About the service:

Janet Fay House is a care home that provides accommodation and personal care for up to eight people with mental health needs.

People’s experience of using this service:

People continued to receive safe care and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support the people safely. People received their medicines as it was prescribed. Staff followed infection control guidance and had access to personal protective equipment.

People continued to receive effective care. Staff were supported and had the skills and knowledge to meet people’s needs. The provider followed the principles of the Mental Capacity Act (2005). Peoples’ nutritional needs were met and they accessed health care when needed. The environment met people’s needs but refurbishment was needed of some areas. One person lived in a self-contained flat and this enabled them to be more independent.

People continued to receive care from staff who were kind and caring. Staff supported and encouraged them to be involve in how decisions were made about their support. Staff respected people’s privacy dignity and independence.

People continued to receive responsive care. Their support needs were assessed and planned with their involvement to ensure they received the support they needed. People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaint process which people were aware of.

The service continued to be well managed. The registered manager was due to leave the service and arrangements were in place to recruit a new manager. Spot checks and audits were taking place to ensure the quality of the service was maintained.

Rating at last inspection:

Rated Good (Report published July 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 9 and 10 May 2016. The first day of the inspection visit was unannounced, the second day was announced. At the last inspection on 15 August 2014, we found that the provider was meeting the Regulations we inspected.

Strensham Hill is registered to provide accommodation and support for a maximum of nine adults with mental health needs. There were seven people living at the home on the day of our visit.

There was no registered manager in post 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. However, the provider did have a new manager in post and was in the process of completing an application to register the manager pending its submission to the Care Quality Commission.

People knew the staff that supported them and staff knew people well and was aware of each person’s individual care needs. However, people gave mixed views on how they were spoken to by staff and we found that, on occasion, staff did not always speak to people respectfully. People felt staff maintained their dignity when being supported with personal care.

People who lived at the home felt secure and safe in the knowledge that staff was available to support them, when they needed to be supported. The provider had systems in place to keep people safe that protected them from the risk of harm and ensured people received their medicines as prescribed.

There was sufficient numbers of staff to meet people’s identified needs. The provider ensured staff were safely recruited and they received the necessary training to meet the support needs of people.

People were involved in decisions about their care and support. The provider had followed the correct procedures when determining if any person was being deprived of their liberty. Staff had good knowledge of what could constitute a restriction on a person’s freedom of choice.

People planned their meals and where appropriate, were supported with meal preparation if they wished. People accessed health and social care professionals with regular appointments when needed. Staff knew when people had appointments or meetings and supported people to attend these.

People's relationships with their family and friends were encouraged and had been supported by the provider.

People’s health care and support needs were assessed and reviewed. People were encouraged to participate in activities and interests outside the home. People knew how to complain and felt their concerns would be addressed. There were processes in place for recording and managing complaints and easy read guidance was available to people. There had been no complaints about the service and staff would support people to raise concerns if and when required.

The provider had established management systems in place to assess and monitor the quality of the service.

We last inspected this service on 8 April 2013. At that time we found people who use the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises. This was because repairs needed were not always promptly resolved.

We found that people were cared for by staff who were not adequately supported to deliver care and treatment safely and to an appropriate standard. Not all staff had completed their mandatory training or had received regular supervision.

We also found that people were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not consistently maintained. People’s personal records did not always provide adequate guidance to staff.

At this inspection we found that these issues had been adequately addressed.

Strensham Hill is home to eight people with learning disabilities who live in one main building, with one self-contained flat on site. There were eight people at home on the day of our inspection. We observed people during the day and talked with two people during our inspection. We talked with the manager and the senior staff. We looked in detail at the care records of three people. We visited on a weekday and telephoned the following day and spoke with two relatives. We spoke two members of staff and looked at three staff files. We noted that the manager had been in post for less than two weeks.

Below is a summary of what we found. The summary describes the records we looked at and what people, relatives and staff told us.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

The staff and manager had a good understanding of safeguarding and whistle blowing policies. Staff understood their role in safeguarding the people they supported. We saw people were cared for in an environment that was safe and clean. There were enough staff on duty to meet the needs of people who lived at the home. There were procedures in place to safeguard people from abuse.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager had an understanding of these safeguards which ensured people’s rights and choices were protected. The manager told us all people leave the home and return when they wish, and no one was currently subject to these safeguards.

Risk assessments and health and safety measures were in place to keep people safe. A person told us, “It’s a nice place to live. I feel safe here, I please myself and come and go when I want to. I’m happy with everything.”

Is the service effective?

Care plans specified people’s individual needs, for example, a person’s emotional support their choices and wishes in relation to the delivery of their care. The service worked well with other agencies and services to make sure people received their care safely and effectively. One person told us, “We do cooking with a member of staff and we go out to the pictures together. We’re going out for a meal today.”

We saw that people were treated with dignity and care. One member of staff told us, “Everyone is treated well here, I feel skilled to do my job.” One person was very pleased to show us around her bedroom. We saw that she was proud of her room and happy with the care she received. We spoke with a relative who told us, “I’m very happy, X is getting good care and the staff are wonderful.”

Is the service caring?

All staff were aware of peoples choices, preferences and support needs. We saw the staff and manager were patient and gave encouragement when they supported people. One person said, “We do cooking with another member of staff and we go out to the pictures together. We’re going out for a meal today.”

Records we looked at showed that people’s wishes and opinions had been taken into account when planning that person’s care. One relative told us, “The staff are fantastic, they are very caring.”

Is the service responsive?

We saw clear and detailed records that ensured the manager could make timely and informed decisions about a person’s care and support. Records showed that other professionals had been involved in peoples care and support when needed. A relative told us, “They keep in touch with me. They do keep us informed very well.”

Is the service well-led?

The manager was aware of their responsibilities in meeting the essential standards of quality and safety. There were systems in place to ensure the quality of the service was regularly assessed and monitored. Staff had regular training and learning opportunities. Staff we spoke with told us they thought the manager was approachable and provided good support. One relative told us, “They handle X behaviours very well, and the accommodation is kept well.”

During our inspection we spoke with six people who used the service, two care staff, and the manager. The people we spoke with were satisfied with the service they received. They told us that they felt safe living in the home. Comments we received included: “It’s alright”, “It’s good” and “The staff are lovely”.

People who used the service were supported to maintain their independence and develop life skills through activities they undertook. People received their medication safely.

Since our previous inspection we saw there had been improvements to staff training and arrangements for safeguarding people from the risk of abuse. However, we still had some concerns about the level of staff support and supervision; the timeliness of repairs to the premises and the quality of people’s personal records.

At the time of our inspection the current manager was working one day a week while on maternity leave and planned to return to work full time within the next two months. The manager was not registered with the Care Quality Commission. The provider and manager are aware of the need to formally apply for this person to become a registered manager in accordance with the relevant legislation.

Eight people were living in the home when we visited and we talked with two of them about their experience of living there.

People’s privacy and dignity were respected. Each person had their own room and one person said staff knocked on the door if they wanted to come in.

People told us about some of the things they were supported to do while living in the home. They told us they were supported to do household ‘chores’ and to cook once a week. They also said they took it in turns to do the household shopping with staff and they went out, for example, to college, to the pub and to restaurants for meals.

Both people we talked with told us they felt safe living there. They both said that if someone did something they did not like, they would tell staff. They said staff “would look into it.”

People told us they would tell staff if they had any complaints about the home but they had not had to do this. One person said “Nothing bothers me” and that they could talk to the manager if they needed to.