1 & 2 Flax Cottages provides accommodation for up to nine people living with a learning disability, in two adjoining bungalows. At our last inspection of this service in March 2016, we gave the service a rating of 'requires improvement' and asked the provider to take action to make improvements. This was because we found the provider had breached Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At the last inspection we found medicines were not always stored or recorded correctly. The provider sent us an action plan outlining the action they would take to meet this regulation. At this inspection, we found this regulation had been met and the rating had improved from ‘requires improvement’ to ‘good.’ The inspection took place on 22 and 26 June 2017 and was unannounced. This meant the provider did not know we would be visiting. We also contacted relatives by telephone on 14 July 2017 to gather their views of the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 checked the management of medicines and found improvements had been made to ensure medicines were stored and administered correctly, with clear instructions for staff.
Regular checks on the safety of the premises and equipment were carried out. The home was clean and generally well maintained. We were made aware that repairs and improvements that needed to be carried out in collaboration between the provider and separate landlord organisation, could take a long time. We have spoken to the provider about this and made a recommendation that the timeliness of repairs is monitored.
Staff received regular training including maintaining the health and safety of people and the safeguarding of vulnerable adults. Training was provided and competency assessed before staff were able to use specialist equipment used by people. Infection control procedures were followed by staff and personal protective equipment was in use.
There were suitable numbers of staff on duty and safe recruitment procedures continued to be followed. There had been a high turnover of staff but we were advised this was now settling. New staff told us they enjoyed working in the home.
Individual and general risks were assessed and a record of accidents and incidents was maintained.
Staff received regular training, supervision and appraisal and told us they felt well supported to carry out their roles. Training about specific conditions had been provided to staff to support people with particular health conditions.
The service was operating within the principles of the Mental Capacity Act 2005. People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported with eating and drinking. Personalised meal plans were in place which contained information about special diets and the level of support people needed. People with specialist nutritional needs were supported by relevant health professionals.
People’s bedrooms were homely and personalised. Support had been provided to allow people to display their belongings and to make their room reflect their interests and personality. Discreet and modern storage had been provided to disguise medical equipment in bedrooms to ensure the environment was relaxing and non-clinical.
Staff were caring and attentive to people. We observed staff having fun with people and supporting them to feel relaxed and safe. The privacy and dignity of people was promoted and independence encouraged.
Person centred care plans were in place and people’s likes, dislikes, needs and preferences were recorded.
People had access to a range of activities inside and out of the home. There were plans to improve the range of activities available and people’s individual activity plans were under review at the time of the inspection.
A complaints procedure was in place. There had been no formal complaints received by the service since the last inspection. People were supported to share their views and feelings at regular meetings and on a one to one basis with staff.
Relatives and staff told us they thought the service was well-led. They described the registered manager as approachable and helpful. Staff told us they were completely person centred and ensured the service revolved around the needs of people.
Regular audits of the quality and safety of the service took place and feedback mechanisms were in place to obtain the views of people, staff and relatives.