United Response - 47 Doublegates Green

Updated 29 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 checked whether the provider was 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.

This comprehensive inspection took place on 10 December 2018 and was announced. We gave the provider short notice that we would be visiting. We did this because the service is a small care home and people are often out during the day. We wanted to make sure someone was in when we arrived at the service. The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

We contacted commissioners and other health and social care professionals who worked with the service to gain their views of the care provided by United Response - 47 Doublegates Green.

The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

During the inspection we reviewed a range of records. This included two people’s care records including care planning documentation and medicines records. We also looked at two staff files, including recruitment, supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures.

The registered manager was not present on the day of the inspection. However, we spoke with them on the telephone after our visit. During the inspection we spoke with a senior service manager, a senior support worker and four support workers. People who used the service had limited communication because of their disability. We spent time observing staff interactions with people throughout the inspection. In addition, we spoke with the relatives of two people who used the service.

Updated 29 January 2019

We inspected United Response - 47 Doublegates Green on 10 December 2018. The inspection was announced. When we last inspected the service in April 2016 we found the provider was meeting the legal requirements in the areas that we looked at and rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

United Response - 47 Doublegates Green 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.

United Response - 47 Doublegates Green is a large purpose-built bungalow situated on a housing estate close to the centre of Ripon. The service is registered to accommodate a maximum number of five people with a learning disability, some of whom have a physical disability. At the time of the inspection there were five people who used the service.

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. Registering the Right Support CQC policy.

At this inspection we found the service remained good.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. We did note the choking risk assessment for one person did not include guidance for staff to follow in the event of this happening. However, we received confirmation after our inspection from the registered manager that this had been undertaken.

Medicines were managed safely with an effective system in place. Staff competencies around administering medicines were regularly checked. However, we did find the staff signature list for those staff who were responsible for the administering of medicine had not been completed. There were some gaps in the recording of room temperatures where medicines were stored. The senior support worker told us they would take immediate action to address this.

The home was clean and tidy and communal areas were well maintained. Appropriate personal protective equipment and hand washing facilities were available. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained.

There were enough staff on duty to meet their needs. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People were supported by a team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place. Where there were gaps in training this had been identified and training had been planned.

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 supported people to maintain a healthy and nutritional diet. People were supported by staff to maintain their health and attend routine health care appointments.

Staff were kind and caring. Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People had access to a range of activities. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager, senior staff and the provider, to monitor and improve the quality of the service. Feedback was sought from people who used the service through meetings and surveys. This information was analysed and action plans produced when needed.