Archived: Care Management Group - Longdown Road

This inspection took place on 25 October 2018 and was unannounced.

Care Management Group (CMG) Longdown Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care 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.

CMG Longdown Road in Epsom is registered to provide accommodation and personal care for up to 10 adults who have a learning disability. At the time of our inspection eight people live here. The service is delivered from a two-story house in a residential area.

It is a requirement of the provider's registration that they have a registered manager in post. 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. The registered manager was present during this inspection.

CMG Longdown Road continues to provide a good level of care and support to people.

People were supported to stay safe. Staff understood their roles in keeping people safe from abuse, and avoidable harm. Risks to people’s health and safety were well managed. This was done with a regard to minimising the restrictions placed on people. People’s medicines were managed in a safe way, and they received them when needed. The home was kept clean by the staff team, with the help of the people who live here.

Accidents and incidents are reviewed by the registered manager and staff team to minimise the risk of them happening again.

No one new had come to live at the home since our last inspection. Procedures were in place to ensure that people’s needs would be assessed, to ensure the home environment would be suitable, and that staff had the skills to be able to meet those needs.

There is a sufficient number of staff deployed to meet people’s needs. A robust recruitment and selection process is in place. This ensures prospective new staff have the right skills and are suitable to work with people living in the home.

People have enough to eat and drink. Food and drink preferences are met through a varied and nutritious diet. People have access to health care professionals when the need arises, as well as for routine check-ups to keep them healthy. Where people lacked the capacity to make specific decisions, the stuff understood and followed the requirements of the Mental Capacity Act 2005. This ensured that decisions made for people in their best interest and any restrictions put into place to keep them safe were done in a lawful way.

People are supported by kind and caring staff. Staff have worked here for many years, and have built caring relationships with people and enjoy their company. People are supported to maintain relationships that are important to them. People are provided with the care, support and equipment they need to stay as independent as possible.

Care records are comprehensive and give a detailed description of the person, and their individual needs. Staff provide care and support that responds to these needs. People would be supported at the end of their lives to have a dignified and as far as possible pain free death.

There was a robust complaints process in place, however this had not been needed as everyone we spoke with was happy with the service.

The home and staff team continue to be well led. The registered manager leads by example and staff are happy in their roles. Quality assurance processes are used to continuously improve the standard of care people receive.

There was a registered manager in post. 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.

The home was well decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid with people’s mobility needs. The home had an airy and homely feel and reflected the interests and lives of the people who lived there.

The inspection took place on 23 March 2016 and was unannounced.

There was positive and caring interaction between people and staff. People gave clear indications to us that they were happy living here, such as smiling or giving positive hand gestures when we spoke with them.

People were safe at CMG Longdown Road because there were sufficient numbers of staff who were appropriately trained to meet the needs of the people who live here.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency. Staff were aware of the home’s contingency plan, if events occurred that stopped the service running. The premises provided were safe to use for their intended purpose.

Staff recruitment procedures were robust to ensure staff were suitable to support people in the home. The provider had carried out appropriate recruitment checks before staff commenced employment.

Staff received regular support in the form of annual appraisals and formal supervision to ensure they gave a good standard of safe care and support. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines. All medicines were administered and disposed of in a safe way.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People had access to drinks and snacks at any time during the day and people were able to have a cup of tea during the night if they asked.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment. People’s health was seen to improve due to the care and support staff gave.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff talking with them and showing interest in what people were doing, such as helping people to write letters to family and loved ones. People looked relaxed and happy with the staff. People could have visitors from family and friends whenever they wanted. The staff knew the people they cared for as individuals, and had supported them for many years, giving a family feel to the home.

Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods in the care plans matched with what we saw on the day of our inspection. People had access to activities that met their needs.

People knew how to make a complaint. The policy was in an easy to read format to help people and relatives know how to make a complaint if they wished. No complaints had been received since our last inspection. Staff knew how to respond to a complaint should one be received.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. The registered manager had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were kept, and were analysed and used to improve the care provided to people. The senior management from the provider regularly visited the home to give people and staff an opportunity to talk to them, and to ensure a good standard of care was being provided to people.

Our inspection team was made up of one inspector. We asked our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that people were treated with respect and in a dignified way by the staff.

People and their relatives told us they felt safe. We saw that safeguarding procedures were clearly displayed and staff understood their responsibilities around keeping people safe.

There were systems in place to record accidents and incidents, complaints, concerns, whistleblowing and investigations. We saw that changes had been made as a result of these events. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted.

We saw the service was safe, clean and hygienic.

Recruitment practice was safe and thorough.

Is the service effective?

People's health and care needs were assessed with them. Specialist dietary, mobility and equipment needs had been identified and implemented in care plans where required

People's needs were taken into account with the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind and attentive staff. We saw staff gave encouragement when supporting people. People commented, 'I like it here; I'm able to do the things I want.' A relative said, I am very happy with the care and support that is given to my family member. Staff understood their behaviours and met their needs.'

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Staff were able to tell us about the people they supported. They knew peoples individual histories and support needs without having to refer to the care records. Staff were seen to take time to talk and listen to what people said. Staff encouraged people to be independent by involving them in activities around the house.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw that people completed a range of activities in and outside the service. People had access to day service and could also be involved in the weekly shopping if they wished. People were also able to keep in contact with friends and relatives.

People knew how to make a complaint if they were unhappy. Information about how to do this was displayed in the dining area in a format that would make it easy to read and understand. The people we spoke with told us they had never felt the need to complain.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service has a quality assurance system that checked a number of aspects of the service. We saw that were a need for improvement had been identified these were corrected quickly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the values of the home and the organisation they worked for.

Quality assurance processes were in place. The manager regularly checked on how the service was performing. This helped to ensure that people received a good quality service at all times.

Senior managers regularly visited the home to make sure that people and staff were happy.

We spoke to one person who used the service and three staff members, including the registered manager.

One person told us 'I like it here; I'm able to do the things I want.' Staff were seen to interact well with people who used the service.

We saw that systems were in place to ensure staff worked with the consent of people who used the service. Staff told us 'Before I do anything I need to ask their permission; if they don't allow me then I don't do the tasks.'

People who used the service, relatives and advocates had been involved in the planning of care. We saw that risks had been identified to protect the welfare and safety of people.

There were systems in place to safeguard people from unsafe premises.

All the staff we spoke with said they felt supported to do their job. We found they received regular supervisions, appraisals, and training to enable them to carry out their roles.

We saw that the provider had systems and procedures in place for dealing with complaints.