Background to this inspection
Updated
11 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was unannounced which meant the provider and staff did not know we were coming. The inspection took place on 26 and 30 October 2018 and was carried out by one inspector.
Before the inspection we looked at notifications that we may have received and communications with people, their relatives and other professionals, such as the local authority safeguarding and commissioning teams as well as other health and social care professionals.
We used a number of different methods to help us understand the experiences of people using the service. The people using the service had complex needs and for some people there was limited or no conversational communication which meant that not everyone was able to tell us their views. We gathered evidence of people’s experiences by talking with two people and by observing interactions with staff. We also looked at how the service communicated with people, their families, advocates and other care professionals. We also spoke with the manager, a deputy manager and four members of the care staff team.
As part of this inspection we reviewed five people’s care plans. We looked at the medicines management, training, appraisal and supervision records for the staff team. We reviewed other records such as complaints information, quality monitoring and audit information, maintenance, safety and fire records.
Updated
11 January 2019
28a King Henrys Walk is a home providing respite residential care and support for up to 10 people with learning disabilities and other complex needs. Over 50 people use the service for short stays, although in emergencies two of the home’s ten beds were kept available to offer urgent placements. This was the case for two people using the service when we visited.
The service is run by Islington Council social services department. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our previous inspection on 31 March 2016, we found that the service was meeting the regulations we looked at and the overall rating was Good.
At this inspection we found the service remained Good.
At the time of our inspection a manager was employed at the service and was undertaking the registration process with the Care Quality Commission. 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.
The service is owned and run by the London Borough of Islington and used the authority’s borough wide safeguarding vulnerable adults from abuse procedures. The four members of care staff we spoke with said that they had training about protecting people from abuse, which training records confirmed. All staff we spoke with had a good understanding of how to keep people safe from harm and how to respond if any concerns arose.
We saw that risks assessments concerning people’s day to day support needs, healthcare conditions and risks associated with daily living and activities were detailed, and regularly reviewed. The instructions for staff were clear. These instructions informed staff about actions to be taken to reduce these risks and how to respond if new risks emerged.
There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards [DoLS] to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS safeguards appropriately and making the necessary applications for assessments when these were required, which was rare, and informing the CQC when DoLS approvals had been granted.
Care was planned and delivered in a consistent way and the service had good procedures in place to plan for every stay that people had at the service. Information and guidance provided to staff was clear.
Care plans showed that the service developed methods of communication best suited to people’s needs. The care plans described how they could ascertain each person’s wishes to maximise opportunities for people to make as many choices that they were meaningfully able to make.
The service and the provider carried out regular audits of all aspects of the service. The provider carried out regular external reviews of the service and sought people’s feedback on how the service operated.
At this inspection we found that the service met all of the regulations that we looked at.