Background to this inspection
Updated
9 May 2019
The inspection:
¿We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
¿The inspection was carried out by one inspector.
Service and service type:
¿This service is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
¿The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not working full time at the service until the end of March 2019. The provider had notified CQC of how the service would be covered until the registered manager worked at the service full-time.
Notice of inspection:
¿This inspection was unannounced.
What we did:
¿ Before the inspection we looked at the information we held about the service, this included whether any statutory notifications had been submitted. Notifications are changes, events or incidents that providers must tell us about.
¿ We checked whether Healthwatch Nottinghamshire had received feedback on the service; they had not. Healthwatch Nottinghamshire is an independent organisation that represents people using health and social care services.
¿The provider completed a Provider Information Return. This is information we require providers to send us to give us some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
¿ Not everyone who used the service could tell us about their experiences of care. We observed how people and staff interacted to help us understand more about people’s experiences of care. We spoke with one person about the service. We also spoke with the temporary assistant service manager, the area operations manager and two care staff. We spoke with two relatives on the telephone on 5 March 2019.
¿ We looked at three people’s care plans and reviewed other records relating to the care people received and how the service was managed. This included risk assessments, quality assurance checks, accident and incident reports and policies and procedures.
¿ After the inspection the registered manager, regional operations manager and assistant service manager sent us information we had requested. This included information relating to the governance of the service, staff recruitment and training records and further information on aspects of people’s care.
Updated
9 May 2019
About the service: ‘Royal Mencap Society - Silverhill Bungalow’ is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both were looked at during this inspection.
The care home accommodates up to 6 younger or older adults living with learning disabilities and / or autism. At the time of our inspection 5 people lived there.
People’s experience of using this service:
¿ Improvements were required to the management oversight and review of incidents involving behaviours that challenged to help ensure the service identified any lessons learnt and worked towards continual improvement.
¿ Risk assessments and care plans were not always in place for the care people received or the equipment people used.
¿People’s needs were assessed and monitored and people’s diverse needs were supported. However, the assessment tool used to assess risks from pressure damage was not one that effectively considered all contributing risks.
¿People were not always supported to have maximum choice and control of their lives with staff that supported them in the least restrictive way possible; this was because some decisions had not been made in line with the principles of the MCA and not all restrictions had been considered in line with DoLS.
¿Some medicines required mixing with food or drink. When this was done advice had not been obtained as to the safety of these methods. Actions were needed to improve the storage and labelling of one prescription cream. Other medicines were stored safely and people received their medicines when they needed them.
¿Staff were recruited safely and there were sufficient staff to meet people’s needs. The provider had taken steps to help prevent people from the risk of abuse.
¿The service was clean and steps had been taken to help protect people from the risks of infection.
¿Other risks for example, environmental risks and those associated with the use of transport were identified so as to enable risks to be effectively managed for people's safety.
¿Staff received support and training to help them in their roles, however some training had not been refreshed since 2010 with no competency checks evident in these areas.
¿Staff made referrals to other health and social care professionals for their advice and guidance regarding people’s care when needed. People had access to healthcare services as required.
¿People had choices of food and drink to help them maintain a balanced diet.
¿People liked their home and were happy with how it had been decorated to reflect their individual tastes.
¿People felt relaxed and liked the staff who cared for them. People’s views were considered when their care was planned. Staff took steps to ensure people’s privacy and dignity was respected. People’s independence was promoted.
¿People received personalised and responsive care and enjoyed how they spent their time at the service. No-one had a complaint to make however, information was available for people on how to complain should they have need to. People’s communication needs were identified and met.
¿Policies and procedures helped to ensure care was delivered in line with current standards. Staff and relatives reported the management team to be open and approachable. People, relatives and staff felt listened to and had opportunities to be involved in the service; more information is in the full report.
Rating at last inspection:
¿The service was previously registered with CQC under a different name. This is the first inspection of the service under its current registration with the CQC.
Why we inspected:
¿This is a scheduled inspection based on the service’s registration date with the CQC.
Follow up:
¿We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.
¿For more details, please see the full report which is on the CQC website at www.cqc.org.uk