Church Road Hostel is a supported living service. Supported living services are where people live in their own home and receive care and/or support in order to promote their independence. The accommodation was provided by another organisation and as Church Road Hostel is not registered for accommodation with the CQC, the premises and related aspects were not inspected. The service provides support for up to 19 people with mental health needs. There were 18 people using the service at the time of our inspection.

This inspection took place on 6 February 2018. The last inspection of this service was carried out in December 2015. At that inspection the service was meeting the regulations we looked at and was rated Good overall and in all five key questions. At this inspection we found the service Requires Improvement within the key questions of safe, effective, responsive and well-led and as a result has received an overall rating of Requires Improvement.

The service did not have registered manager but a new manager had joined the service and was in the process of registering with the CQC. 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 were not always safe because the provider did not fully and appropriately assess all of the risks people presented with. As a result risk management plans were not in place to mitigate all known risks.

People were supported by staff who did not have up to date training. Staff did not receive training during the year leading up to our inspection.

People were bored and unstimulated. The service did not provide meaningful activities to people within the home or in the community. People received little support to develop the skills necessary to move on to independent living. For example, there were no systematic programmes in place for teaching skills around activities for daily living such as shopping or cooking.

Poor governance was evident at the service. People’s care had been planned by a management team which had not identified or taken action to resolve shortfalls in quality. The provider’s quality assurance checks had not identified or rectified failings in people’s safety and activity levels or in staff training. A new manager came into post just prior to our inspection. They emphasized their commitment to address these issues and drive improvements.

The provider used appropriately robust recruitment practices to ensure people were supported by safe and suitable staff. Medicines storage, administration and recording practices at the service were safe. Staff conducted checks and drills to maintain their preparedness to keep people safe in the event of a fire.

People’s needs were assessed and they were supported by supervised and appraised staff. People were treated in line with the Mental Capacity Act 2005 and had access to healthcare services whenever they required. People’s nutritional needs were being reassessed because the service provided one meal to people each day and people were not always motivated to prepare healthy meals at other times.

People received their support from staff who were caring and kind. Staff knew people well and provided emotional support when it was required. Staff respected people’s privacy and supported them to make decisions.

During this inspection we found breaches relating to risk management, staffing, person centred care and good governance. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Church Road Hostel is a supported living service that provides twenty four hour personal care support to people with mental health needs. There were 17 people using the service at the time of this inspection.

This inspection took place on 10 December 2015 and was unannounced. At our previous inspection in April 2014, we found the provider was meeting the regulations we inspected.

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.

People told us they liked staying at Church Road Hostel and said the staff who supported them were polite and caring towards them. There was a relaxed and friendly atmosphere when we visited.

People were supported to have their health needs met. Staff worked with the person to access the GP and other local health services as appropriate to help make sure their individual health needs were met. We saw that people’s prescribed medicines were being stored securely and managed safely.

There were systems and processes in place to protect people from the risk of harm and staff were aware of safeguarding procedures. Appropriate recruitment checks took place before staff started work.

Staff received training which gave them the knowledge and skills to support people effectively. Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People were asked for their consent to the care and support they received.

There was a system in place for dealing with people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take appropriate action.

The registered manager understood their role and responsibilities and positive feedback was received from staff about their leadership. There were effective systems in place to help ensure the safety and quality of the service provided.

Below is a summary of what we found. The summary is based on our observations during the inspection visit, speaking with eight people using the service, three staff members supporting them and from looking at care records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Feedback about the service included "Very good", "I like it here" and "No problems". All of the people we spoke with said that they felt able to raise any issues or concerns with the staff who worked at Church Road Hostel.

We saw that Safeguarding procedures were in place and staff understood how to safeguard the people they supported. Financial procedures had been reviewed following a recent Safeguarding investigation with improved oversight and auditing of records at provider level.

Is the service effective?

People’s assessed needs were being met by experienced staff with the necessary skills and knowledge. Staff had access to training and supervision to help them do their jobs well.

Individual health and care needs were assessed and people were involved in reviewing their support plans. The use of more specific measurable actions within individual plans could however benefit people using the service in helping them to reach their set goals.

Is the service caring?

People using the service told us they were treated with dignity and respect. Their comments included "The staff are nice, no animosity here", "The staff are very helpful" and "They're nice people".

We saw that people could be as independent as they wanted to be and were able to come and go from the Hostel as they pleased. Assessments were undertaken and support was provided to individuals with their activities of daily living as required.

Is the service responsive?

People using the service told us that they would welcome more things to do including trips out with staff. Plans were in place to provide alternative activities and the service should continue to look at creative ways to enable people to live as full a life as possible.

Is the service well-led?

An acting manager was in post at the time of this inspection. Staff spoken to had worked at the service for a number of years and had a good understanding of the ethos of the home.

Quality assurance processes were in place however these could be developed to more fully involve people using the service and ensure that their views were acted upon.

We spoke to three people who use the service. All told us they had support plans and risk assessments and they met regularly with their key workers to talk about their health and social care needs. They also told us they also had regular contact with their care coordinators and appropriate health care professionals.

They told us they were provided with a lunch time meal each day. One person said “The food is okay. I am a diabetic and staff know what I need and they help me”. Another person said “The food is good, we get a meal at 12.30 and that does me most of the day”.

One person said “there is enough staff around as far as I am concerned, it helps that they have been around as long as I have, they make sure I am alright and everything is in place”. Another person said “The staff are really good actually, they treat me with respect. I needed a place like this to get me ready to go back into the community”. They told us they if they had any concerns about the service they would tell staff or the manager and they would do something about it.

A care manager for one of the people using the service said the support their client received from their key worker was significant in developing their self-esteem and independence. Another care manager told us the service was meeting the basic day to day needs of the residents, if a person using the service asked for assistance, generally the staff responded in an appropriate manner.

We found that important information relating to a person using the services care and support needs was not readily available to staff.

We found the registered provider had failed to notify the Care Quality Commission about incidents that had happened at the home.

We spoke to four people who use the service. They told us there were regular residents meetings with managers and staff, if they wished to attend, where they could express their veiws about the service.

They told us if they had any concerns about the service they would speak to the manager or staff.

They told us their privacy was respected and that staff treated them with dignity and respect.

They told us they had support plans and they met regularly with their key workers to talk about their health and social care needs.

They told us they felt safe living at the hostel and there was enough staff around when they needed them.

On this occasion we did not speak to people who use the service.

We spoke to four people who use the service. All told us that they require minimal support from staff, they generally spend time in their rooms, shop for food and cook their own meals, and they can have visits from or visit and stay with family or friends and can go about their daily routines independently. They told us they were treated with respect by staff and managers. One person told us, “there is always a member of staff around if I need them”.

They told us that there are house meetings with managers and staff if they wish to attend to talk about the home. However those we spoke to told us that they get on with their own lives and generally don’t get involved with how the service is run. They told us that if they had any concerns about the running of the service they would speak to the manager or staff.

People told us that they knew what treatment they were receiving and had regular contact with health care professionals to discuss their health care needs. They told us they meet regularly with their key worker, care coordinators, General Practitioners and health care professionals to talk about their health and care needs.

We spoke to two care coordinators, one care coordinator told us that staff always attend care plan review meetings with the person using the service and the service works to achieve the actions agreed in the care plans. The other care coordinator told us the person always attends health care appointments regularly and on time and the service was working in line with the persons care plan.

People told us they felt safe, could talk to staff about their concerns and that staff would take their concerns seriously and would do something about them. They told us that if they had a complaint they knew the procedure to be followed and would do so if they needed to.