This inspection took place on 27 January 2016 and 08 February 2016 and was unannounced. The service had not been inspected previously since it was registered 19 February 2015. Moti Willow is registered to provide accommodation and personal care for up to 7 people with Mental Health needs. At the time of our inspection 7 people were living at the home.
There was a manager in post who was in the process of registering with the 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 and associated Regulations about how the service is run.
People were independently organising their leisure activities, they had regular visits to local shops and their family. There were also activities provided in the home or other locations owned by the provider for people to participate in. The manager told us they were discussing with people what activities they wanted the service to organise and support them with. There were workshops organised for people to learn about their rights, hygiene and healthy eating.
Risks associated with daily activities and people`s mental health needs were identified however there were no clear plans how to manage and mitigate these. Agency staff working regularly at the service were not knowledgeable about the signs and symptoms in case people had a relapse in their mental health conditions.
People were involved in review meetings with their key worker where they discussed different aspects of their care needs. The care plans contained personal information about people, medical history and appointments, care reviews and incident reports, there were no detailed plans about how people communicated, risk assessments and personalised plans around the support needs for people`s mental health needs.
Accidents and incidents were recorded and information was sent to the provider`s head office as well. The manager told us they were investigating incidents or accidents and they were looking for trends if it was a need for it.
The manager told us they were encouraging people to be independent and in control of their life. People told us they were encouraged to participate and help in daily tasks, cooking, setting tables, laundry, keeping their bedroom tidy, however there were no plans developed to ensure staff had a systematic and consistent approach when supporting people to become more independent. People had no clear goals for them to achieve and monitor their progress.
People received support from staff who had been appropriately trained and were knowledgeable in how to protect people from abuse. Regular staff knew how to report concerns and were able to tell us when they would report under the whistleblowing policy to the local safeguarding authority or the CQC. However agency staff who was regularly working at the service had not received training about the mental health conditions people lived with.
People were supported by appropriate numbers of staff, some of which were agency staff. The manager had been recruiting to build up a permanent staff team to ensure people were supported by a permanent staff and received consistent support.
Recruitment processes were thorough and ensured staff employed were of good character and fit to support people with complex mental health issues. They received an induction and on-going training and had regular supervision with the manager.
People were supported to have their medicines safely by appropriately trained staff who`s competency to administer people`s medicines was regularly checked.
People were supported to cook their own food and they were encouraged to eat a varied and nutritious diet and to drink sufficient amounts to maintain their health. People were able to access health care professionals, such as GP’s as and when required, staff supported people to attend hospital appointments when needed.
People had access to the complaint procedure and this was explained to them in the regular meetings they had. People were confident that if they had to raise any issues staff would be receptive to their concerns.
People`s dignity and privacy was respected; people had keys to their bedrooms and staff was seen knocking and giving people time to respond and invite them in before they entered people`s personal space.
There were several audits carried out by the manager monthly and six monthly by the provider and they looked at areas like infection control, health and safety, medicines management, supervisions, care reviews. A quality survey had been sent out to people, relatives, staff and health and social care professionals. The service only received the results from people who used the service at the time of our inspection.