Park View is a purpose built complex comprising of three individual bungalows located to the west of Hull city centre. The purpose built establishment; consists of three bungalows each of which have five single ground floor bedrooms, a lounge/dining room, one bathroom and two separate toilets. The three bungalows share a large garden but each has its own patio area. Each of the bungalows has recently undergone extensive refurbishment, including the provision of new kitchens and redecoration throughout. The service is registered to provide care and accommodation for up to fifteen adults who have a learning disability, and who may also have physical needs. The home is owned and managed by Kingston Upon Hull City Council.
The service was last inspected on 13 September 2014 and was meeting all the regulations assessed during the inspection. We undertook this inspection on 5 and 13 May 2015 and the inspection was unannounced which meant the registered provider did not know we would be visiting the service.
The people who used the service had complex needs and were not all able to tell us fully about their experiences. We used a Short Observational Framework for Inspection [SOFI] to help us understand the experiences of the people who used the service. SOFI is a way of observing care to help us understand the experiences of people who were unable to speak with us. We observed people being treated with dignity and respect and enjoying the interaction with staff. Staff knew how to communicate with people and involve them in how they were supported and cared for.
The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission [CQC]; they had been registered since October 2010. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.
The registered manager completed quality checks on areas such as care plans and records. We found some of these had been effective in identifying gaps in information, but not in ensuring follow up action was completed in a timely manner. For example, in two records maintained for people who used the service, we found information was not current, risk assessments had not been reviewed within agreed timescales and checks on lifting equipment had not always been recorded. This meant that staff may not have had up to date guidance about how to meet these people’s needs and there was a risk of important care being missed.
Staffing levels had been increased since the last inspection and were structured to meet people’s individual needs. There was sufficient staff on duty. Staff received training, but there was not a formal supervision process in place which led to some staff not receiving supervision or support on a regular basis.
Recruitment practices were safe and relevant checks had been completed before staff commenced work.
People were able to access their GP, attend routine health checks and access other health care professionals as required.
The registered provider had policies and systems in place to manage risks, safeguard vulnerable people from abuse and for the safe handling of medicines. Medicines were ordered, stored administered and disposed of safely. People received their medicines as prescribed. Only staff who had received training were involved in the administration of medicine.
We found people’s health and nutritional needs were met and people were supported to plan their own preferred menus. They accessed professional advice and treatment from community services when required. We found people received care in a person-centred way with care plans describing people’s preferences for care and staff followed this guidance.
We observed positive staff interactions with the people they cared for. Privacy and dignity was respected and staff supported people to be independent and to make their own choices. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interest. The recording of the assessments to check people’s capacity could be improved as there had been no mental capacity assessments completed for any of the people who used the service at the time of our inspection.
CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 deprivation of liberties Safeguards (DoLS), and to report on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The registered manager had a good understanding about these and when they should be applied. However, there had been no DoLS applications made on behalf of the people who used the service, even though they required constant supervision and were unable to leave the service independently.
These issues meant that the registered provider was not meeting the requirements of the law regarding the need to obtain lawful consent for the people who used the service. You can see what action we told the registered provider to take at the back of the full version of this report.
There was a complaints procedure and relatives told us they would feel able to make complaints on their relative’s behalf and these would be acted on.
People were supported to engage in a range of social activities in the home and within the local community.