Care service description

37 Spenser Road provides personal care and support to 13 people with learning disabilities. The house is in a residential part of Herne Bay and there is another bungalow at the back which is also part of this registration.

Rating at last inspection

At the last inspection, the service was rated Good and Requires Improvement in the ‘Well Led’ domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 18 October 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 17 of the Health and Social Care Act Regulated Activities Regulations 2014, Good governance. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Optima Care Limited – 37 Spenser Road on our website at www.cqc.org.uk.

At this inspection we found the service remained Good overall and is now rated Good in the Well Led domain.

Why the service is rated Good

The registered manager told us that improvements had been made since the last inspection. The company had appointed a new operations director who visited the service regularly. To further support the registered managers the company had implemented a mentoring programme where managers supported each other and discussed good practice.

Staff told us the manager had good leadership skills and they worked hard as a team. They said they always had confidence in the registered manager and improvements had been made by the organisation to make them feel more valued.

People, their relatives and staff were asked for feedback about the quality of the service; however the outcome of the surveys was not presented in a meaningful way to inform the people living at Spenser Road what, if any, improvements had been made. A recommendation had been made in this report.

Senior managers carried out checks on the service to ensure the quality of the service was being monitored and improved. Accidents and incidents had been recorded, and analysed to look for patterns and trends to reduce the risk of them happening again.

The service had links with the community to ensure that people enjoyed an active social life visiting cafes, and other venues.

Staff ensured people received personalised care with equality, dignity and respect. Staff said that the registered manager was always available for practical support, assistance and advice.

Residents meetings were held regularly to ensure people were involved in their care and had the opportunity to voice their opinions.

Staff were supported by the registered manager through their supervision sessions, staff meetings and appraisals.

The registered manager had submitted notifications to CQC in an appropriate and timely manner in line with CQC guidelines.

We carried out this inspection on 18 October 2016.

37 Spenser Road provides residential care and support for up to 13 people with learning disabilities. At the time of our inspection there were 13 people living at the home.

The service had a registered 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 2008 and associated Regulations about how the service is run.

People, relatives and staff spoke highly of the registered manager who they described as approachable, caring and responsive. However, we were told the provider did not have a regular presence in the home and staff felt their concerns were not always listened to at provider level. There was little face to face contact with the provider's senior management and limited feedback which meant the registered manager and staff did not feel consistently supported.

Relatives and staff told us people who lived at the home were safe. Staff told us they would follow the provider's safeguarding policies and procedures and knew what actions to take if they had any concerns about people's wellbeing. Staff were effective in identifying risks to people’s safety and ensured the focus was on managing risks rather than imposing restrictions on people by removing risks entirely.

There were enough staff on duty to meet people's care and welfare needs and keep them safe. Checks were carried out prior to staff starting work to ensure their suitability to work with people who lived in the home. New staff received an induction into the home which covered all the training considered essential to support people safely and effectively.

Staff understood the principles of the Mental Capacity Act (2005) and how to support people with decision making. When people were not able to give consent to their care and support, staff knew they must act in people's best interests.

Care plans contained information for staff to help them provide personalised care and to ensure people remained safe and to maintain their health. Care was reviewed regularly with the involvement of people and their relatives.

Staff supported people to manage their physical and mental health and supported them to attend medical appointments. People were given their medicines safely and as prescribed.

Staff were thoughtful and considerate in their interactions with people and took time to listen to what they had to say. Staff had a good understanding and knowledge of people’s needs, routines and preferences. Relatives were confident that staff treated people with dignity and respected their privacy and independence. Staff supported people to maintain family relationships which were important to them. People knew how to complain and could share their views and opinions about the service they received.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People were taking part in activities at home and in the community. We spoke to and spent time with some of the people in 37 Spenser Road. Not everyone living in the home was able to talk about their lifestyle with us so we talked to some people and observed the interactions between other people and staff. We saw people smiling and responding to what staff were saying to them. People’s hobbies and interests were supported and they were helped to achieve their personal goals and aspirations. People said or expressed that they were happy with the service. People were occupied and laughing and interacting with each other and staff.

People received support to maintain a healthy, active lifestyle. They were able to pursue a variety of hobbies and interests in the home and out in the community. People were assisted to attend health care checks and community health professionals were involved to provide advice and support when needed.

The home was safe and suited people’s needs. Each bedroom was single and personalised and reflected people’s interests. There was a maintenance plan and generally the home was well maintained. Some repairs and redecoration were needed in areas where there had been some water damage that the provider had noted. People had the equipment they needed that was well maintained and suitable for their needs.

There was a good staffing level to support people with their lifestyles. The majority of the staff team had worked together for several years and had got to know the people using the service well.

The home had clear well organised documentation and records.

We spoke with and spent time with eight people living in 37 Spenser road. Not everyone living in the home was able to talk about their lifestyle with us so we observed the interactions between the people and staff. People said or expressed that they were happy with the service. People were laughing and interacting with each other.

People received support to maintain a healthy, active lifestyle. They were able to pursue a variety of hobbies and interests in the home, at the day centre and out in the community. People were assisted to attend health care checks and community health professionals were involved to provide advice and support when needed. A healthy balanced diet was offered to people who were able to choose the food they ate from discussion with the staff. People were supported to develop their independence skills, including making snacks and drinks.

People were assisted to express their views and make important decisions because the staff helped them with their communication and spent time with them.

There was a stable staff team and a clear recruitment process. People were helped to express themselves if they had a complaint and families were encouraged to air their views and give suggestions for improvement.

Not all the people living in the home were able to tell us about their experiences so we used an observational framework and observed the interactions between the people living in the home and the staff.

People smiled and laughed when participating in various activities with the staff. People talked about some of the things they liked to do.

We observed people looking comfortable and at ease in the home and with staff.

People said that staff asked them what they liked and what they wanted to do.