This inspection took place on 29 January 2015 and was unannounced.
During our last inspection of Mosaic House on 29 July 2013 we found no breaches of the regulations assessed.
Mosaic House is a home situated in North Wembley and is registered to provide accommodation and personal care to five people who have mental health needs. At the time of our inspection the home had no vacancies. The registered provider was also the registered manager, as they had previously provided direct management to the home. However, at the time of our inspection a new manager had been appointed and they were undergoing the process of becoming the registered manager for the home. 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 2008 and associated Regulations about how the service is run.
People we spoke with told us that they felt safe living at the home. They were positive about the care that they received and told us that staff members respected their privacy and dignity.
People were protected from the risk of abuse. The provider had taken reasonable steps to identify potential areas of concern and prevent abuse from happening. Staff members demonstrated that they understood how to safeguard the people whom they were supporting. People living at Mosaic House told us that they felt safe.
Written risk assessments were in place for people living at Mosaic House. These were up to date and reflected identified needs.
Medicines at the home were well managed and people told us that they received these on time.
The physical environment at the home was suitable for the people who lived there and was clean and well maintained. Regular safety checks took place and we saw that these were up to date.
Staff recruitment processes were in place to ensure that workers employed at the home were suitable. Staffing rotas met the current support needs of people, and we saw that additional staff were provided to support activities where required.
Staff members received regular supervision, team meetings took place each month, and staff felt that they were well supported.
People’s dietary needs were met by the home, and there was evidence that people were enabled to make choices about the food and drink that they received.
Other health and social care professionals were involved with people’s treatment and support.
Quality assurance monitoring took place regularly and records of this were in place. Policies and procedures were in place that generally met requirements. However, we did not see a policy in respect of the Mental Capacity Act, although there was one in relation to Deprivation of Liberty that required updating to encompass recent guidance.
There was limited evidence to show that people who used the service had been involved in making decisions about their care. Care documents were not always signed to show consent, and some people told us that they had not been involved in the process. We discussed our concerns with the manager and were assured that this would be addressed.
Staff training was generally good and met national standards for staff working in social care organisations. A number of staff members had achieved a relevant qualification. However, Mental Capacity Act training had not been updated to reflect recent developments to the Deprivation of Liberty Safeguards.
We have made a recommendation about staff training on The Mental Capacity Act and Deprivation of Liberty Safeguards.
The care plans maintained by the home lacked detail about people’s needs and did not provide guidance in respect of how support should be provided by staff.
The new manager told us that they had already identified some of our concerns, and we saw evidence that these had been discussed with staff and that action had commenced to improve the quality of care plans.
We have made a recommendation about the development of care plans.