Archived: Real Life Options - 2 Frederick Street

Real Life Options – 2 Frederick Street is a residential care home providing personal care to 3 people at the time of the inspection. The service can support a maximum of 3 people with a learning disability.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to take part in activities and pursue their interests in their local area.

The provider ensured people received care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

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

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture:

Staff placed people’s wishes, needs and rights at the heart of everything they did. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. People and those important to them, including advocates, were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Real Life Options – 2 Frederick Street on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Frederick Street is a 'care home'. People in care homes receive accommodation and nursing or 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. Frederick Street accommodated three people at the time of the inspection.

The service was last inspected on December 2015 and the rating for this inspection was Good. At this inspection we found the service remained Good.

Risks to people arising from their health and support needs as well as those relating to the premises were assessed, and plans were in place to minimise them. We have made a recommendation about fire and evacuation drills.

People received their medicine safely and were supported to access the support of health care professionals when needed. The provider had taken steps to minimise the risk of abuse because staff knew how to identify and report it.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal. We have made a recommendation about training.

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.

People received a varied and nutritional diet.

The interactions between people and staff showed that staff knew the people really well.

Care was planned and delivered in way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes as well as their life histories.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. Processes were in place to assess and monitor the quality of the service provided and drive improvement.

Further information is in the detailed findings below.

The inspection took place on 7 December and 21 December 2015. The first day of the inspection was unannounced which meant that the staff and registered provider did not know that we would be visiting. We informed the registered provider of our visit on 21 December 2015.

We last inspected the service in January 2014 and found that it was not in breach of any regulations at that time.

Real Life Options - 2 Frederick Street provides residential care and support for up to three people who live with a learning disability. 2 Frederick Street is a purpose built bungalow. People who use the service live in one half of the building; in the other half of the building (4 Frederick Street) the registered providers run a supported living service Externally there is a well maintained and specially adapted garden. 2 Frederick Street is situated close to local amenities within a 5 minute walk to the town centre and a 15 minute drive to a large retail park which has a cinema, restaurants and bowling.

The home had 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.

At the time of our inspection the registered manager for the service was also acting as a divisional manager for the provider. We were told that this was a temporary arrangement that had been formally put in place from 1 June 2015 and was due to cease in January 2016. Whilst the registered manager was performing this additional role a senior member of staff from had been tasked with overseeing the day to day running of the home. The registered manager still had regular involvement and visited the service at least once or twice a week.

During our inspection we saw that people were relaxed and smiling and engaged with staff in a positive way. From our observations it was clear that staff knew the people who lived at the service well and we saw that they responded to their care needs accordingly.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns without fear of recrimination. The registered provider has a whistle blowing hotline and information regarding this was clearly displayed within the home.

We looked at care plans and found that they were written in a person centred way and included easy read documents and pictures. The care records we viewed showed us that people had appropriate access to health care professionals such as dentists and opticians. We saw that individual risk assessments were not in place in place to cover all of the key risks specific to the person however we saw evidence that this was addressed following our visit.

We observed that people were encouraged to be independent and to participate in activities that were meaningful to them. We saw people having their nails painted and engaging in craft activities during our inspection. We were also told that in good weather people enjoyed spending time in the garden. People were supported to go out into the local community and during our visit one person went to a local shop with staff.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work. The checks included obtaining references from previous employers to ensure that staff were safe to work with vulnerable people.

Staff received appropriate training and demonstrated that they had the skills and knowledge to provide support to the people they cared for. Staff also received regular supervisions and annual appraisals.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

We saw that people were provided with a choice of healthy food and drinks to help ensure their nutritional needs were met. We saw that there was a four week menu in place offering a good variety of dishes and staff also demonstrated knowledge of people’s likes, dislikes and special dietary requirements.

There was a complaints procedure in place and this had been produced in an easy read format with pictures.

The registered provider and registered manager had systems in place for monitoring and assessing the service. Action plans were produced to address any issues identified during the quality assurance process and any necessary changes were implemented.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced and checked such as fire equipment and electrical safety.

We spoke with staff who told us they felt supported and that the registered manager was always available and approachable. Throughout our visit we saw that people who used the service and staff were comfortable and relaxed with the registered manager and each other. Staff were observed to be caring and respected people’s privacy and dignity. There was a relaxed atmosphere and we saw staff interacted with each other and people who used the service in a very friendly and respectful manner.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We found that where people did not have the capacity to consent, staff worked in line with legal requirements.

We found that people experienced care, treatment and support that met their needs and protected their rights. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Staff had received appropriate professional development, and, from time to time, were enabled to obtain further relevant qualifications. The provider had in place a complaints procedure and comments and complaints people made were responded to appropriately.