Archived: Popis Gardens

Updated 5 April 2017

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 took place on 22 and 23 February 2017 and was unannounced. We carried out this inspection due to concerns raised with us about the service. The inspection was undertaken by one inspector.

As part of our inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us.

During the inspection we observed staff support people who used the service, we spoke with three people who used the service, six staff members, representatives of the senior management team and the manager. We spoke with staff from an external agency contracted by the local authority to provide additional support for people outside the home. We also spoke with relatives of four people who used the service to obtain their feedback on how people were supported to live their lives.

We received feedback from representatives of the local authority health and community services and staff from external support agencies. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed care records relating to two people who used the service and other documents central to people's health and well-being. These included staff training records, medication records and quality audits.

Updated 5 April 2017

This inspection was carried out on 22 and 23 February 2017 and was unannounced. We carried out this inspection due to concerns we received about the service. At the last inspection on 12 October 2016 the provider was found to be meeting all the standards we inspected. At this inspection we found that they were not meeting all of the regulations. This was in relation to safety, staffing, person centred care and management systems. You can see what action we took at the back of our report.

Popis Gardens provides accommodation and personal care for up to ten adults with learning disabilities. The accommodation is split between two bungalows. There were seven people using the service at the time of this inspection.

The home did not have a registered manager. The manager had been in post since October 2016 and had started the process to register with Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Regular reviews of care plans and risk assessments had not been routinely undertaken to help ensure that people’s care remained appropriate to meet their needs. Potential risks to people’s safety and welfare had not been identified and managed appropriately.

Some staff told us that they had not always felt supported in their roles. There had been four managers at Popis Gardens in the past two years and the staff team had found this challenging as each manager had a different approach and a different way of working. Staff had received training in relation to the Mental Capacity Act 2005 (MCA). The service was working within the principles of the MCA however; staff members did not demonstrate a clear understanding of their role in protecting people's rights in accordance with this legislation.

Staff respected people’s dignity as much as possible. However, there had been instances where people's personal care had not been provided by care staff of the same gender which had the effect of significantly compromising people’s dignity.

People did not always receive food choices, care and support in such a way that met their individual choices and preferences. People who used the service and their relatives told us and our observation confirmed that there was a lack of meaningful activities and engagement opportunities at Popis Gardens.

The provider’s governance systems were not used at the home to effectively assess the quality of the service provided. Staff were not confident when raising issues with senior management team as this had not proved effective in bringing about necessary improvements. Continued concerns that had the potential to have a negative impact on the quality of care and support provided had not been identified and managed appropriately by the senior management team.

People told us that they felt safe living at Popis Gardens. The staff team had been trained in how to safeguard people from avoidable harm and were able to tell us about the potential risks and signs of abuse. People received their medicines safely. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so.

Staff received training to support them to care for people safely. People’s weights were regularly monitored and were noted to be stable and there had been no concerns raised by health professionals in relation to people’s dietary intake. People were supported to access health professionals as needed.

People and their relatives spoke positively about the permanent staff team and told us that staff were kind and caring. People's records were stored appropriately to help maintain the dignity and confidentiality of people who used the service. External advocacy services had been secured to support people when making important decisions about their lives. People were supported to maintain relationships with their relatives.

The environment throughout the home was warm and welcoming and people's individual bedrooms were personalised. People’s care plans were sufficiently detailed to be able to guide staff to provide individualised care and support. Complaints were managed in accordance with the provider’s policy and procedures however; actions had not always been taken in a timely manner.

The manager was already aware of the issues that we identified during the course of this inspection and had made a request to the provider’s human resources department for additional support. An interim regional manager had made a commitment to support the manager in addressing areas of concern starting with the staffing concerns.

People who used the service responded openly to the manager and told us they felt supported.