Archived: Coriander Road

Some areas of the service were not well maintained. Some of the kitchen flooring was perforated and there were areas of unpainted wood that could allow a transfer of infection. Equipment in the laundry required the plinths to be repaired or replaced as the boarding had started to wear away and could also allow the transfer of infection. There was similar boarding in the bathroom which also required attention.

This compromised infection control measures and the effectiveness of cleaning, which meant this could contribute to the spread of infection to people and staff.

Quality assurance audits undertaken by the provider, were not effective in identifying the shortfalls found during the inspection.

We found the following examples of good practice.

¿ The provider had ensured continual supplies of personal protective equipment (PPE). This included face masks and aprons and we saw staff used these appropriately. Staff were encouraged to change their PPE regularly.

¿ Used PPE was disposed of in foot operated pedal bins situated throughout the home. This reduced the potential for transfer of infection.

¿ Staff encouraged people to wash their hands frequently throughout the day. Where this was not possible, hand sanitiser was offered as a means to reduce the transfer of infection.

¿ The provider participated in regular COVID-19 testing of people living in the service and staff. That ensured action could be taken swiftly to reduce the potential spread of infection if a positive test was returned.

¿ Areas were cleaned and disinfected with cleaning products approved to reduce the potential transfer of infection.

¿ Risk assessments had been completed to protect people and any staff who may be at a higher risk of contracting COVID-19, measures were in place to support them.

¿ Staff worked in set teams which lessened the potential of cross infection within shift members.

Further information is in the detailed findings below.

25 -27 Coriander Road is a residential care home providing personal care to three people with a learning disability and/or autism spectrum disorder. People are accommodated in two semi-detached houses. The service can support up to four people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were safe, risks were assessed, monitored and well managed. Staff knew how to report concerns when people’s safety and wellbeing was at risk. Staffing levels met people’s personalised care needs. Staff followed good practice guidelines to prevent the spread of infection and the home was clean and tidy. People’s medicines were managed safely.

People’s dietary needs were met, and healthy eating was promoted. Staff ensured people's healthcare needs were met. Staff were alert and responsive to any changes in people's needs and liaised with health care professionals. Staff received an induction before they started work with the service and felt well supported by the management team. Continued professional development for staff was promoted and encouraged by the registered manager.

People were supported by staff who knew them well. Care was personalised according to people's support needs and preferences. People’s independence and social engagement was promoted. Staff supported people to take part in activities and hobbies of their choice. Staff supported people to maintain relationships with family and friends. Staff spoke with pride about supporting people to live fulfilling lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The manager and area manager completed audits to monitor the quality of the service. The service put improvements in place if these audits proved not to be effective. People, relatives and staff were supported to feedback about the service and the service linked and worked well with other organisations. The manager and area manager promoted a positive culture and were passionate about continuing to improve the experience for people using the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 31 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Coriander Road is registered to provide accommodation and personal care for up to four people with learning disabilities. On the day of our inspection there were three people using the service.

At the last Care Quality Commission (CQC) inspection on 2 September 2015, the service was rated Good in all domains.

At this inspection we found the service remained Good.

People were protected from harm and staff were clear of their role to keep people safe and protect them from harm. There were enough staff to meet people’s needs. The provider followed safe recruitment practices.

Risks associated with people’s care needs and the environment had been assessed and measures put in place to prevent avoidable harm.

People received their medicines as required and medicines were managed and administered safely.

Staff had received training, support and guidance to meet the needs of the people who used the service.

People were supported in line with the requirements of the Mental Capacity Act. People’s mental capacity to consent to their care had been assessed where there was a reasonable belief that they may not be able to make a specific decision.

Systems were in place to monitor the health and wellbeing of people who used the service. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have enough to eat and drink. Where people had dietary requirements, these were met and staff understood how to provide these.

Staff had a clear understanding of their role and how to support people who used the service as individuals. Staff knew people well and treated them with kindness and compassion. People’s dignity was maintained and promoted.

People’s independence was promoted. Staff communicated with people in a way that maximised their understanding and aided them to make choices.

People were supported to follow their interests and engage in activities that they enjoyed and were meaningful to them.

Staff felt supported by the registered manager. The registered manager supervised staff and regularly checked their competency to carry out their role.

There were a range of audit systems in place to measure the quality and care delivered so that improvements could be made.

The registered manager was aware of their responsibility to report events that occurred within the service to CQC and external agencies.

Our inspection of 23 September 2013 found that people were not always protected against the risks associated with medicines. At this inspection we found that sufficient improvements had been made to achieve compliance with the regulation.

Our inspection of 23 May 2013 found that people were not protected against the risks associated with the unsafe use and management of medicines. This was because the home had not kept complete records about the amount of medication that was kept on the premises.

At this inspection we found the service had taken action to record the amount of medication. However we found discrepancies within these records. In addition, we found that a medication error had not been dealt with appropriately. This meant that people were not protected from the risks associated with medicines

We did speak with the relative of one person who used the service. They told us 'they make sure [the persons'] got a good life'.

We spoke with a support worker and found they had a good understanding of the needs of people who used the service and were enthusiastic about their role.

We looked at the support plans and records of two people who used the service and found support plans were detailed and thorough and provided clear guidance to staff about how the persons' care should be delivered. Staff were aware of consent and capacity issues which meant that people's legal rights were upheld.

People were not protected against the risks associated with the unsafe use and management of medicines. This was because the home had not kept complete records about the amount of medication that was kept on the premises.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people and received training appropriate for their role.

Records were stored securely and could be located promptly when required.

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Please see our previous report for further details and for information on people's experiences of using the service.

At this inspection we found that the provider had made the necessary improvements to become compliant with this standard.