The inspection took place on 9 and 15 December 2014 and 12 January 2015. This was an unannounced inspection on day one, and announced on the other two days. We last inspected the service in July 2014. At that inspection we found the home was meeting all of the regulations that we inspected.
13 Hutton Avenue provides residential care for up to nine people with learning and/or physical disabilities. At the time of our inspection there were eight people living at the home.
The home had 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.
People told us they felt safe living at the home. Relatives told us they were confident their family member lived in a safe environment. One relative told us, “My relative is very safe here, there have been no issues.” Another relative told us, “100% confident with this place, much better than where they used to be.”
People lived in a clean, tidy and homely environment, with bedrooms tailored to people’s specific needs, likes and dislikes.
One person told us, “[Name of staff member] gives me my medicine.” Relatives told us their family member received their medicine on time and no issues were reported to us. Staff at the home were trained to administer medicines to people safely and securely.
Staff we spoke with had a good understanding of safeguarding procedures. They also knew how to report any concerns they had and would not be frightened to do that. The provider had procedures in place to monitor and investigate any safeguarding matters.
Staff followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). MCA assessments and ‘best interests’ decisions had been made where there were doubts about a person’s capacity to make decisions. The registered manager had also made DoLS applications to the local authority.
Staff had a good understanding of how to manage people’s behaviours that challenged the service and had individualised strategies to help them manage.
Relatives and staff all told us they felt there were enough staff to meet people’s needs, although it was busy at times. The registered manager monitored staffing levels to ensure enough trained staff were available at all times. The provider had systems in place for the recruitment of all staff at the home, including suitability for the post, full history, references and security checks. The registered manager had a programme of staff training in place and monitored this to ensure all staff were kept up to date with any training needs.
The registered manager told us any maintenance work was done by the provider upon request. The provider also had emergency procedures in place for staff to follow and staff knew how to access this information and how to use it.
People told us they enjoyed the food that was prepared at the home. We saw people helping in the preparation. We found people received nutritious meals, snacks and refreshments throughout the day.
People were respected and treated with dignity, compassion, warmth and kindness. People and their relatives that we spoke with highlighted the quality of care provided by staff at the home. One relative told us, “Staff discuss my daughter’s needs with us as a family.” And “If my [name] is unwell they are very quick to let me know and to get the GP.”
People were treated as individuals and monitored so any changes in their needs were identified and procedures put in place to address that change. People’s records were regularly reviewed and discussed with the person where possible and their relatives and best interest decisions made if necessary.
We saw activities taking place within the home and records of outside activities, although these were not always recorded. One relative told us, “My [family member] has a better social life than me, staff ensure that my [family member] goes out on trips.” Another relative said, “The staff organise trips out for everyone, [name] enjoys them.”
There had been no complaints since the last scheduled inspection. Information on how to complain was available to people at the home and to relatives and visitors alike. The registered manager explained what she would do if a complaint was made and said, “We take anything like that [complaints or concerns] very seriously.” One relative told us, “If I had to complain I would see the manager she is very approachable.”
People were regularly asked their views on the home and about their care, both verbally and in pictorial format. The majority of relatives confirmed they were asked their views, during visits, reviews of care or annual service reviews. One person confirmed they had completed a review when showed the form. A relative told us, “Staff are always asking our views though.”
The registered manager and the operational manager monitored the quality of the service through a wide variety of audits and checks within the home. We saw when an issue had been identified the registered manager had put measures in place to deal with the problem and the operational manager monitored these in-house checks for completeness.