We carried out a review of the data available to us about 19 Forrest Road on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about 19 Forrest Road, you can give feedback on this service.
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 the last inspection, the service was rated Good.
At this inspection we found the service remained Good overall.
Why the service is rated Good:
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 the last inspection in March 2016 we found a breach of Regulation 19 HSCA RA Regulations 2014 Fit and proper persons employed. The service had not consistently conducted sufficient checks to ensure prospective staff were safe to work with vulnerable people. At this inspection we found action had been taken and improvements made.
The service had robust recruitment procedures in place and conducted background checks of all prospective staff. References were obtained and criminal background checks were recorded ensuring staff were suitable for their roles.
People remained safe living in the service. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enabled people to live their lives as they chose. People received their medicines safely.
People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored. People’s nutritional needs were met.
The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.
People had access to information about their care and staff supported people in their preferred method of communication. Staff also provided people with emotional support.
The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly and their views were sought and acted upon.
The service was well led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos. The service had strong links with the local community.
The registered manager monitored the quality of the service and strived for continuous improvement. There was a very clear vision to deliver high quality care and support and promote a positive culture that was person-centred, open and inclusive. This achieved positive outcomes for people and contributed to their quality of life. The registered manager was robustly supported by the operations manager.
19 Forrest Road is purpose built and can accommodate people who require wheelchair access; each person has their own bedroom with an en-suite. There are a number of communal areas within the service: including the kitchen, dining room, lounge, activities room and a small upstairs lounge. Entry and exit to the service is secure for people via a key code. People have access to a large secure rear garden. The service has two vehicles to enable staff to take people out into the community or to attend appointments.
The service had a registered manager. 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 provider had ensured that there were sufficient staff deployed to meet people’s needs and preferences regarding the gender of care staff providing their personal care. Staffing was responsive to people’s needs and enough staff were available at the correct time to support people to attend their activities. Each staff shift had a senior member of staff, who led and guided the staff team in their work to ensure people received safe care.
The provider had completed recruitment checks in relation to staff. However, they had not always ensured that applicants had provided a full employment history or a satisfactory written explanation for any gaps. Therefore there was the potential that people might have been placed at risk from the recruitment of staff as the provider had not fully assured themselves of their suitability for their role.
People told us they felt safe in the care of staff. People were safe as staff understood their roles and responsibilities in relation to safeguarding and safeguarding alerts had been made to the relevant authority as required to ensure people were safeguarded against the risk of abuse.
Risks to people had been identified and assessed, specific risks to people in relation to financial abuse and exploitation had been identified and addressed by the provider to ensure their safety. Staff understood and managed risks to people. Incidents were correctly documented and reviewed to ensure any further action required was taken to ensure people’s safety.
People received their medicines from appropriately trained and competent staff. People’s medicines were stored in accordance with legal requirements. Staff had access to appropriate guidance to ensure they administered people’s medicines safely.
Staff were required to undertake the recognised industry standard induction if they were new to social care. Staff were then provided with ongoing training opportunities; relevant to the needs of the people they supported and received regular supervision of their work. The provider encouraged and supported staff to undertake professional qualifications. People were supported effectively by staff who were appropriately trained and supervised in their role.
People’s consent to their care had been sought. Where people lacked the capacity to make specific decisions staff had followed the requirements of the Mental Capacity Act 2005. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Applications had been submitted for five people living at the service. People’s human rights were protected as decisions made on their behalf met legal requirements.
People had a diet and nutrition care plan which described any support they required from staff with eating and drinking. People made choices about their meals and the time they ate and were involved with the preparation of meals where possible.
Staff ensured people received an annual review of their health with their GP and had a resulting action plan to ensure their health care needs were met. People were supported to access a range of healthcare professionals as required in order to maintain good health.
People experienced positive, supportive relationships with the staff who cared for them. They told us “Staff are very friendly and caring” and “Staff are good.” Staff understood people’s personal histories and had access to relevant written information about them which they used to form relationships with people.
Staff were provided with information about each person’s communication needs. This enabled them to understand how to enable people to be involved in making daily decisions about their care and treatment.
People’s care plans stated how people were to be supported to maintain their privacy and dignity. Staff understood how to uphold people’s dignity when providing their care and this was confirmed by people.
People’s needs had been assessed prior to them being accommodated at the service. Their care plans were developed in consultation with them and regularly reviewed to ensure they reflected their ongoing needs.
Staff were responsive to people’s moods and behaviours which could challenge staff. They altered their response to people depending on the person’s behaviours and how receptive they were to positive guidance or to being distracted away from the situation to ensure people’s safety.
People were supported to maintain relationships that were important to them. They were also enabled by staff to develop and pursue their interests and hobbies. Staff assisted people to access the community regularly.
People understood how to make a complaint and were regularly asked if they had any complaints about the service or feedback. The provider sought and acted upon feedback about the service.
The provider had values which underpinned the provision of people’s care. Staff were observed to apply these throughout their work with people. The registered manager worked alongside staff to ensure they could monitor staffs behaviours for people.
People and staff provided positive feedback about the management of the service. The registered manager had a good understanding of the service and the people they cared for. They were very visible within the service and approachable. They encouraged people and staff to raise any issues which they needed to in order to ensure people were well cared for. There were clear processes in place to provide management cover 24 hours a day or in the event of the manager’s absence.
The registered manager completed both weekly and monthly reports for the provider about the quality of the service. The provider visited the service regularly and provided the registered manager with a written report following each visit of their findings and any actions required to improve the quality of the service for people. There were systems in place to regularly update the provider on the quality of care and to drive improvements to the service for people.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.