Flora Innes House

Updated 22 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 unannounced comprehensive inspection took place on 19 January 2018 by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We contacted the social care commissioners who monitor the care and support of people living at Flora Innes House who told us they had no concerns. We checked the information we held about the service including statutory notifications. A notification is information about important events which the provider is required to send us by law.

During this inspection we met six people using the service and spoke with four people, and five relatives. Two people were not able to communicate clearly using speech, we spent time observing their care and how staff interacted with them. We also spoke with eight members of staff including a member of the board, the registered manager, the assistant manager, another registered manager working for the provider and four care staff.

We looked at the care records for two people who used the service and seven medicines records. We also examined other records relating to the management and running of the service. These included three staff recruitment files, training records, supervisions and appraisals. We looked at the staff rotas, complaints, incidents and accident reports and quality monitoring audits.

Updated 22 March 2018

This inspection took place on 19 January 2018 and was unannounced.

This was the second comprehensive inspection carried out at Flora Innes House. The last comprehensive inspection was 8 October 2015 where we rated the service as Good. The overall rating for this inspection was also Good, however, there were areas that required improvement in the Well Led domain.

Flora Innes House is a care home for adults with learning disabilities. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Flora Innes House does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Flora Innes House accommodates up to nine people in one building. On the day of our visit, there were nine people using the service.

The service had a 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 and associated Regulations about how the service is run.

The provider did not always enable the registered manager the autonomy they required to assess, monitor the service or make changes in a timely way. Some areas of the service required more frequent quality monitoring to identify issues. The registered manager implemented more frequent systems during the inspection however we have been unable to assess these systems for effectiveness.

The provider had recognised that the aging and changing needs of people using the service meant that the existing environment, activities and working practices would need to be updated to meet people’s needs. Although this had been discussed at board level actions had not yet been implemented to accommodate everyone’s future needs.

There was a strong sense of belonging shared by staff and people using the service. All staff believed in the ethos of the service of providing care that was inspired by the principles of Austrian philosopher, Rudolf Steiner.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place and were reviewed regularly; people received their care as planned to mitigate their assessed risks.

Staffing levels ensured that people's care and support needs were safely met. Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

People were supported to express themselves, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred.

People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

We made a recommendation that the provider refers to research and guidelines on providing residential and supported living for adults with learning disabilities.