NE Lincs Crisis (Field View) is a short stay care service situated in a residential area of Grimsby in North East Lincolnshire. The service is registered with the Care Quality Commission (CQC) to provide accommodation and support for up to five people. The service provides three beds for crisis care support for people with mental health needs for a maximum of seven days and two beds for people who need respite support which has no specific length of stay.

This unannounced inspection took place on the 3, 4 and 11 May 2018. At the last inspection of the service on 7 March 2016, the service was compliant with all areas we assessed.

NE Lincs Crisis (Field View) 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.

At the time of our inspection there were two people using the service, but neither were receiving a regulated activity.

The service had a registered manager in place. ‘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.’

One person we spoke with told us staff were kind and caring and respected their privacy and dignity. Staff knew how to protect people from the risk of abuse and harm. They completed safeguarding training and had policies and procedures to guide them. Staff were clear about the alerting procedures to the local safeguarding team.

Staff were recruited safely and we saw staffing levels had been evaluated to ensure they were appropriate. People accessing the service managed their own medicines and brought their own food into the service, which they prepared independently. The service maintained an ‘open door’ policy which meant only people assessed as having capacity were able to access the service.

Staff had access to a range of training, supervision and support. Staff told us this provided them with the necessary skills to support people using the service. They told us both the registered manager and service manager were supportive of them in their roles and approachable.

The registered manager had a range of experience to run the service and understood the requirement to report accidents, incidents and other notifiable events to the Care Quality Commission. A range of audits were regularly carried out to enable the quality of the service to be monitored and enable the service to learn. People who used the service, their relatives and

other stakeholders were consulted and feedback from them was used to help the service to develop.

NE Lincs crisis (Field View) is a short stay care service situated in a residential area of Grimsby in North East Lincolnshire. The service is registered with the Care Quality Commission (CQC) to provide accommodation and support for up to five people. The service provides three beds for crisis care support for a maximum of seven days and two beds for people who need respite support which has no specific length of stay.

At the time of our inspection three people were accessing the service for support. The service provides support for adults who have mental health conditions. The service offers five bedrooms over two levels. There is also a large communal lounge, dining / kitchen facilities, chill out / activity area, quiet seating space, bathroom and toilet facilities and outdoor garden space with a smoking shed. The service offers private parking for two cars and on street parting is also available.

The inspection took place on 7 March 2016 and was unannounced. The last inspection took place in January 2014 and the service was compliant with all of the areas that we assessed. At the time of our inspection the service had a 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 service understood how to keep people safe, however issues were raised about the lone working practices in place at the service. We recommended that the registered provider continues to review and monitor this and consider the impact on people’s support and associated risks to staff when lone working.

There were policies and procedures to guide staff in how to safeguard people from the risk of harm and abuse. Staff understood how to report potential abuse and had received training to reinforce their understanding.

The registered manager and staff were following the principles of the Mental Capacity Act 2005 (MCA) and had a good understanding of the legislation and ensured people were not being deprived of their liberty (DoLS). We found that staff had been recruited safely and appropriate checks had been completed prior to them working with vulnerable people.

Staff had a good knowledge and understanding of the needs of the people they were supporting and people told us staff were considerate and kind. There was strong partnership links between the service and local mental health professionals and the service had a good reputation for providing an effective, valued service.

People told us the leadership at the service was approachable and supportive and people were encouraged to give their views and opinions on the service. The registered provider promoted an open and transparent organisation and staff were supported through regular supervision, team meetings and yearly appraisals. Robust auditing systems were in place to assess and monitor the quality of the service provided.

We looked at two care records of people who used the service and saw that consent had been signed to their care and support. The care records included the completion of daily diary notes by staff to ensure a person’s care needs were up to date and relevant to their needs.

A person who used the service told us, “I am seeing my care co-ordinator later today and she pays regular visits to me and gives me the best advice to enable me to make positive decisions about my care.”

We found that medication was managed in a way that ensured the safety of the people that used the service.

We looked at the staffing rota which confirmed there were enough staff on duty to support people’s needs.

Records we looked at included comments, “I would just like to say thank you for making me feel very welcome and being supportive, you all do a brilliant job” and “Thank you for your time and understanding you do a great job for which I am truly grateful.”

We observed good information governance principles and secure access controls. This meant that records were held securely, remained confidential and access to information was only accessed by those staff that needed to.

One person told us, “I couldn’t wish for a better place. I got to choose my room. It’s a good warm bedroom.” Staff supported people with what they wanted to do. One person who had just returned from a visit told us, “I watch TV and put on what I want. I sing along to music and I can play CD’s in my bedroom.” People’s choices were supported with appropriate information. One person said, “If you can’t read very well they will read for you.”

People felt safe in the service and they spoke positively about their care. One person said, “They will look after you. They will check on you to see you are ok and they will always support you.” People were involved in reviews of their care. One person told us, “They will discuss my care record with me.” If a person’s mental health deteriorated contingency arrangements were in place to provide additional professional support. A person who used the service told us, “The service is joined up with external mental health services.”

People spoke positively about the staff that worked with them. One person told us, “Staff are absolutely brilliant here. Everybody that works here listens to you. They are really good staff.”

People completed a satisfaction questionnaire at the end of their period with the service. One person told us, “I have completed surveys several times.” People understood how to make complaints. One person told us, “I would know what to do if I had a complaint but I have never had any complaints.”

We undertook an announced inspection of this service on 28 April 2011 (the provider was given short notice of the visit as this included the manager’s interview for registration with the Care Quality Commission (CQC).

We observed positive interaction between the staff and people who use the service. We spoke to the people who were residing at the home and they spoke positively about the staff and the support that they received. They told us that they were respected and described staff as being ‘kind and thoughtful’. One person told us that the staff spent lots of time talking with them, they were very supportive and gave good advice. People using the service also told us that the home was comfortable and very clean and tidy.