Archived: The Vines

The Vines is located in Mapperley, Nottinghamshire. The service provides respite care for people with a range of needs including those with learning and physical disabilities. The service is registered to provide accommodation and support with personal care for up to four people.

The service had a registered manager in place at the time of our inspection. 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.

People and their relatives felt safe. People were protected from the risk of abuse as management and staff had a very good understanding of their roles and responsibilities if they suspected abuse was happening.

Risks to people’s safety were identified and assessments carried out and followed by staff to minimise the risk of harm.

People received care and support in a timely way as there were enough staff to meet people’s needs. People could be assured of safe recruitment practices.

People received their medicines as prescribed and the management of medicines was safe.

People received support from staff who received training and support to ensure they could carry out their roles effectively. Staff had their competency checked if using specialist equipment or carrying out specific procedures and felt supported and confident in their role.

People were encouraged and supported to make independent decisions wherever possible. In the event people lacked capacity to make their own decisions, the Mental Capacity Act (2005) was followed to ensure people’s rights were protected.

People were supported to maintain their nutritional and health needs. Referrals were made to health care professionals for additional support or guidance when needed and staff followed their guidance to ensure people maintained good health.

People were supported in a respectful and friendly manner and we observed that positive caring relationships had been developed between staff and people using the service. Where possible people were involved in planning their own support.

Staff understood peoples support needs and ensured they received personalised responsive care. Detailed and up to date guidance was contained within people’s support plans. People had the opportunity to take part in activities as they wished.

People, who used the service, and their relatives, knew how to raise an issue or complaint and were confident these would be listened to and acted upon.

Some improvements were required to systems to ensure people were supported in a consistently clean and safe environment and that regular audits were effective in identifying and responding to issues.

There was an open and transparent working culture at The Vines. People who used the service, their relatives and staff felt listened to and able to make suggestions to drive improvements at the service.

Is the service safe?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Although the service had currently no applications to be submitted for a DoLS order, proper policies and procedures were in place. We saw the appropriate staff understood when an application should be made, and how to submit one.

The manager told us how they were considering the needs of a person for a future stay at the service, whose treatment plan involved an aspect of care which may be seen as depriving them of their liberty. The service was consulting with the local Deprivation of Liberty Safeguards team in order to find the least restrictive way to provide care for the person.

We saw staff had attended regular training in both Safeguarding Adults and Deprivation of Liberty Safeguards training and had regular training updates and staff meeting discussions in these areas.

Is the service effective?

We spoke to people whose family members used the service for respite care the ones we spoke to all told us that it was a valuable service for their family member, to which they felt provided a safe and stimulating break for their sibling and a much needed break for their family as carers. One person told us 'his behaviour is calmer since he has been using the service.'

We looked at six care files and found the service effectively identified individual needs and based care and support programmes upon those needs. The service respected the equality and diversity of the people who used its services by customising the experience of their respite stay to that person's assessed needs, making sure the care, facilities and nutrition were provided individually to that person.

People were unable to tell us themselves about their experience of the service due to the severity of their disabilities, but carers and family members told us they thought the service was effective in providing the care their family members needed.

Staff told us people staying at the home go out each day to be involved in activities, in places like college on weekdays and on leisure trips and activities at the weekends.

Is the service caring?

Staff at the service had a good knowledge of the complex needs of people who used the service, supported by detailed and up to date care plans.

People were unable to tell us themselves about their experience of the service, but we saw staff caring for people in a caring manner, responding to individual needs in a patient and dignified way. We saw members of staff talking to people and telling them about the care they were about to provide for them in a simple and reassuring way.

Is the service responsive?

The managers of the home met with people before they used the respite service to identify if the service could meet their needs. Records showed that this process had included consulting with family members and carers, as well as professional such as doctors and physiotherapists to plan the best way of delivering a service to the person.

A member of staff told us that they always consulted people to make sure the service was right for them before arranging for them to stay. A relative of a person who used the service told us 'We requested respite care for [relative] at short notice due to a family emergency, and they were able to offer him care on the day we contacted them.'

Is the service well-led?

A relative of a person who used the service described the service as 'very good', stating the providers involved them as relatives in discussions and reviews of care and they shared a diary of events when her relative visited the home.

The manager told us and records showed a stable staff team who were well trained in essential skills of care provision such as safeguarding, manual handling and management of medicines. The provider had policies and systems in place indicating the service to be efficiently and professionally led. We saw a statement of purpose document for the service which outlined the way the service was run.

One parent told us 'I only have to call up [senior staff member] they make sure everything is sorted out for us when my [relative] is staying at the home.

We did not speak with people using the service at this inspection due to their complex needs. We inspected care records.

We found that the provider had met the compliance action that we set at our previous inspection and people experienced care, treatment and support that met their needs. However, we also found that where people did not have the capacity to consent, the provider did not always act in accordance with legal requirements.

All three relatives told us they felt their relatives' needs were met and staff supported them appropriately.

One relative said, 'My {relative} has never been healthier and happier. There is consistency in their care as the same staff work at the day centre as The Vines, so they know everyone well.' Another relative said, 'I have no concerns, the staff are brilliant at meeting their health and hygiene needs.'

We observed staff were kind and caring and they supported people appropriately and in line with their plan of care.

One relative told us they were always informed when new staff had been employed and they would be supporting their relative. They also told us that their relative had been involved in the interview process so they could have a say in respect of the staff recruited to work at the location.

Relatives told us they felt that staff were well trained to carry out their job role.

There were areas such as staff training and care planning in which further development was needed. The provider had produced an action plan to work towards addressing these issues.

There was a relaxed atmosphere in the home and people were at ease in the company of the staff that supported them. Staff were courteous in their approach to people and interacted confidently with them. The staff had undergone training which enabled them to care for people's complex needs safely and efficiently.

We observed that people were offered support at a level which encouraged meaningful activities and ensured that their individual needs were met.

We noted that people were encouraged to express their preferences and were involved in planning their care and making decisions about their support and how they spent their time. People's relatives were also involved in this process.

The provider had systems in place to ensure people who used this service and their relatives were involved in the quality monitoring processes for this service. They were encouraged to share their views and opinions to help improve the standard of care provision.