Colham Road

About the service

Colham Road is a care home for up to 13 adults with a learning disability. People living at the service had complex healthcare needs and some had physical disabilities. Most people did not use words to communicate. The service was divided into 4 lodges off a central communal seating area. Each lodge had a front door, and communal facilities such as a lounge and dining room. People had their own bedrooms. There was equipment used to help people move, this included ceiling track hoists, as well as specialist beds and chairs.

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

The service was able to demonstrate how they were meeting most of the underpinning principles of right support, right care, right culture. However, we identified some areas where improvements were needed.

Right Support: The systems for managing people's medicines were not always effectively implemented and this increased the risks to people using the service. The systems for preventing and controlling infection were not always followed.

The service was well equipped to meet the needs of people with physical disabilities. However, the dedicated sensory room was no longer in use, meaning people could not access this equipment and resource.

People were supported to make choices where possible. The staff knew people well and worked with others, including their families, to understand people's preferences. The staff had a good understanding of how people communicated and used different techniques to help present information in a way people understood. The staff supported people to have meaningful lives and pursue a range of interests and social activities. The staff did not use restraint. The staff worked closely with other professionals to help make sure people's needs were met.

Right Care: Staff promoted equality and diversity, helping people to celebrate their culture and religion. Staff treated people with kindness and respected their privacy. They were gentle, caring, and responsive to people's needs. Staff understood how to protect people from poor care and abuse.

The service had enough appropriately skilled staff to meet people's needs and keep them safe. The staff had access to a range of training and had the information they needed to care for people well.

Care and support plans included personalised information and guidance for staff to meet individual needs. Their planned care, health needs and medicines were regularly reviewed by staff and other professionals involved in their care.

Right culture: Staff understood people's strengths, impairments, and sensitives. They provided compassionate and empowering care tailored to their needs. Staff turnover was low, and this helped to ensure people were supported by the same consistent staff who knew them well. Staff placed people's wishes, needs, and rights at the heart of their work. The staff involved people's families and other professionals when developing care plans.

Relatives and staff felt well supported by the management team and able to raise concerns with them. They felt concerns were acted on and lessons learnt when things went wrong. There were systems to monitor and audit the service to help improve quality and people's experiences.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 November 2017).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

Follow up

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

At the last comprehensive inspection, 9 and 10 September 2015, the service was rated Good.

At this inspection, 17 and 23 October 2017, we found the service remained Good.

We observed positive interactions between the staff and the people using the service and we received positive feedback from relatives and professionals to gain their views on the service.

Feedback from people using the service, relatives and staff we spoke with was positive about the service.

There were checks and systems to ensure the fire procedures were followed and that equipment was in place to help protect people in the event of a fire.

Staff received training on safeguarding adults from the risk of abuse and there were policies and procedures in place.

People’s care records included their needs and preferences and were individualised. We saw information had been reviewed on a regular basis.

Staff continued to receive support through one to one and group meetings. They also received an annual appraisal of their work. Training on various topics and refresher training had been arranged in various subjects that were relevant to staff member's roles and responsibilities.

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

There were sufficient numbers of staff working to meet people’s needs. Recruitment checks were carried out to make sure staff were suitable to work with people using the service.

People received the medicines they needed safely.

People continued to access the health care services they needed and their nutritional needs were being met.

There was a complaints procedure available, which was also in a pictorial version to address the communication needs of some people.

The service was well-led by an experienced manager who worked alongside the staff team to support people who used the service. There were good systems for auditing the quality of the service.

We undertook this unannounced focused inspection to check that the Provider had followed their plan and to confirm that they now met the legal requirement. This report only covers our findings in relation to the requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Colham Road on our website at www.cqc.org.uk

Colham Road is a care home that provides accommodation for up to 13 people who have learning and/or physical disabilities. The service comprises of four lodges all linked by a communal main entrance. People can move about between the different lodges. There were thirteen people using the service at the time of the inspection.

There was 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 our focused inspection on the 17 December 2015, we found that the provider had followed their plan of action which they had told us would be completed by 15 September 2015 and the legal requirement had been met.

Records were kept of the prescribed medicines delivered to the service and carried over from the previous cycle to ensure the amount at any one time in the service was correct. Only staff who had received medicine training administered medicines to people.

There had been an increase in the audits and spot checks on people's medicines to ensure people were safely receiving their medicines.

The registered manager had introduced a checklist and guidelines to remind staff of their roles and responsibilities when carrying out the task of working with and administering medicines.

Pain protocols were being completed to ensure staff were aware of how people might communicate when they were in pain and required pain relief.

Overall the systems in place for managing people's medicines had improved and minimised medicine errors occurring.

We found that people's needs had been assessed and a personalised care plan developed providing guidance for staff about how to meet people's needs. Care plans contained information about people's preferences, likes and dislikes and had been reviewed and updated at regular intervals to ensure they reflected people's current needs.

People's nutritional needs were met. A variety of nutritious meals were provided and people's dietary needs had been assessed to ensure they received appropriate assistance and support during mealtimes.

The environment was maintained to a satisfactory standard and health and safety checks were being carried out to ensure the environment remained safe for staff and people using the service.

There were sufficient numbers of suitably experienced and trained staff to meet people's needs effectively.

Records were generally accurate, in good order and kept up to date, however, some records were not signed or dated, therefore it was not possible to tell if they were current or who had written them.

We used a number of different methods to help us understand the experiences of people using the service. Some of the people using the service had varied and complex needs which meant they were not able to tell us their experiences. We spoke to the relatives and representatives of three people, spoke with one person who uses the service and met with the majority of the staff team.

One person who uses the service said they were happy living in the home. They told us that staff were "nice". Relatives said in recent times the staff team had become more consistent and they said there were less agency staff in the home. One relative told us staff were caring and people were supported to engage in various activities.

Staff told us that there had been staff shortages, but this had improved. They confirmed the staff team worked well together to ensure people's individual needs were being met. Staff said people were not at risk of harm or neglect. The manager told us that staffing levels were increased as and when necessary, such as when people had an appointment or if there was a day trip planned.