We carried out an unannounced inspection of the service on 12 January 2016.
Little Acres provides accommodation and personal care for up to 25 people living with a learning disability, physical and sensory needs, including autistic spectrum disorder. At the time of our inspection there were 15 people living at the service.
Little Acres is required to have 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. At the time of the inspection there was not a manager registered with the Care Quality Commission. The previous registered manager deregistered in September 2015. A manager was in place and told us that they would be shortly submitting their registered manager application. We will monitor this.
People received a safe service. Staff were aware of the safeguarding procedures to protect people from abuse and avoidable harm and had received appropriate training. Risks were known by staff and managed appropriatly. However, some shortfalls were identified with care and risk plans. These were not always as detailed as they should have been or reviewed in line with the providers review system.
People received their medicines as prescribed and these were managed correctly. Some action was required with regard to medicines prescribed for use as and when required. Safe recruitment practices meant as far as possible only people suitable to work for the service were employed. Staff received an induction, training and appropriate support.
Accidents and incidents were recorded and appropriate action was taken to reduce further risks. However, there was no analysis or review of this information to help identify any themes, patterns or concerns.
There were sufficient experienced, skilled and trained staff available to meet people’s needs. People’s dependency needs had been reviewed and were monitored for any changes.
People received sufficient to eat and drink and were positive about the choice, quality and quantity of food and drinks available. People’s lunchtime experience could have been better. People were supported to access healthcare services to maintain their health. People’s healthcare needs had been assessed and were regularly monitored, feedback from healthcare professionals were positive about how people’s health needs were met.
Staff were kind, caring and respectful towards the people they supported. They understood people’s individual needs, preferences and routines.
CQC is required by law to monitor the operation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and to report on what we find. This is legislation that protects people who are unable to make specific decisions about their care and treatment. It ensures best interest decisions are made correctly and a person’s liberty and freedom is not unlawfully restricted. Assessments and best interest decisions had been made for some people but had not been reviewed when required. Some people had not had MCA assessments completed where these were required. The provider took action to immediately address this.
People who used the service including their relatives were supported to share their experience and wishes about the service through regular meetings and annual feedback questionnaires. Communication between relatives and external professionals was good.
People told us they knew who was in charge and they would raise any complaints or concerns with them. Information about how to make a complaint was available but not presented in an easy read format for people with communication needs. Confidentiality was maintained and there were no restrictions on visitors.
The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits. Some shortfalls were identified with record keeping; this was acknowledged by the manager and regional director who took immediate action to address this.