The inspection took place on the 28 June 2016 and was announced.The service was registered in November 2014 and had not previously been inspected.
The service is registered to provide accommodation and personal care and support to a maximum of six people, and at the time of the inspection they were at full capacity. The service offers support to people with complex health needs, acquired brain injuries and physical and learning disabilities. It is located a short distance from the centre of Winsford.
A manager was in post who had been registered with the CQC since December 2014. The registered manager was supported by another manager who was based onsite and helped with the day-to-day running of the service. 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.
Staff had received training in safeguarding and knew how to recognise the signs that may indicate abuse is taking place. The registered provider had a safeguarding policy in place, and staff were clear how and who to report their concerns to.
There were sufficient numbers of staff in place to meet people’s needs. People’s relatives told us that they had never seen the service short staffed. The registered provider had robust recruitment measures in place to ensure that staff were of suitable character and skill. This included checks by the disclosure and barring service (DBS), and obtaining references from previous employers.
People were supported to take their medication by staff who had been trained in the safe administration of medicines. Medication was stored securely, and appropriate records were in place to document when these had been administered.
Staff had received training and support which enabled them to carry out their roles effectively. Staff demonstrated a good understanding of the roles and responsibilities in relation to the MCA, and people were offered choice and control over their care needs. This ensured that people’s liberties were protected in accordance with the law.
People received the necessary support during meal times, and there were clear instructions in care records for staff to follow around this. Charts were in place to monitor people’s nutritional and fluid intake, where they were at risk of weight-loss. People were supported to access health and social care professionals where required. This ensured that people’s health and well-being was maintained.
Positive relationships had been developed between staff and people using the service. Throughout the inspection there was a lot of laughter and warmth, and staff spoke positively about the people they supported. The service had received a number of compliments from outside agencies about the staff. The staff team had won ‘best care team’ at the national care awards in 2015 due to their work with people using the service.
People were frequently supported to engage in activities, both outside and inside the service. There were examples of people going Kayaking, out for walks and there had been a recent holiday to Blackpool. This demonstrated a compassionate approach, and also ensured that people received the social stimulation they needed.
The registered provider had a complaints policy in place, and people’s relatives felt able to complain. There was an easy read complaints policy in place for people using the service, however no complaints had been received. The registered manager was aware of how to access the local advocacy service, to support people with decision making, and we saw that one person had the details of their advocate pinned to the notice board.
Staff and people’s relatives told us that management were approachable and supportive. There were clear lines of accountability in place, and staff knew who to report to if they had any concerns. There was a process in place for learning from any issues that may have occurred. Information around any issues was cascaded to staff so that they were aware of risks, and how to prevent these occurring in the future.
The registered manager and the registered provider carried out audits and quality checks of the service to ensure that standards of care were maintained. This included checks on care records, the environment and infection control. Follow up action had been taken in response to any issues identified within a timely manner.