This inspection took place on 28 July 2015 and was unannounced. At the last inspection on 25 September 2013 we found the service was meeting the regulations we looked at.
89 Grosvenor Avenue is a care home that can accommodate up to five adults with personal care and support needs. The home specialises in supporting people living with a learning disability or autistic spectrum disorder. There were five people living at the home at the time of our inspection.
The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
Although staff were suitably trained and knowledgeable about the care and support people required, we found the work performance and professional development of staff was not formally appraised by the registered manager. The meant staff might not be appropriately supported to carry out all the duties they were employed to perform. Furthermore, the registered manager was unable to locate Hospital Passports that we were told had been developed for everyone who lived at the home. Hospital Passports are important documents that contain information medical staff need to know about a person and their health care needs in the event of them being admitted to hospital.
People were safe living at the home. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. There were appropriate plans in place to ensure identified risks to people were minimised. Staff had access to appropriate guidance and knew how to keep people safe in the home and the wider community. The registered manager ensured regular maintenance and service checks were carried out at the home to ensure the environment was safe.
People using the service and their relatives told us they were happy with the quality of the care and support provided by staff working in the home. Staff looked after people in a way which was kind, caring and respectful. Our observations and discussions with people using the service and their relatives supported this. We saw staff spoke with people in a warm and respectful way and ensured information they wanted to communicate to people was done in a way that people could understand. Staff knew how to ensure people received care and support in a dignified and respectful way.
People were encouraged to maintain social relationships with people who were important to them, such as their relatives. There were no restrictions on visiting times and we saw staff made peoples’ guests feel welcome. Staff encouraged people to participate in meaningful social, educational and vocational activities that interested them. Staff also supported people to maintain their independence so far as possible, as well as learn new independent living skills, where appropriate.
Care plans had been developed for each person using the service, which reflected their specific needs and preferences for how they were cared for and supported. These plans gave clear guidance and instructions to staff about how they should care and support people and ensure their needs were met. Consent to care was sought by staff prior to any support being provided. People were involved in making decisions about the level of care and support they needed and how they wanted this to be provided. Where people's needs changed, the service responded by reviewing the care and support people received, which included their care plan.
People and their relatives felt comfortable raising any issues they might have about the home with the registered manager. The service had arrangements in place to deal with people’s concerns and complaints appropriately.
People were supported to keep healthy and well. Staff ensured people were able to access health care professionals and services quickly when they needed them. Staff worked closely with other health and social professionals to ensure people received the care and support they needed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration. People received their medicines as prescribed and staff knew how to manage medicines safely.
There were enough suitably trained and competent staff to care for and support people. The registered manager continuously reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service.
The registered manager understood when a Deprivation of Liberty Safeguards (DoLS) authorisation application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.
The registered manager demonstrated good leadership. It was clear they understood their role and responsibilities, and staff told us they were supportive and fair. The registered manager encouraged an open and transparent culture. They proactively sought the views of people, relatives, visitors, staff and external health and social care professionals about how the care and support people received could be improved.
The provider and managers carried out regular checks of key aspects of the service to monitor and assess the safety and quality of the service that people experienced. The registered manager took appropriate action to make changes and improvements when this was needed.