About the service:

Outreach Community & Residential Services - 118 Kings Road is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both premises and the care provided, and both were looked at during this inspection. The home provides care and accommodation for up to four people who have learning disabilities or who have autistic spectrum conditions. At the time of the inspection there were four people living at the home.

People’s experience of using this service:

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

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. The outcomes for people using the service reflected the principles and values of registering the right support. This was because peoples support focused on them having choice and control and as many opportunities as possible for them to gain new skills and become more independent.

People felt safe and risks to people were managed effectively.

The service placed great importance on supporting people to maintain and develop interests which were important to them and which contributed to them living meaningful lives.

People told us their individual beliefs, as well as their Jewish religion and culture, were respected.

Promoting and maintaining people’s independence was at the heart of the service.

Staff received the training and support they needed to carry out their roles effectively. Staff members had been safely recruited and there were sufficient numbers of staff to provide people with the person-centred support they needed.

Medicines were managed safely and people were supported to ensure their health needs were met.

Care records were person centred. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

The home was well led. People’s needs and the care and support they received was reviewed regularly. Quality assurance systems were in place to monitor and continually improve the quality of the service provided.

Rating at last inspection:

At our last inspection, published in August 2016, we rated the service as good.

Why we inspected:

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

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was an announced inspection, which took place on 5 July 2016. We had previously carried out an inspection on 23 July 2014 when we found the service to be compliant with all the regulations that were in force at the time.

118 Kings Road is a care home registered to provide accommodation and personal care for up to four people who have a learning disability or mental health needs. At the time of this inspection, four people were using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 who lived at the home who were able to speak with us told us they felt safe at the home. They said they could approach the registered manager, the staff or a relative if they had any worries or concerns. They were confident they would be listened to and that any problems would be sorted out.

Recruitment processes were sufficiently robust and should help protect people who used the service from the risk of staff who were unsuitable to work with vulnerable adults.

We saw that there had been an increase in staffing to ensure that there were sufficient staff available to meet people’s changing needs. No outside agency staff were used by the service. This meant that people who used the service received consistent support from a staff team who knew them well.

There were systems in place to ensure the safe administration of medicines and effective infection control practices. Staff had received the training they needed to support people safely and effectively.

People had the access they needed to health and social care professionals.

People we spoke with told us that their Jewish faith and culture was observed, for example, attending Shule, celebrating Shabbos and buying kosher food.

The atmosphere in the service was relaxed and friendly and there was a good rapport between people who used the service and the staff supporting them.

We saw that those who used the service had person centred care records, which included easy read formats and photographs that helped people to be involved.

People had access to a range of activities that met their individual needs and were encouraged to be as an independent as possible.

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends.

We saw records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

All the people we spoke with told us the registered manager and the project manager were approachable and would always listen and respond if they raised any concerns.

During this inspection, we contacted the commissioner and safeguarding teams at the local authority. They raised no concerns about the service with us.

We saw that the service asked people for feedback about the service and what they thought about the quality of service they received.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe? Is the service caring? Is the service effective? Is the service responsive to people’s needs? Is the service well led?

Below is a summary of what we found. The summary is based on speaking with two people who used the service and two staff members who supported them, observation and looking at records.

Is the service safe?

People who lived at the home who we spoke with told us they felt safe at the home. They said they could approach a staff member if they had any worries or concerns. They were confident they would be listened to and that the problem would be sorted out.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service effective?

People told us that their individual needs, choices and preferences were acted upon and were respected by the staff supporting them. In the section of the person’s care records ‘How best to support me’ it stated, “Just ask me and I will tell you.”

The staff supporting people told us about what action had been taken when the physical health needs of a person had changed. Records we saw showed that action had been taken to contact the appropriate health care professionals.

Is the service caring?

Most people had lived at the home for a long time. Interactions between people and the staff supporting them were seen to be frequent, friendly and the atmosphere was calm and relaxed.

The support workers told us, “It’s their home and we are there to support them and not to tell them what to do. We want them to have the best.”

Is the service responsive to people’s needs?

Wherever possible people who lived at the home were encouraged to maintain contact with their family and friends.

We were told by people we spoke with that their Jewish faith and culture was observed, for example, celebrating Shabbos and buying kosher food.

People were involved in activities within the community. We saw in the ‘Dreams and Aspirations’ section of their support records the person had said they wanted to go on holiday and trips out. We saw that these goals had been achieved.

Is the service well-led?

The manager of the home was registered with the Care Quality Commission (CQC). We saw that records that showed that the registered manager carried out regular audits of the home’s records and health and safety checks.

Support workers said that they felt comfortable to raise any concerns that they had with the deputy manager.

People were supported in promoting their independence and community involvement. People enjoyed different activities. One person had gone out with a relative to do some shopping, another person had been out for a walk and was enjoying watching sport on the television and another had gone out for a trip out on the bus.

People’s food and drink met their religious or cultural needs. We looked at arrangements for food and drink and also the arrangements in the kitchen. We were told that the kitchen followed kosher practices and different chopping boards were used for different food types such as meat.

There were systems in place to reduce the risk and spread of infection. People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

Appropriate checks were undertaken before staff began work. There were effective recruitment and selection processes in place. We spoke with a support worker who confirmed they had submitted an application form, had an interview and a criminal record check before starting to support people.

Prior to our visit we contacted the commissioning team about the service. They informed us that they were not aware of any concerns about 118 King’s Road.

People told us that they knew each other well and got on fairly well together. They told us that generally they were “happy” living at the home. They said that they “did there own thing” for example one person liked to go out for a walk and another liked to watch television. Some people went out to the Outreach Day Centre and the Outreach Leisure group.

People confirmed that their cultural and religious needs were met and that staff followed kosher practices when shopping and in the kitchen. One person said that they visited relatives at Shabbos and that support workers did the household task during that time. People said that they were looking forward to Hanukkah the Festival of Lights.

Before our visit we contacted the local commissioning team and the safeguarding team. They confirmed that they had no concerns about the home.

One person who had lived at the home for a long time said that it was “Alright.” When asked if they were well supported they said, “Yes thank you.” Both people indicated that they could do what they wanted to do.

We were told by the local commissioning team and the safeguarding co-ordinator that there were no issues or concerns with the provider or at 118 Kings Road at this time. This was confirmed by the registered manager.

People who lived at the home indicated that they “liked” the support workers. The bank worker said that she worked at the home on a regular basis and knew the people who lived there well. The new support worker said that she had no concerns about her ability to support people. The registered manager confirmed that the home was fully staffed and she had no concerns about the ability of the staff team.

People who lived at the home said that if they had any concerns they would speak with a relative, the registered manager or a support worker. One person said that they were confident that someone would try and sort out any problems. Both people said that they had no concerns at this time.