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.