensure they were suitable to work with vulnerable adults before starting work. There were enough staff to safely meet people’s needs in a timely manner. Staff had appropriate qualifications, knowledge and skills to perform their roles and there were systems and opportunities for staff to develop their skills and discuss good practice.

People were appropriately supported to make decisions in accordance with the Mental Capacity Act, 2005 (MCA). Whilst the manager had an understanding of the MCA and Deprivation of Liberty Safeguards (DoLS), some members of staff could not consistently demonstrate an understanding of these pieces of legislation and how they applied in practice.

Our observations of a meal time and our review of records evidenced that people’s nutritional needs were met. People’s physical health needs were monitored and referrals were made when needed to health professionals. Staff also supported people to attend and access health and medical appointments when needed.

People were supported to maintain contact with their family members and to access existing day time and evening activities during respite stays at Warminster Road. The service had an open and transparent culture that actively encouraged feedback from people who used the service, their relatives and staff.