Archived: Room 29/30, Basepoint Winchester

Room 29/30 provides personal care to adults with a learning disability, physical disabilities, mental health needs or sensory impairment. At the time of our inspection twelve people were receiving personal care.

Room 29/30 has 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.

Staff had received safeguarding training and were able to describe sources and signs of abuse and potential harm. The registered manager told us that the safeguarding policy had just been updated and was available to staff online.

Each person had a health and safety risk assessment which considered which aspects of a person’s care could present risks to their health, safety and wellbeing. Staff told us there was specific guidance to mitigate risks, such as checking the water temperature before people stepped into the shower. One staff member told us that if they identified any further risks they would notify the office immediately who would update the risk assessments. Risk assessments were regularly reviewed and updated.

Incidents and accidents were recorded appropriately and investigated where necessary. There had only been one accident in the last year. Appropriate actions had been taken to prevent the accident from re-occurring and the service had worked with other agencies to ensure appropriate measures had been put in place. This meant the provider took action to reduce the risk of further incidents and accidents.

There were enough staff to meet the needs of people using the service. The rostering system identified the calls and then matched these with staff available to cover. People told us that they had never had a missed call from staff. Bank staff were available to cover emergencies such as staff sickness.

Recruitment procedures were safe. There was a recruitment policy in place, which was followed by the registered manager. Disclosure and Barring (DBS) checks were carried out before anyone could be recruited. These checks identify if prospective staff had a criminal record or were barred from working with people at risk. Potential staff had to provide two references and a full employment history, to ensure they were suitable to work within the service.

The service was not responsible for administering medicines to people. People were reminded to take their medicine or to reorder their medicines from their GP where necessary. Staff had received medication awareness training, as a safeguard, in case there were any incidents involving people’s medicine which they needed to respond to.

Staff had received appropriate training to deliver the care and support for people using the service. Records showed that training covered all essential areas such as emergency first aid, fire prevention and awareness, infection control and manual handling. Training was delivered via e-learning and workshops and staff could request additional training in areas where they had a specific interest or need.

People were asked for consent before care and support was provided. Everyone said they were asked for their consent. Everyone using the service had the capacity to give valid consent for the care and support they received.

Food and nutrition was not included as part of the service provided to people. People were supported to go shopping to purchase their own food.

Health professionals were appropriately involved in people’s care. People were supported to attend medical appointments when they requested it.

People told us that staff were kind and caring. Staff told us they got to know people by talking to them and listening to them. They were able to describe people’s individual likes and dislikes such as the types of toiletries they preferred or their hobbies. We observed mutual positive caring relationships between staff and people. Staff knew how to treat people with dignity and respect.

People were supported to be as independent as possible. The service was set up to maintain people’s independence in their own homes. Staff told us they encouraged people to do as much as possible for themselves in terms of washing, shopping, cleaning and organising their medicine.

People were involved in writing their support plans. Person centred assessments were carried out when a person started to receive care and support. Where they were able to, people had written these themselves. They included information about people's health needs, sensory ability, mental health and a skills checklist identifying strengths and areas where support was required. Specific guidelines were written about how people liked to receive their support.

Support plans were kept up to date with six monthly reviews. People’s support plans which were held in the office demonstrated that these reviews had taken place, however people’s support plans in their own homes were not quite as up to date. Staff told us they were in the process of ensuring that support plans in people’s homes reflected the updates described in the office copy. People were able to communicate their needs verbally.

Feedback was encouraged from people and staff. A ‘Service user working together group’ had been implemented, which met monthly. This included people using the service and staff who had volunteered. The group were involved in developing policies and practices for the provider which could be implemented across all the provider’s services.

Regular staff meetings were held, which gave staff the opportunity to raise their views. They could also discuss matters individually with managers during supervision meetings. All the staff we spoke with said they could talk to the registered or deputy manager any time if they had any concerns or worries. An annual survey was carried out and people were asked their views about the service they received.

There was an open and transparent culture within the service. Staff told us that management were open always kept them updated. Key values, such as person centred care, underpinned the service and were demonstrated through support and care provided to people. Staff were valued by the provider and protected from risk, such as lone working.

The registered manager was well known and respected amongst staff and people. Everyone said they would speak with her if they had a concern. The registered manager made the required notifications to the CQC. A notification is important information about the provider which the service has a legal duty to notify CQC about.

An effective system of quality control was in place to ensure the quality of the service delivered to people. A continuous improvement plan had been written in September 2015. The plan focussed on making the support, the team and the environment even better.

People who use the service, or their relatives, all said they were asked for their consent before care was given. One person told us 'Yes, they ask all the time.'

People were positive about the care they received. One person said 'I am happy with everything' and another said 'In general I find it's pretty good.' One person told us that they liked their independence and didn't want care staff to do everything for them. They said that staff respected this. Everyone said they were satisfied with the care.

We saw that staff had completed an application form, provided references covering the last five years employment, provided proof of identification and received a Criminal Records Bureau (CRB) or Disclosure and Barring (DBS) check.

We reviewed the results of the last customer satisfaction survey which was carried out in April 2013. People were asked about aspects of care. Responses were positive and included comments such as 'I am happy with all the support workers,' and 'I feel safer in the shower now.' The feedback survey had also been sent out in picture format for those people who found it difficult to respond to written questions.

People had safe and appropriate care and support, because their needs were assessed before they received a service, and reviewed regularly.

One person, who was the most recent to receive a service from the agency, said that the staff were "experienced and good at their job". They felt that the service "sets high standards" for the staff it recruits. People received a service that was flexible to meet their changing needs.

We looked at safeguarding referrals that had been made, reviewed staff training records, talked to staff and reviewed care plans. We found that people were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse, prevent abuse from happening and respond appropriately to allegations and concerns.

Through talking to staff and people who use the service, looking at the induction programme, training records and the rota for support staff, we found that people's care needs were met by competent staff.

The provider had in place systems that sought people's views, and took account of complaints and comments. This meant the provider had an effective system to assess and monitor the quality of the service.