The inspection took place on the 17 February 2015. This inspection was unannounced. During our last inspection we found the provider satisfied the legal requirements in the areas that we looked at.
The home had two managers who job shared the position, one of whom was the registered manager. 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.
50 Cherry Orchard provides accommodation and personal care for up to five people who have learning disabilities. At the time of our inspection there were four people living in the home. The main aims of the service are to treat everyone as individuals and involve them in choices about their daily living which promote their independence. Relatives we spoke with were positive about the care and support their family member received.
CQC is required by law to monitor the application of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The Mental Capacity Act 2005 sets out what must be done to make sure that the rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care or treatment. This includes decisions about depriving people of their liberty so that they get the care and treatment they need where there is no less restrictive way of achieving this. DoLS require providers to submit applications to a ‘Supervisory Body’, the appropriate local authority, for authority to do so. Whilst all necessary DoLS applications had been, or were in the process of being submitted by the provider the requirements of the Mental Capacity Act were not always followed by the provider when reaching a best interest decision on behalf a person who lacked capacity.
This is a breach of Regulation 18 of the Health and Social care act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the end of this report.
Because of people’s complex needs they were unable to tell us verbally about their experiences of living at 50 Cherry Orchard. From our observations staff members’ approach to people who use the service was warm and caring. We saw that positive praise and choices were offered and that communication was calm and respectful. People were encouraged to make their rooms at the home their own personal space.
People were involved in deciding what food and drink they would like. Staff showed us a folder of pictures of food they used to support people with choosing and planning the weekly menu. If they wanted to people could be involved in the preparation of food at mealtimes.
Each person had a care plan that outlined their needs and the support required to meet those needs. People were supported in a range of interests, both as activities together or on an individual basis, which suited their needs. They were encouraged to take part in activities outside of the home to enable them to access their local community.
There were enough qualified, skilled and experienced staff to meet people’s needs. All necessary checks had been completed before new staff members had started work at the home and they had completed an induction programme when they started work. Staff members received training in areas that improved their capability in providing care and support to people who lived at the home and had regular supervision and appraisal meetings with the manager at which their performance and development were discussed
The provider had systems in place to ensure that medicines were administered and disposed of safely. All medicines were stored securely.
There was a management structure in the home that provided people with clear lines of responsibility and accountability. The provider had an effective system to regularly assess and monitor the quality of service that people received and an effective complaints system.