Archived: Choice Support - 16-18 Dartford Road

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.

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 our comprehensive inspection on 21 and 22 June 2017, we found there were not always enough staff on duty to meet people's needs and the systems used in assessing and monitoring the quality of the service was not always effective. Following that inspection, the provider wrote to tell us the actions they would take to address our concerns. At this inspection we found that the provider had completed these actions and complied with the regulations.

There were enough staff available to support people’s needs including supporting them access the local community for social interactions and to participate in activities that stimulated them. There were effective systems in place to assess and monitor the quality of the service and this included daily, weekly, monthly and quarterly audits in areas such as medicines, infection control and health and safety.

The provider had safeguarding policies and procedures in place and staff knew of their responsibility to protect people from abuse. Staff said they would whistle-blow if they had any concerns of poor practices. The provider had safe recruitment processes in place and staff were checked before being employed to work at the service. People’s medicines were managed safely. People were protected from the risk of infection because staff followed appropriate infection control protocols to reduce the spread of diseases and accidents and incidents were reported and recorded to drive improvements.

There were systems in place to deal with avoidable harm. Risk to people had been identified, assessed and had appropriate management plans in place to prevent or minimise the risk occurring and staff knew of actions to take to mitigate risks to people. People had personal emergency evacuation plans in place which provided both staff and the emergency services information on how to evacuate people safely in the event of an emergency.

People’s needs were regularly assessed to ensure they were being met. Staff were supported through induction, training and supervision to ensure they had the knowledge and skills to perform their role effectively. Staff treated people with kindness and compassion and respected their privacy and dignity. Staff promoted people’s independence and involved them in household tasks that they had the ability to undertake. Staff understood the Equality Act and promoted people's diversity. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to maintain good health and to eat and drink sufficient amounts for their wellbeing. People were supported to access healthcare services when required. The provider worked in partnership with other health and social care organisations to provide a joined-up service. The home was suitable and meeting people’s needs because of the way it was designed, decorated and adapted for their use.

There was appropriate guidance in place to ensure people’s communication needs were met. Each person had a care plan that provided guidance for staff on how their physical, mental and social care needs should be met. People were supported to maintain relationship with people that were important to them. People were supported to engage in activities of interest that stimulated them. The provider had a complaints policy in place and people knew how to make a complaint. Where required people were supported with end of life care needs.

There was a registered manger in post who notified CQC of significant events at the service. The provider displayed their CQC rating at the home and on their website to ensure people had access to this information. There was an organisational structure in place and staff knew of their individual responsibilities. People, their relatives and staff views were sought to improve the quality of the service. The provider worked with key organisations to plan and deliver an effective service. There were systems in place to support continuous learning and improve the quality of the service.

Choice support – 16 -18 Dartford road, provides accommodation for people who require nursing or personal care for up to five adults who have a range of needs including learning disabilities. There were five people receiving personal care and support at the time of our inspection.

At this inspection, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. We found there were not always enough staff on duty to meet people’s needs at all times to support them to take part in a range of activities in support of their need for social interaction and stimulation.

You can see what action we have asked the provider to take at the back of the full version of this report.

The provider had systems and processes in place to assess and monitor the quality of services people received, and to make improvements where required. Staff used the results of audits to identify how improvements could be made to the service. However, we found that the audits had not identified the concerns in relation to dependency of people and staff deployment, supporting people in a wide range of activities at all times, and medicines cabinet temperatures were not monitored.

People and their relatives told us they felt safe and that staff and the registered manager treated them well. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service which were up to date and included detailed guidance for staff to reduce risks.

There was an effective system to manage accidents and incidents, and to prevent them happening again. The service carried out comprehensive background checks of staff before they started working. Staff supported people so that they took their medicines safely.

The service provided an induction and training, and supported staff through regular supervision to help them undertake their role. Staff prepared, reviewed, and updated care plans for every person.

The provider had taken action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed.

Staff assessed people’s nutritional needs and supported them to have a balanced diet. Staff supported people to access the healthcare services they required and monitored their healthcare appointments.

People and their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.

Staff supported people in a way which was kind, respectful and encouraged them to maintain their independence. Staff also protected people’s privacy and dignity, and human rights.

The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary.

There was a positive culture at the home where people felt included and consulted. People and their relatives commented positively about staff and the registered manager. Staff felt supported by the registered manager.

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. The registered manager was also working in the capacity of an area manager for the provider for 12 weeks.

The provider had initiated the process to change the service from a residential care service to a supported living service and to ensure a smooth transition of the service; an action plan had been developed and consultations with various stakeholders were in progress at the time of the inspection.