The inspection took place on the 11 and 15 December 2015. At our previous inspection on 11 April 2014 we found the provider was meeting regulations in relation to the outcomes we inspected. Talgarth Road is registered with the Care Quality Commission to provide care and accommodation for up to 10 people with mental health problems. The service was at full occupancy at the time of our inspection and the age group of people using the service ranged from adults in their 30’s through to their 70’s.
There are 10 single occupancy bedrooms, which do not have en-suite facilities. There are communal sitting rooms, a dining room, bathrooms and shower rooms. There is a garden at the rear of the premises. The building is three storeys and does not have a passenger lift.
There was a registered manager in post, who had worked at the service for several years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were not able to safely access support from the night time support worker because they could not reach the office. People told us they had to go into the rear garden and bang on a window or use their mobile telephone and ring for assistance.
We found that people had limited access to food during the night time and had to ask staff for access to some food items during the day if they wanted to make a nutritious snack.
Staff had received training about how to protect people from abuse and described how they would report any concerns. We observed areas of the premises that needed to be improved and saw that the provider had established a schedule of required improvements for the environment, which was taking place at the time of this inspection. The four care plans we looked at contained risk assessments, which showed that any risks to their safety and welfare had been assessed and planned for. There were sufficient staff to support people, however we observed that preparation for meal times was a busy time for staff and did not consistently involve people using the service. Medicines were stored, administered and disposed of safely. Staff undertook appropriate medicines training and could describe their duties in regard to the safe management of medicines.
Staff had regular supervision and training, including training about how to meet the needs of people with mental health difficulties. This meant that people were supported by staff with suitable knowledge and skills to meet their needs.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. We found that staff understood the provider’s policy and could explain how they protected people’s rights.
We saw that people had positive relationships with staff, who spoke with them in a kind and respectful manner. Relatives and health care professionals told us that staff were caring. People’s privacy was maintained, for example we saw staff knock on bedroom doors and await permission to enter and people were given their mail directly.
People using the service told us they were happy with their care and we received positive remarks from their families. Care plans reflected people’s needs as identified at their Care Planning Approach meetings and were up to date, although some people said they would like more support for working towards a more independent lifestyle. People were encouraged to get involved with the planning and reviewing of their goals, and relatives told us they were consulted about their family member’s care and support. People accessed community medical and healthcare facilities and staff attended appointments with them, if required.
People’s relatives told us they liked how the service was managed and they described the registered manager as being “a wonderful man” and “very caring”. We observed the registered manager interacting well with people who used the service and staff, and staff told us they felt properly supported by him. There were systems in place for the ongoing monitoring of the quality and effectiveness of the service. However, this monitoring was not consistently effective.
We found two breaches of regulations relating to the safety and suitability of the premises and nutrition. You can see what actions we told the provider to take at the back of the full version of this report.