We carried out an unannounced inspection on the 9 April 2015. This is the first inspection undertaken by the Care Quality Commission. Cardinals Way provides care and support for two adults with mental health difficulties and associated needs. There are two live in care workers staying at the service at all times. There are bathroom facilities, a communal lounge a large kitchen with a dining area and a small garden with access through the kitchen.
There was a registered manager in place at the time of the 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.
We found that Cardinals Way provided a personalised, person-centred service in which people were in control of their support and participated in decision-making for themselves and the service. People were encouraged and enabled to be more independent and there was a clear ethos and culture to promote recovery.
Staff had a good understanding of safeguarding adults’ procedures and keeping people safe. They knew how to recognise and report concerns appropriately and understood how to ‘Whistle blow’.
Medicines were stored and administered correctly and staff had completed the appropriate training to ensure they were competent to administer medicines safely.
Risk assessments and care plans for people using the service were effective; they were individual and recorded all the required information. People and their relatives were involved in the care planning process and outcomes they were working towards were realistic and recorded in a simple, pictorial format that was easier for people to understand.
People consented to their care and treatment and staff had a good understating of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS exist to protect the rights of people who lack the mental capacity to make certain decisions about their own wellbeing. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.
Care workers were well trained and staff had all undergone an induction programme before starting at the service. They each received regular one to one supervision, with a strong emphasis on reflective practice and learning.
People had access to healthcare services and received on-going healthcare support from a local GP and regular visits to the service were undertaken by visiting professionals. Reviews of people’s mental health and healthcare were also undertaken by the multi-disciplinary team.
People’s dignity and privacy was maintained. They were supported with personal care and other tasks and were encouraged to do as much for themselves as possible in order to maintain and increase their independence.
Care plans were detailed and covered areas relating to personal care, social interaction, life histories, mental health, activities and financial matters. We saw evidence that people who used the service and their relatives were involved in planning their care.
People were given information on how to make a complaint and how to access advocacy services. No complaints had been received and one compliment was recorded from a relative, praising the staff team for the improvement seen in the wellbeing of their family member since they had been living at the service.
The registered manager conducted regular audits at the service including random spot checks to ensure the service was delivering high quality care. Actions were carried through and discussed with the staff team for learning and improvements.