Background to this inspection
Updated
11 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 11 and 13 December 2018, and the first day was unannounced. The inspection was carried out by two adult social care inspectors and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of service. The inspection team was supported by a registered sign language interpreter during the first day of the inspection. This was because people living at the service and some staff communicated using sign language.
Prior to the inspection, the provider completed a Provider Information Return (PIR). This is a form which gives key information about the service, what the service does well and any improvements they plan to make. We also looked at the notifications we had received from the service. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We reviewed other information to help inform us about the level of risk for this service. We considered this information to help us to make a judgement about the service.
During the inspection we spoke with five people living at the service. We spoke with seven members of staff, as well as the registered manager. After the inspection spoke with three family members and received feedback from five other professionals who were involved with the service.
We looked at four care records and the medicines administration records for everyone living at the service. We looked at four staff files, and staff training records. We also looked at a range of records and documents including meeting minutes, policies, audits and environmental reports.
Updated
11 January 2019
We undertook an inspection at Gallaudet Home on 11 and 13 December 2018. The first day was unannounced. The last inspection of the service was carried out in October and November 2017. At that time, we identified several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and rated the service ‘requires improvement’. Shortfalls related to training and supervision, people’s involvement in developing care plans and risk assessments, the implementation of actions identified in audits, and people’s feedback about the service.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve in specific areas. At this inspection we rated the service ‘good’ because we found the necessary improvements had been made, and further improvement work was ongoing.
Gallaudet Home 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.
Gallaudet provides care for up to eight people. At the time of our inspection there were eight people living there. The service is in a long, single storied building which is accessible to people in wheelchairs or with limited mobility. Communal areas included a lounge, dining area and kitchen. Bedrooms were all accessible from the main corridor, and some were en suite.
The service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
A manager was going through the process of registering with CQC at the time of our inspection. Their registration was completed shortly after our inspection. A registered manager has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Systems and processes were in place to protect people from harm, and staff had received training in safeguarding. They knew what they must to do protect people and the provider had made safeguarding referrals to the local authority appropriately.
The provider had systems in place to ensure people were safe, including risk management, checks on the environment and safe fire management processes.
Risk assessments relating to people who used the service were clear and described potential hazards and control measures in place. These gave staff information about how to support people safely and ensure risks were managed effectively.
People were supported by adequate numbers of staff to meet their needs, although regular agency staff supported shortfalls in staffing numbers. Recruitment was ongoing, and the provider followed safe procedures to ensure prospective staff were suitable to work in the service.
People's medicines were administered as prescribed and managed safely. Medicines administration records were accurate and clear. Some staff required updates in medicines competency checks. We have made a recommendation about the storage of controlled drugs.
Staff were trained in a range of relevant subjects, although some training and records required updating. Staff usually received regular supervision and appraisals, and the staff we spoke with felt supported.
People were supported to have choice and control in their lives. Their privacy and dignity was respected and people were encouraged to be as independent as possible; the policies and systems in the service supported this practice.
Relatives told us that they were consulted and informed about people’s care. Records were clear and reflected people's needs and preferences.
Staff had a good understanding of people's needs and preferences, and were compassionate and caring. People were comfortable around staff, and relatives told us that staff were patient and supportive
Systems were in place to monitor and review the quality of care. These were continuing to be developed, but action plans were in place to achieve improvement when this was still needed.
Staff had a good understanding of people's needs and preferences, and were compassionate, kind and caring. People were comfortable in the presence of staff and confident in their abilities.