About the service:

Gascoigne Road Care Home is a residential care home providing accommodation and personal care to 10 people, at the time of the inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

• People and staff were positive about the management and the service. However, the service was rated ‘requires improvement for ‘well led’ at this inspection. There was not an effective system in place to monitor training and to obtain people’s feedback on the running of the home regularly.

• We also found that staff references had not been recorded to evidence that references had been sought and received. We made a recommendation in this area.

• People continued to receive a safe service.

• Risks associated with people’s needs had been assessed.

• There were sufficient staff to meet people’s needs.

• Medicines were being managed safely.

• Staff had the knowledge and received the support they required to meet people’s individual needs.

• People were supported with their nutritional needs and had choices with meals.

• The staff worked well with external health care professionals and people were supported with their needs and accessed health services when required.

• People continued to receive care from staff who were kind and compassionate. Staff treated people with dignity and respected their privacy.

• Staff had developed positive relationships with the people they supported. They understood people’s needs, preferences, and what was important to them.

• People’s independence was promoted and their privacy and dignity was respected.

• Care plans were person centred and detailed people’s support needs.

• People received opportunities to pursue their interests and hobbies, and social activities were offered.

• The service met the characteristics for a rating of ‘Good’ in all but one of the key questions we inspected. Therefore, our overall rating for the service after this inspection was ‘Good’.

• More information is in our full report.

Rating at last inspection:

• At the last inspection on 26 June 2016 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’. However, the rating for Well-Led had deteriorated to ‘Requires Improvement’.

Why we inspected:

• This was a planned inspection based on the rating of the last inspection.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

We inspected 80 Gascoigne Road on 28 and 29 June 2016. This was an unannounced inspection.

80 Gascoigne Road is operated by the London Borough of Barking and Dagenham. It provides care and support to up to 12 people in a residential setting, specifically for people with learning disabilities. At the time of inspection, the service was caring for 12 people. Our last inspection of the service was in 2014 and at that time the service was found to be compliant.

There was a registered manager in place at the time of our inspection. 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.

Systems were in place to ensure that people using the service were safe. Care staff had undertaken training about safeguarding adults and had a good understanding about safeguarding principles and how to raise an alert.

Risk assessments were carried out and were robust and detailed. Risk assessments were updated in line with people’s changing needs.

Medicines were managed safely for people. Effective systems for the management, administration, storage, and disposal of medicines were in place.

Care staff were aware of their responsibilities under the Mental Capacity Act 2005 and how to ensure people using the service were given support to make decisions. Care staff were mindful of consent and ensuring that people were given autonomy and respect. The service was aware of its responsibility to inform CQC of any Deprivation of Liberty authorisations.

Care staff received relevant training to their role as well as a detailed induction programme and we saw records of robust recruitment. Relevant checks had been carried out before staff commenced employment.

Staff appraisal, training, and supervision supported them in their role. Care staff understood best practice guidance and implemented them to meet the needs of people. The registered manager supported staff so that they were effective in their role to care for people and deliver quality care.

People had access to health care services to meet their needs and professional guidance was implemented to maintain their health. Referrals were made to health professionals when needed and visits to and from health professionals were recorded.

Care plans were detailed and person centred and people were involved in their care planning and decision making. Staff knew people well, were aware of their personal histories, and understood their likes and dislikes. Staff were aware of people’s communication needs and adapted the communication methods accordingly.

Care staff provided care and support to people in a way which respected their dignity and privacy and people using the service told us about ways in which this was upheld.

The registered manager for the service had a good relationship with care staff and the people using the service and their relatives. There was open communications between all parties. The service had quality assurance systems in place.

The service was providing care to eight people with learning disabilities. We spoke with two people during the inspection and met another two people. The people we spoke with said they were happy at the home. One person said, "I like living here." Another person said "it is very nice." This person also said they had been able to make friends. People told us they enjoyed the activities on offer at the home and were able to choose what they wanted to do.

The provider assessed people's individual needs and preferences to ensure their care was safe and people's rights were protected. Care was provided with people's consent. Senior staff were aware of their responsibilities under the Mental Capacity Act (2005).

The provider had refurbished the home since the last inspection to make better use of the available space. People using the service told us they liked the changes which included an additional living room and en-suite shower facilities. The home was clean and well maintained. There were sufficient staff members on duty during the day and at night to care for the number of people currently living in the home.

People living at Gascoigne Road Care Home experience varying levels of difficulties expressing their views due to having learning and physical disabilities. Some of the people using the service were able to give us verbal feedback about the service. They made positive comments about the care and support that was provided to them at Gascoigne Road Care Home.

We found that people using the service were treated with respect and were involved in making decisions regarding their care. People’s independence and autonomy was promoted.

The service was undergoing a major development and restructuring and we saw evidence of meetings with people who use the service and their relatives to involve and inform them about the changes.

Some of the people using the service were able to give us verbal feedback about the service. They made positive comments about the care and support that was provided to them at Gascoigne Road Care Home. Some of their comments included, “I feel safe in here. The manager and staff are wonderful and if I am unhappy with anything I could complain to the manager” and “I am happy and comfortable here. Every member of staff is good and they are kind and helpful”. Another person told us, “I am happy in the home and with the staff. I get to do what I want to do and the staff are very supportive”.

For those people who were unable to give us verbal feedback, we observed that they were comfortable and relaxed with the staff. The staff understood their communication needs and supported them in their chosen activities throughout our inspection. People’s non-verbal actions indicated that they were happy in the home. In one case we saw a person reading their favourite books about buses and smiling, while another was smiling throughout their participation in a game. In a third case a person gave the ‘thumbs up’ while participating in an activity with the staff.

We spoke with the staff on duty during our inspection and they told us that people using the service were receiving good care. They told us that people were informed of everything; given choice and that their dignity and rights were promoted. They also told us that they did not make decisions for them.

We looked at the most recent survey results that was held with relatives and noted that they were very happy with the services provided by the home. Some of the comments included: “The best home around”, “We are very happy with the care” and “We are happy that ‘X’ is being looked after well and enjoying living in the service”.