The inspection took place on 18 April 2018 and was unannounced. When we last inspected the service in March 2017 they were meeting the regulations we looked at and we rated the service Good overall and in all five key questions.Scott House provides care and support for up to 21 adults living with long term mental health needs. There were 14 people living at the service when we inspected it.
Scott House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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 2008 and associated Regulations about how the service is run.
Our inspection of the home’s environment identified the need for redecoration and refurbishment in a number of different areas of the home because of the potential for infection and the potential risk to people and to their mental well-being. The provider told us they had identified the need for significant refurbishment of the home and had implemented a plan to carry out appropriate works designed to address these needs. We saw evidence of the work already started in the home. A number of improvements were noted. One shower room on the ground floor was refurbished as well as one bedroom on the same floor and the dining room was in the process of refurbishment. The registered manager and the regional manager told us the plan was to complete the works before the end of the year.
People were not always supported by staff who were regularly supervised or appraised.
People told us they felt safe. Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse.
There were enough staff on duty to meet people's needs and there were always additional staff able to cover in the event of staff absence. Robust employment checks were in place to help to ensure new staff were appropriate to be working with and supporting people.
The risks to people's safety and wellbeing were assessed and regularly reviewed.
People were supported with the management of their medicines and there were regular audits by the management team. People were not always supported by staff who were sufficiently well trained, supervised and appraised.
People's healthcare needs were met and staff supported them to attend medical appointments.
People lived in a comfortable environment which was clean and free of hazards. They were able to personalise their bedrooms as they wished.
Staff had undertaken training in the Mental Capacity Act 2005 and were aware of their responsibilities in relation to people who might be deprived of their liberty. They ensured people were given choices and the opportunity to make decisions.
Throughout the inspection, we observed staff caring for people in a way that took into account their diversity, values and human rights. People were supported to make decisions about their activities in the home and in the community.
Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management.
Work was being progressed to ensure people had a choice about what happened to them in the event of their death and that staff had the information they needed to make sure people’s final wishes would be respected.
There was a clear management structure at the service, and people and staff told us that the registered manager and deputy manager were supportive and approachable. There was a transparent and open culture within the service and people and staff were supported to raise concerns and make suggestions about where improvements could be made.
The provider did not have effective systems in place to monitor the quality of the service. Where issues were identified they were not always addressed promptly.
During this inspection, we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.