Archived: Choice Support - 2 Endymion Road

Choice Support – 2 Endymion Road is a ‘care home’ for people who have a learning disability. People in care homes receive accommodation and 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 home accommodates a maximum of six people. At the time of our inspection there were six people living at the home.

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.

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.

Staff understood their responsibilities to keep people safe from potential abuse, bullying or discrimination.

Risks had been recorded in people’s care plans and ways to reduce these risks had been explored and were being followed appropriately. Staff understood that there was a balance between taking risks and maintaining people’s independence.

People had been living at the home for a long time and it was clear that 2 Endymion Road was very much people’s home. People were relaxed with staff and the way staff interacted with people had a positive effect on their well-being.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

Staff were positive about working at the home and told us they appreciated the support and encouragement they received from the newly appointed registered manager.

People were supported to have maximum 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.

Staff understood the principles of the Mental Capacity Act 2005 and knew that they must offer as much choice to people as possible in making day to day decisions about their care.

People were included in making choices about what they wanted to eat and staff understood and followed people’s nutritional plans in respect of any healthcare needs people had.

People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences. Everyone had an individual plan of care which was reviewed on a regular basis and reflected their uniqueness.

Relatives told us that the management and staff listened to them and acted on their suggestions and wishes.

People were supported to raise any concerns or complaints and relatives were happy to raise any issues with the registered manager if they needed to.

People, their relatives, staff and health and social care professionals were all included in monitoring the quality of the service. The registered manager and staff understood that observation was very important to identify people’s well-being where people did not always communicate verbally.

Choice Support - 2 Endymion Road is a residential care home that provides accommodation and personal care for up to six people with learning disabilities. The provider organisation Choice Support is a large organisation that provides residential services for people with learning disabilities nationally. The service is a four story house situated on a residential street near to shops, a park and transport links.

There was not a registered manager in place. 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.

We found three breaches of the regulations during our visit. This was because the service was not always maintaining high levels of cleanliness and was not observing good infection control and good food hygiene practices to ensure people’s safety. In addition, although people had individual risk assessments that had been reviewed some hazards had not been appropriately risk assessed to ensure people’s safety. These concerns had not been highlighted or addressed by the quality assurance systems in place.

However we found that relatives felt that staff were caring and respectful and they told us that there had been improvements in staff communication and practice during the past years. We saw sensitive interactions from staff who talked with people and checked they were comfortable and had enjoyed their day’s activities. There were enough staff on duty to meet the support needs of people when we visited. Staff were familiar with people and could tell us about their support needs. People had person centred plans that highlighted to staff how people communicated and how they wished to be supported and what they liked to do.

People were supported to attend their health care appointments and staff could tell us about people’s health requirements to remain well. We saw that people were supported to eat a healthy diet and remain hydrated. People with specific dietary needs were supported to follow the health professional’s advice. We saw that medicines administration was undertaken appropriately by trained staff.

The service worked to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff received varied training and supervision sessions to undertake their role and could tell us for example about their responsibilities with regard to MCA and DoLS and safeguarding adults.

Staff described the deputy manager and service manager as supportive and they could approach them at any time to discuss concerns. Staff told us they were supported in their careers and enjoyed their work. There were good lines of communication in the service and staff met individually with people to ascertain their views. There was a complaints procedure and relatives told us they could raise concerns and these were addressed.

The provider had commissioned an external easy read survey to obtain feedback as to how they might improve the service quality.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Regulation. Regulation 12: Safe care and treatment, Regulation 15 Premises and equipment, and Regulation 17 Good governance.

You can see what action we told the provider to take at the back of the full version of the report.

We noted that the service had made improvements to the management of people's finances by opening individual bank accounts for each person and putting in place regular money auditing systems. We saw that care plans were reviewed regularly with the involvement of people's representatives and health and social care professionals.

There were effective recruitment systems in place. This meant that people were supported by staff who were appropriately vetted. We also noted that there were sufficient numbers of staff on each shift to meet people's needs.