Waterfield Supported Homes Limited - 10 Dowanhill Road is a care home that provides services to people with mental health conditions. The home can accommodate a maximum of seven people. At the time of our inspection, seven people were using the service.

At the last inspection, the service was rated Good.

At this inspection, we found the service remained Good.

People were safe and happy living at the service. Staff knew how to identify abuse and understood their responsibility to report any concerns to keep people safe. Staff had received training on safeguarding adults and were aware of the policies and procedures to report poor practice and suspected abuse. The systems in place remained effective in protecting people against abuse and harm. Risks to people were assessed and managed appropriately.

People received their medicines safely from staff who were trained and assessed as competent to do so. Medicines were managed appropriately and administered in line with the provider’s procedures.

There were sufficient numbers of staff to support people safely and to meet their needs. New staff underwent appropriate checks to ensure they were suitable to provide people’s care.

People’s care was delivered in line with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff sought people’s consent to care and treatment and respected their decisions. People were involved in planning their care and were supported to make decisions about how they wanted to live their lives.

People were supported to have 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 by trained staff with the right skills and knowledge to perform in their role. Staff ensured people received a healthy balanced diet and that food choices met their preferences. People accessed healthcare services when needed and were supported to maintain their well-being.

Staff provided people’s care with kindness and compassion. People had developed positive relationships with staff. People’s records and information were stored securely and staff respected their confidentiality.

People knew how to make a complaint and were confident their concerns would be addressed. The provider had an up to date complaints procedure which set a timeframe and process for resolving any concerns raised. Feedback from people and their relatives was sought regularly and used to develop the service.

A registered manager was in post. People and staff found the registered manager approachable and supportive. The registered manager was actively involved in the day-to-day running of the service and easily available to staff for guidance and support.

An open and transparent culture at the service encouraged staff to learn from mistakes and to respond positively to any concerns raised about their practice. The quality of the service was subject to regular checks and audits and action was taken to address any shortfalls identified.

Further information is in the detailed findings below.

Waterfield Supported Homes Limited - 10 Dowanhill Road is a care home that provides services to people with mental health conditions. The home can accommodate a maximum of seven people. At the time of our inspection, seven people were using the service.

At the last inspection, the service was rated Good.

At this inspection, we found the service remained Good.

People were safe and happy living at the service. Staff knew how to identify abuse and understood their responsibility to report any concerns to keep people safe. Staff had received training on safeguarding adults and were aware of the policies and procedures to report poor practice and suspected abuse. The systems in place remained effective in protecting people against abuse and harm. Risks to people were assessed and managed appropriately.

People received their medicines safely from staff who were trained and assessed as competent to do so. Medicines were managed appropriately and administered in line with the provider’s procedures.

There were sufficient numbers of staff to support people safely and to meet their needs. New staff underwent appropriate checks to ensure they were suitable to provide people’s care.

People’s care was delivered in line with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff sought people’s consent to care and treatment and respected their decisions. People were involved in planning their care and were supported to make decisions about how they wanted to live their lives.

People were supported to have 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 by trained staff with the right skills and knowledge to perform in their role. Staff ensured people received a healthy balanced diet and that food choices met their preferences. People accessed healthcare services when needed and were supported to maintain their well-being.

Staff provided people’s care with kindness and compassion. People had developed positive relationships with staff. People’s records and information were stored securely and staff respected their confidentiality.

People knew how to make a complaint and were confident their concerns would be addressed. The provider had an up to date complaints procedure which set a timeframe and process for resolving any concerns raised. Feedback from people and their relatives was sought regularly and used to develop the service.

A registered manager was in post. People and staff found the registered manager approachable and supportive. The registered manager was actively involved in the day-to-day running of the service and easily available to staff for guidance and support.

An open and transparent culture at the service encouraged staff to learn from mistakes and to respond positively to any concerns raised about their practice. The quality of the service was subject to regular checks and audits and action was taken to address any shortfalls identified.

Further information is in the detailed findings below.

We spoke with four of the people using the service. Three people commented that everything was fine and they were satisfied with their care. One person raised a number of issues, which related to historical events. They asked that we pass their comments to the manager, which we did.

At our last inspection in June 2013 we found that people did not always experience care and support that met their needs, as care was not always being delivered in line with individual care plans. At this visit we found that care records, including care plans and risk assessments were in place and were regularly reviewed.

At our last inspection we found that people who used the service were not protected from the risk of financial abuse, as not all financial records relating to those people were accurate or up to date. At this visit we examined the financial records for one of the people using the service and found they were up to date.

At our last inspection we also found that the provider did not have effective recruitment processes in place. At this visit we reviewed the records for a new member of staff and found that all of the required documentation was available, and all of the required checks had been undertaken.

At our last inspection, we had found that the quality assurance systems in place in the home were not robust enough. On this visit we found that complaint recording had improved, as had the accuracy of care records. People using the service had also been asked to comment on the quality of the service they received.

We found that people using the service were involved in their care, and that they felt that they were well cared for. One person told us "it's OK here, staff are all right". Another person told us "I am well looked after".

People were supported to maintain their independence and access the community. They were encouraged to undertake activities of daily living for themselves, with staff available for support if required.

We found that each person using the service had a care plan tailored to their support needs, however staff were not always following these plans.

Staff demonstrated knowledge in recognising potential signs of abuse. Some of the people had their finances administered by staff. We found that the records relating to their finances were not up to date.

The recruitment and selection processes for new staff were not robust enough as not all required checks had been undertaken before staff started work.

There were monitoring checks undertaken with regard to health and safety, but we found that the monitoring of the quality of the care being provided was not as thorough as it needed to be. Staff periodically obtained the views of people using the service but the outcomes of these surveys were not available for us to see.

We carried out this inspection to see if the service had taken action to address the areas of non compliance we identified at our last inspection of 31 August 2012. At that inspection we found that people were not fully protected against the risks of unsafe care and treatment because the provider did not notify the Care Quality Commission (CQC) without delay of incidents as specified in the regulations. The provider wrote to us in September 2012 and said that copies of all incidents had now been sent to the CQC as required via e-mail. They had also said that all future incidents reported to the care co-ordinators will simultaneously be sent to CQC.

At this inspection on 9 January 2013, we found that whilst there had not been any notifiable incidents since our August visit, the provider had retrospectively sent us notifications of earlier incidents. This meant that the provider was now aware of its statutory responsibilities and this protected the people using the service against the risks of unsafe care and treatment.

As this was a follow up to check on the non-compliance identified at our last inspection we did not speak with people using the service on this occasion.

During our inspection we spoke with one person using the service who told us they were happy at the home and that the staff were very kind. We also spoke with the relative of another person who felt that the home treated people with dignity and respect and provided them with good care.

We saw that the staff were polite, kind and caring and helped people in making choices about what they wanted to do. We found them patient and ready to listen and respectful towards the people in their care.

We spoke with the placement authority who had no concerns about the service and was positive about the way the home managed the complex needs of people placed there.