Archived: The Gate

Updated 15 September 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 was planned to check whether the provider was 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 30 August 2016 and was announced. The provider was given 48 hours’ notice because we needed to be sure that someone would be in. The inspection was undertaken by an adult social care inspector. At the time of this inspection the service was supporting four people. The support packages ranged from 11 hours to 53 hours per week.

We visited with one person in their home and also spoke to two people who used the service on the telephone. We spoke with the relatives of the three people who used the community support service, two support staff, a team leader and the acting manager.

Before our inspection, we reviewed all the information we held about the home including notifications that had been sent to us from the home. We had received a provider information return (PIR) from the provider which helped us to prepare for the inspection. 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 looked at documentation relating to people who used the service, staff and the management of the service. We looked at two people’s written records, including the plans of their care. We also looked at the systems used to manage people’s medication, including the storage and records kept. We looked at the quality assurance systems to check if they were robust and identified areas for improvement.

Updated 15 September 2016

The inspection took place on 30 August 2016 and was announced. The provider was given short notice of the visit. This was because we needed to be sure key staff would be available for us to speak with. At the last inspection December 2013, the service was judged compliant with the regulations inspected.

The Gate is registered as both a supported living service and a domiciliary care service for people with learning disabilities and associated complex needs living in their own homes. At the time of this inspection the service was supporting four people. The support packages ranged from 11 hours to 53 hours per week.

The service did not have a registered manager. However, the service was actively looking to appoint a manager and while this process was taking place the nominated individual, who was one of the managing directors for the organisation was acting as the manager. 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 and associated Regulations about how the service is run.

People we visited told us that the service had really helped them to achieve their independence and increased their confidence. They were very complimentary about the staff that supported them. People we spoke with said they would definitely recommend the service to others.

There were enough skilled and experienced staff and there was a programme of training, supervision and appraisal to support staff to meet people’s needs. Procedures in relation to

recruitment and retention of staff were robust and ensured only suitable people were employed in the service.

The acting manager was aware of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). There were policies and procedures in place and key staff had been trained. This helped to make sure people were safeguarded from excessive or unnecessary restrictions being place on them.

Medications procedures were in place including protocols for the use of ‘as and when required’ (PRN) medications. Staff had received training in medication management and medication was audited in line with the provider’s procedures.

There was good guidance for staff regarding how people expressed pain or discomfort, so they could respond appropriately and seek input from health care professionals, if necessary. People had access to a good range of health care services and staff actively advocated for people if they felt health care services were not as responsive as they should be.

People were encouraged to make decisions about meals, and were supported to go shopping and be involved in menu planning. We saw people were involved and consulted about all aspects of their care and support, where they were able, including suggestions for activities.

We observed good interactions between staff and people who used the service. People were happy to discuss the day’s events and one person told us about their likes and interests. One person told us how they enjoyed meeting with friends and had a keen interest in cars and motor cycles.

People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it.

They had systems in place to assess and monitor the quality of the service and to continually review safeguarding concerns, accidents and incidents. Where action plans were in place to make improvements, these were monitored to make sure they were delivered. We saw copies of reports produced by the acting manager and by an external assessor. The reports included any actions required and these were checked each month to determine progress.