Whalley Road

We found the following examples of good practice.

There were effective processes to minimise the risk to people, staff and visitors from catching and spreading infection. These included regular testing of staff and people living in the home and testing of visitors to the home, when restrictions allowed. Signage was in place to remind staff, visitors and people about the use of personal protective equipment (PPE), the importance of washing hands and regular use of hand sanitisers. This was provided in easy read and large print to be easily understood.

There were enough stocks of PPE with PPE stations and hand sanitisers available throughout the home which helped ensure staff and visitors had access when required.

Person centred care plans and risk assessments were in place for people who were in isolation and/or had tested positive. One person had been given an easy to understand story line book to help explain the pandemic and how to stay safe. The registered manager had the garage converted into an activity and games room during the most stringent lock-downs. This was also now being used for a weekly art class.

Visiting was subject to government restrictions when the national lockdowns had been in force. People were supported to maintain contact with their relatives in different ways including the use of social media and telephone calls; this assisted in promoting people's mental wellbeing. A safe visiting area had been developed to the rear of the home, with a separate entrance and this was used for visitors to carry out lateral flow tests before entering the main building.

Whalley Road is a residential care home that provides accommodation, nursing care, support and rehabilitation for up to nine people with a mental illness or learning disability. The home is situated in the Accrington area of Lancashire. Accommodation is provided in single en suite bedrooms.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had been responsible for managing the service since October 2016 and registered with CQC since 11 October 2017.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. The registered manager and staff were observed to have positive relationships with people living in the home.

One person who used the service told us they did not always feel safe in the home due to the behaviour of another individual. The registered manager told us they had taken action to involve external professionals and advocacy services in a review of this person’s care and support needs. This should help to ensure people felt safe living in the home.

Systems were in place to ensure staff were safely recruited. People who used the service told us staff provided the right level of support to meet their needs and to achieve their rehabilitation goals.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Robust systems were in place to ensure the safe handling of medicines. People were supported to take responsibility for their own medicines whenever possible.

Care records we reviewed included information about the risks people might experience. Care plans were in place to help ensure staff provided the level of support necessary to manage the identified risks. Care plans were regularly reviewed to address any changes in a person’s needs.

Regular checks took place to ensure the safety and cleanliness of the environment. People who used the service were responsible for cleaning their own bedrooms, with support from staff as necessary. Systems were also in place to reduce the risk of cross infection in the service.

Staff told us they received the induction, training and supervision they needed to be able to carry out their roles effectively. Staff demonstrated a commitment to providing high quality personalised care for the individuals who lived in the home.

Staff were able to demonstrate a good understanding of the legal frameworks under which people’s placements at Whalley Road were arranged. The registered manager had taken appropriate action to apply for restrictions in place in an individual’s best interests to be legally authorised.

People who used the service were encouraged to participate in activities which met their interests and helped to promote their health and well-being.

Records we reviewed showed that, where necessary, people were provided with support from staff to attend health appointments. People were also supported by staff, as far as possible, to maintain a healthy diet.

We noted systems were in place to encourage people who used the service to comment on the care and support they received. However, improvements needed to be made to document the actions taken by the registered manager to address any negative feedback received in satisfaction surveys.

Staff told us they enjoyed working at Whalley Road. However, we received mixed feedback about the leadership and management in the home and the wider service. Whilst some staff told us the registered manager and provider were approachable and supportive, other staff felt their opinions were not always listened to. In addition, some staff told us that the confidentiality of information shared with senior managers was not always maintained as requested.

We received positive feedback from community based professionals regarding the quality of care provided in the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 service was last inspected in May 2013 and was found to be meeting the regulations applicable at that time.

During this inspection we found the service to be in breach of Regulation 12 (2) (g) of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. This is relating to medicines management and the high number of medicines errors being made. You can see what action we told the provider to take at the back of this report.

The approach the registered manager was taking in relation to addressing medicines errors with staff was not proving to be effective.

During this inspection we received positive feedback from people who used the service, staff members and community professionals. People expressed satisfaction with the service provided and spoke very highly of the staff that supported them, referring to them as “Kind” and “Helpful”.

The provider ensured processes and procedures were in place to maintain a protect and suitable environment for all people using the service and their visitors. Detailed and up to date health/ safety checks and audits were completed on a regular basis. People indicated they felt safe living at the service. Suitable training was offered to staff to ensure they were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify the relevant authorities when required.

Over the two days of the inspection we found the service had adequate staffing levels. People indicated their needs were met appropriately and staff were always present around the service for people to talk to at any time. We observed regular staff interaction to support this.

We found a safe recruitment system in place. Appropriate steps were taken to verify new employees’ character and fitness to work. Following successful appointment to the role the provider ensured a robust induction plan was carried out which ensured staff were equipped with the correct skills and knowledge to effectively support people in an informed, confident and self-assured manner.

We saw the service had created detailed individual risk assessments for all people using the service. These risk assessments included daily living tasks, accessing the community alone and positive risk taking. Mental health and Home Office professionals were liaised with on a regular basis as part of the risk assessment process.

The provider had considered and implemented adequate documentation to support the development of the care planning process and support the delivery of care. Each plan was individual to the person's needs. Effective systems were implemented to maintain independence, by providing a detailed plan covering essential information support staff needed to follow. This ensured clear information was available about people's needs, wishes, feelings and health conditions. Care plans were kept under regular review.

Staff displayed an awareness of the Mental Capacity Act 2005 and had completed appropriate training. Appropriate referrals had been submitted to the local authority by the registered manager.

Staff spoken with were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. The manager also demonstrated their knowledge about the process to follow should it be necessary to place any restrictions on a person who uses the service in their best interests. At the time of inspection we found that no person using the service wasbeing deprived of their liberty.

We observed people making themselves snacks and drinks throughout the day and contributing to the preparation of meals. We saw the food was freshly prepared. We noted appropriate referrals had been made to health professionals and instructions were strictly followed in cases where people had known dietary requirements.

We saw positive staff interaction and engagement with people using the service. Staff addressed people in a respectful and caring manner and gained consent when required. The service had a calm and warm atmosphere.

People using the service indicated they were happy with the service. We saw positive feedback from people using the service by means of house meetings and a range of quality questionnaires. People told us although the registered manager usually stayed in her office they felt able to approach her if they required any assistance or had any questions.

People were provided with care plans which were reviewed regularly and updated when required. People said they felt safe living in the home and were able to discuss concerns or issues with the staff if they wished to. We saw that the people using the service were involved in planning their care and are in control of how their support is provided for them.

Risk assessments were reviewed regularly in respect of the environment so that people and staff were safe.

Staff received training and supervision to enable them to carry out their roles effectively and care for the people they supported