Micholl's House

Updated 17 November 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.

At our previous inspection in September 2016 the service was in breach of two regulations. Requirements were made to address those breaches and recommendations were made to address other areas of practice that required improvement.

This inspection took place on 10 and 11 October 2017. It was an unannounced inspection which meant staff and the provider did not know we would be visiting. The inspection was undertaken by two inspectors on both days and an expert by experience on day one. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert was experienced in living with someone with learning disabilities, autism and management of challenging behaviours.

Prior to the inspection we requested a Provider Information Record (PIR) on the service. The PIR is a form that the provider submits to the Commission which gives us key information about the service, what it does well and what improvements they plan to make. We reviewed other information we held about the service such as notifications and safeguarding alerts. We contacted health care professionals involved with the service to obtain their views about the care provided. We have included their written feedback within the report.

During the inspection we walked around the home to review the environment people lived in. We spoke with the registered manager, deputy manager, twelve care staff and six people who used the service. We spoke with eight relatives and one staff member by telephone after the inspection. We received written feedback from another relative. We looked at a number of records relating to individuals care and the running of the home. These included eight care plans, medicine records for eight people, shift planners, five staff recruitment files, staff training and six staff supervision records.

We asked the provider to send further documents after the inspection. The provider sent us documents which we used as additional evidence.

Updated 17 November 2017

This inspection took place on 10 and 11 October 2017. It was an unannounced visit to the service. This meant the service did not know we were coming.

Micholl's house is a care home which provides accommodation and personal care for up to twenty people with a learning disability. The home had been purpose built and is made up of four individual units. Each unit accommodates five people. There are two units on the ground floor and two units on the first floor. At the time of our inspection there were twenty people living there.

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 home was previously inspected in September 2016. At that inspection they were found to be in breach of two Regulations of the Health and Social Care Act 2009 and got an overall “Requires Improvement” rating. At this inspection we found those regulations had been met and the service had made good progress in improving the service which resulted in an overall good rating.

People were happy with the care provided and had positive relationships with staff. The majority of relatives spoken with were happy with the care provided. They felt thankful to staff. One relative described it as “Home from home where my family member is happy”. People had access to activities. Two relatives were unhappy with their family members care in relation to their access to activities. Another relative was unhappy with many aspects of their family members care and was considering if this was the right placement for their family member. This was fed back to the registered manager to address.

Systems were in place to safeguard people. Risks to people were identified and managed which promoted people’s independence. People had support plans in place which provided guidance to staff on the support required. Care plans were updated and reviewed as people’s needs changed.

The home had a higher than expected number of medicine errors reported over the course of the year. Measures were put in place to address those errors. The medicines records viewed showed medicines were safely managed.

People were consulted with on their care and the service worked to the principles of the Mental Capacity Act 2005. Their health and nutritional needs were met.

Staff were suitably recruited, inducted, trained, supervised and supported. This enabled them to have the right skills and training to support people effectively. The home had a number of staff vacancies and used bank and agency staff to cover the vacancies. Staff felt the staffing levels were sufficient. Some relatives felt the staffing levels were not always sufficient and that one to one observation of their family member was not consistently maintained and impacted on community activities people had access to. This was fed back to the manager to follow up on.

People’s privacy and dignity was promoted. Staff were kind, caring and had a good knowledge of the people they were supporting. They were aware of people’s needs, risks and the support required to promote their safety. People were provided with information in a format suitable to their needs and staff used symbols and pictures to communicate with people.

People and their relatives knew who to contact to raise a concern or complaint. Monthly resident's meetings took place which enabled people to raise issues which affected them as a group. An annual survey was undertaken to enable the provider to get feedback on the service. Systems were in place to audit the service to enable the provider to satisfy themselves the service was running effectively. Where issues were identified action was taken to make improvements.

People who used the service, staff and the majority of relatives were happy with the way the home was managed. The registered manager was described as accessible, approachable, flexible, brilliant and had the right attitude. The registered manager had made positive changes to the service. They had developed a committed staff team who were clear about their roles and responsibilities .The registered manager acted as a positive role model and was clear of what needed to improve to benefit people.