This unannounced inspection of Applelea took place on 11 December 2015. The home provides accommodation and support for up to four people who have learning disabilities or autism. The primary aim at Applelea is to support people to lead a full and active life within their local community and continue with life-long learning and personal development. The home is a detached house, within a residential area, which has been furnished to meet individual needs.
At the time of the inspection there were four people living in the home. People had their own en-suite bedrooms which had been specially adapted to meet their needs. Since our last inspection a conservatory had been added to provide a sensory room and space if people wished peace and quiet or somewhere to calm their anxieties. There was a large rear garden with an extensive lawn to which people had constant access.
The service had a registered manager. 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.
Relatives and an advocate told us staff always provided reassurance when people were anxious and made them feel safe. Staff had completed safeguarding training and had access to current legislation and guidance. Staff had identified and responded appropriately to safeguarding incidents to protect people from harm. People were safeguarded from the risk of abuse as incidents were reported and acted upon.
Risks to people had been identified in their care plans and measures were implemented to manage these safely. Staff were able to demonstrate their understanding of the risks to people’s health and welfare, and followed guidance to manage them safely. People were kept safe by staff who understood people’s risk assessments and management plans.
During our inspection we saw there were enough staff to respond immediately when people required their support. Staff had time to devote their full attention to people and focus on their individual needs. There were sufficient numbers of staff deployed with the necessary experience and skills to support people safely.
Staff completed an induction course based on nationally recognised standards and spent time working with experienced staff. This ensured they had the appropriate knowledge and skills to support people effectively. Staff had undergone required pre-employment checks, to ensure people were protected from the risk of being supported by unsuitable staff.
Medicines were administered safely in a way people preferred, by trained staff who had their competency regularly assessed by the provider. The registered manager reinforced this training by discussing issues related to the safe management of medicines during all staff supervisions. Medicines were stored and disposed of safely, in accordance with current legislation and guidance.
People and their relatives and advocates told us they were actively involved in making decisions about their care. Staff supported people to identify their individual wishes and needs by using their individual methods of communication. People were encouraged to make their own decisions and to be as independent as they were able to be.
Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. The MCA 2005 legislation provides a legal framework that sets out how to support people who do not have capacity to make a specific decision. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made on their behalf.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide a lawful way to deprive someone of their liberty, where it is in their best interests or is necessary to protect them from harm. The registered manager had completed the required training and was aware of relevant case law. Since the last inspection the provider had made four DoLS applications. The registered manager had taken the necessary action to ensure people’s human rights were recognised and protected.
People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice. Where people had been identified to be at risk of choking staff supported them discreetly to minimise such risks, protecting them from harm and promoting their dignity.
People’s dignity and privacy were respected and supported by staff at all times. Staff referred people to relevant healthcare services promptly when people’s assessed needs changed.
The provider had deployed sufficient staff to provide stimulating activities for people. The activities programme ensured people were supported to pursue social activities which protected them from social isolation.
Relatives told us they had no reason to complain but knew how to do so if required and that the staff r encouraged them to raise concerns. Two complaints had been made since the last inspection which had been dealt with in accordance with the provider’s policy. The registered manager listened to people’s comments and implemented identified learning from incidents and accidents.
Staff understood the values of the provider, which we observed being demonstrated in practice. The senior staff provided clear and direct leadership and effectively operated systems to assure the quality of the home and drive improvements.
Records accurately reflected people’s needs and were up to date. Staff were provided with necessary information and guidance contained in detailed care plans and risk assessments to meet people’s needs. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons.