13 July 2018
During an inspection looking at part of the service
This inspection took place on the 13 and 27 July 2018 and the first day of inspection was unannounced. The delay between the two dates of inspection were unavoidable. On the second day of inspection we were able to speak with the individual living at Albert Road. This was a focused inspection carried out by one adult social care inspector. The inspection had been brought forward prompted by information received by the Care Quality Commission from members of the public.
This focused inspection was carried out to assess any current risks to people using the service. We therefore only looked at three domains where the key lines of enquiry are concerned with safety, nutrition and leadership of the service. No other concerns had been identified through our ongoing monitoring. Therefore, the other two domains, namely caring and responsive were not assessed as part of this focussed inspection. A full comprehensive inspection will be carried out at a later date.
There was no 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. The registered manager had left before the service opened. Another manager had also left the day before this inspection took place.
The service was not always safe. Risks to people had been assessed and plans were in place to keep risks to a minimum, however some of these risks were not reflective of the person’s current environment. Paperwork contained references to a previous home, although many of the risks within the support plan were still valid. Environmental risk assessments in relation to Albert Road had not been completed however the service had taken the necessary steps to try and ensure people’s safety and well-being when accessing the community alone.
Staff had supported the individual at another location prior to the person moving into Albert Road and we saw that some members of staff had built up a good rapport with the individual and knew how to provide effective care and support.
The service was working within the principles of the Mental Capacity Act (MCA) 2005 and no authorisations to deprive a person of their liberty were required at the time of this inspection. Staff had received training in the principles associated with the MCA and DoLS. Although the individual had capacity we did not see any evidence of their involvement in the planning of their own care and consenting to care, and support plans were not signed.
All staff assumed responsibility for food preparation and cooking and had received training in basic food hygiene. There had been an issue preparing food on the hob since the home opened due to the lack of proper cooking equipment, however this had been resolved by the first day of our inspection.
We saw that people brought in their own personal effects from home when moving into Albert Road, including televisions, although TV aerial points in bedrooms were not yet working. People’s general health was monitored on a daily basis and any changes which required additional support or intervention were responded to.
Staff considered the culture of the home had previously not been open and transparent, however this had improved since the manager had left the service. The person living at Albert Road had aspects of their safety compromised due to a lack of basic equipment and issues had not been addressed by the manager or the provider in a timely manner.
There were systems in place to monitor, analyse and improve the service, although these were in their infancy given the newness of the service. The service balanced potential risks against the person’s right to take informed risks, in order to promote their independence.
Supervision of staff and key worker meetings had taken place since the service had opened and there were plans in place for a new manager to take over this role. There was evidence of good partnership working with other health and social care professionals for the benefit of people living at Albert Road.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.