We carried out this inspection of Edgar Street Residential Home on 30 June and 1 July 2015. The inspection was unannounced on the first day. Edgar Street provides accommodation and personal care for six adults with learning disabilities. The service does not provide nursing care. At the time of the inspection there were six people accommodated in the home.
Edgar Street is a semi-detached domestic style house in a residential area on the outskirts of Accrington. It is in close to local amenities and the town's amenities are within easy reach with a bus route and rail transport near to the home. Accommodation is in single occupancy bedrooms. There is a patio and garden for the residents' use.
At the previous inspection on 01 August 2013 we found the service was meeting all the regulations we looked at.
There was a registered manager in day to day charge of 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 told us they felt safe. They had been guided on how to keep safe when they were out and about in the community and what they should do if they did not like how they were treated.
We found individual risks had been assessed and discussed with people. Staff had guidance on how to safely manage risks whilst ensuring people’s independence, rights and lifestyle choices were respected and they supported people to lead full and meaningful lives safely.
Staff expressed a good understanding of safeguarding and protection matters. They told us they were confident to take action if they witnessed or suspected any abusive or neglectful practice and had received training about the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS). The MCA 2005 and DoLS provide legal safeguards for people who may be unable to make decisions about their care. We noted appropriate DoLS applications had been made to ensure people were safe and their best interests were considered.
People using the service could be confident they would be protected from financial mismanagement. There were good procedures followed and staff guidance in place to support this. Confidentiality was also a key feature in staff contractual arrangements. This helped to make sure information shared about people was on a need to know basis.
A safe and fair recruitment process had been followed and proper checks had been completed before staff began working for the service. We found there were enough staff to meet people's needs in a flexible way. Arrangements were in place to provide management support with on call arrangements for evenings and weekends.
People were receiving safe support with their medicines. Staff responsible for supporting people with medicines had completed training. This had included an assessment to make sure they were capable in this task.
Arrangements were in place to promote the safety and security of the premises, this included reviewing and checking systems such as fire alarms. Staff had been trained to deal with emergencies.
People spoken with made positive comments about the staff who supported them. Staff were described as being very good and helpful. People were cared for by staff who had received a good standard of training and who were supported by the registered manager. People who used the service were involved in staff induction training.
Staff told us they worked very well as a team and were given enough information to care for people as they needed and wanted. Staff were knowledgeable about people’s individual needs and promoted people’s rights and choices. People using the service were seen to be valued and staff communicated very well with them. Achievements were celebrated.
Each person had an individual care plan. These were well written and sufficiently detailed to ensure people’s care was personalised. People’s changing needs were identified, recorded and regularly reviewed. People were given additional support when they required this and they had a key worker to support them. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs had changed. This meant people received prompt, co-ordinated and effective care.
Health and social care professionals we had contact with told us “I have visited a service user at the home on several occasions and met with the home manager. The staff team were observed to support the service user appropriately, being responsive to her needs.” Another gave details describing how the manager worked well with them to do care plans and risk assessments. They commented, “All the staff from Edgar St are a pleasure to work with and are very committed to the needs of people using their service”.
People we spoke with were satisfied with the support they received with nutrition. They told us they enjoyed their meals and could have what they wanted. People were supported to shop, prepare and cook meals and consideration had been given to healthy eating, likes, dislikes and dietary needs.
There were opportunities for involvement in meaningful activities both inside and outside the home. Activities provided people with appropriate skills whilst promoting enjoyment, improvement and independence. These included, for example, shopping trips, excursions and holidays, meals out, swimming, and domestic skills such as cleaning and baking. People told us they were supported to maintain contact with their friends and family. There were regular house meetings to discuss day to day matters, meals and activities.
There were suitable complaints processes in place. People were encouraged to voice any concerns in day to day discussions with staff and the registered manager, during their reviews, house meetings and in surveys. There was a formal complaints system to manage and respond to any issue of concern raised.
There were effective systems in place to assess and monitor the quality of the service. They included monthly checks of the medication systems, support plans, staff training, finance, nutrition, safety and the environment. There was evidence improvements had been made when any shortfalls had been noted.
Confidence was expressed in the management of the home by people using the service, staff and health and social care professionals who visited.
There were systems and processes in place to consult with people who used the service, other stakeholders and staff. Regular meetings and consultation surveys meant people had the opportunity to develop the service. Arrangements were in place to encourage and promote on-going communication, discussion and openness.