Background to this inspection
Updated
16 February 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 18 January 2016 and was announced. This was so that key people could be available to participate in the inspection, and for people living in the service to be made aware we would be visiting their home. The inspection team consisted of two inspectors.
Before the inspection, we reviewed information we held about the service. This included previous inspection reports, and any notifications, (A notification is information about important events which the service is required to send us by law) and any complaints we have received. Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We sent out questionnaires for staff and visiting professionals to complete. This enabled us to ensure we were addressing any potential areas of concern. We received feedback from a social care professional and four relatives about their experiences of the service provided.
There were seven people living in the service at the time of our inspection. We used a number of different methods to help us understand the views of these people, who had complex needs which meant they were not able to tell us about their experiences. We spent time in the service observing the care provided and spoke with five people. We spoke with the registered manager, two senior care workers and six care workers. As part of our inspection looked in detail at the care provided for three people, and we reviewed their care and support plans. We looked at records of meals provided, medication administration records, the compliments and complaints log, incident and accidents records, policies and procedures, meeting minutes, and staff training records. We also looked at the service’s quality assurance audits.
The service was last inspected on 23 August 2013 when no concerns were identified.
Updated
16 February 2016
This inspection took place on 18 January 2016 and was announced.
9-11 Rutland Gardens is a supported living scheme where people live in their own home under a tenancy agreement, and is registered to provide personal care. People received personal care or social support in order to promote their independence. The support provided was tailored to meet people’s individual needs and enable the person to be as autonomous and independent as possible. 9-11 Rutland Gardens has up to seven people with a learning disability living in the service. At the time of the inspection there were seven adult males living in the service whose behaviour can be complex. The service is a large Victorian property made up of two separate houses with three floors. People have single bedroom accommodation and a range of communal facilities they can use. The service is situated in a residential area with easy access to local amenities, transport links and the city centre.
The service had a registered manager, who was present throughout the inspection, who has been in their current post for a number of years and knew the service well. 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 service was going through a significant period of review, where the provider and local stakeholders were looking at the service provision and what was needed and how the service would best be provided in the future.
Care staff were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were being updated, but did not fully detail that the bank care staff had been able to attend refresher training to meet the provider’s requirements. This is an area in need of improvement.
There were procedures in place for the safe administration of medicines. However, regular audits had not been maintained. This had meant that issues to be improved had not been highlighted, such as guidance for staff to follow on the administration of ‘PRN’ (as and when required medicines) had not all be reviewed to ensure the guidance was still up-to-date. There were gaps in the records of the checks of the temperature for medicines held in a refrigerator. This is an area in need of improvement.
Relatives told us people were safe in the service. One relative told us, “I have asked him not to be moved. I know he is alright and they won’t do anything to him. “People were supported by staff that were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. There were systems in place that ensured this knowledge was checked and updated. Medicines were managed and administered safely. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.
Care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence. People’s care and support plans and risk assessments were up-to-date, were detailed and reviewed regularly.
Consent was sought from people with regard to the care that was delivered. Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation, which they put into practice. Where people were unable to make decisions for themselves staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.
People were supported to eat a healthy and nutritious diet. They had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans.
People were supported by kind caring staff. There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. The number of staff on duty had enabled people to be supported to attend social activities.
Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the registered manager who they described as very approachable.
Relatives, staff and visiting healthcare professional told us the service was well led. People and their representatives were asked to complete a satisfaction questionnaire to help identify any improvements to the care provided. People had the opportunity to attend regular weekly ‘tenants' meetings’. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.