Pershore Road is a ‘care home’ which provides accommodation and rehabilitative support for up to ten people with mental health conditions. There were seven people living in the home when we visited. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The inspection took place on 28 November 2018 and was unannounced.

At our last inspection on 4 February 2016 we rated the service as overall ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive a safe service. Medication was well managed and people received the right medication at the right time. Appropriate action had been taken to cover recent staff absence and there were sufficient staff on duty to support people. People were encouraged to take positive risks which enabled them to feel part of the community and developed their independence.

People continued to receive an effective service. The layout of the home was designed in such a way to allow people to practice and prepare for independent living. Staff received specialist training which enabled them to provide effective support to the people using the service. People enjoyed having the opportunity to prepare food that they had chosen and prepared.

People continued to receive care from staff who were polite and respectful. People’s independence had improved as a result of staff support and people told us they felt involved in decisions about their care and support.

People continued to receive a responsive service. Thorough assessments were carried out prior to people moving in to ensure placements were suitable and support was personalised depending on people’s well-being and progress. People knew how to complain and had used the provider’s complaints procedures to raise any concerns.

The service continued to be consistently well-led. People and staff were happy and confident with the way the service was being led. The provider was proactively using a variety of ways to ensure people were involved improving the service and had established a range of partnerships with other organisations which benefitted people.

Further information is in the detailed findings below

This inspection took place on 4 February 2016 and was unannounced. The service was meeting all the regulations we looked at in January 2014.

Pershore Road Residential Care is a short term rehabilitation service for up to 18 months to adults experiencing mental health problems. The service is registered with the Commission to provide personal care for up to ten people. At the time of our inspection there were nine people using the service however one person was in hospital and another was away on holiday.

There was a registered manager at this location who was present for this 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 and associated Regulations about how the service is run.

People were kept safe by staff who were confident to whistle blow if they felt someone was at risk of harm. People were able to express if they felt unsafe.

People had their needs and requests responded to promptly. All the people and staff we spoke with told us that there were enough staff to meet people’s care needs. There were robust recruitment, induction and training processes in place to ensure staff were suitable to support the people who used the service.

Medication was managed safely. People were supported to manage their own medicines when appropriate and could tell us how they took their medication as prescribed. Staff involved appropriate health professionals promptly when there were concerns about people’s medicines.

People’s rights to receive care in line with their wishes were upheld as they were supported in line with the principles of the Mental Capacity Act 2005 (MCA). Staff supported people to make choices and lead an independent life as much as possible. Staff respected the choices people made.

People were supported to buy and prepare their own food and drinks. Staff supported people when necessary to help them make informed decisions about maintaining a balanced diet and eating healthily. Meal times were promoted as opportunities for people to develop their social skills.

People had developed caring relationships with the staff who supported them to pursue their personal preferences. Staff took an interest it promoting people’s wellbeing and helping them to achieve their goals such as independent living.

People felt that concerns would be sorted out quickly without the need to resort to the formal complaints process. Records showed that any issues were dealt with appropriately.

The service encouraged people to comment on how the service operated and to be involved in directing how their care was provided and developed. People were involved in the recruitment of new staff and organising meetings.

The service had a clear leadership structure which staff understood. Staff told us and records showed that they had regular supervisions to identify how they could best improve the care people received.

There were processes for monitoring and improving the quality of the care people received. The provider conducted regular audits and we saw that effective action had been taken when it was identified improvements were needed.

There were three people living at the home on the day of our inspection and another three people who were currently visiting during the day as part of their transition into the service. We spoke with three people who used the service. All the people we spoke to told us that they liked living at the home. One person told us, “All the staff are friendly and helpful”. We spent time observing how staff supported people, looked at care records, talked with four members of staff and another health professional who was visiting the service.

Care was planned and designed to meet people’s individual health and welfare needs.

People received sufficient quantities of food and drink to meet their needs and were supported to make choices about what they ate and drank. A person who used the service told us that they were, “Encouraged to eat healthily”.

People were protected against the risks associated with medicines because the provider had appropriate arrangements for managing medicines safely.

Managers and staff told us and we saw that the provider had robust recruitment procedures in place to ensure that people employed at the service were of good character. We saw that staff had the necessary skills, qualifications and knowledge to meet the needs of the people who used the service.

The provider had robust systems in place to assess and monitor the quality of the service provided.

At the time of our inspection the provider did not have a registered manager in post.

During our inspection we spoke with three people who used the service, three care staff, the operations manager and a visiting health professional. The registered manager was currently on sick leave and had been absent for long periods over the last year.

People who used the service were generally satisfied with the care and support they received at the home. Comments we received from people about the service included: “It’s alright, it’s a nice place” and “It’s an average place.”

People who used the service were supported to maintain their independence and this was respected. Facilities provided enabled people to live independently in the home but with the confidence that support was available if they needed it. People were able to maintain community involvement and life skills through activities that they undertook.

We did however have some concerns with the systems in place to monitor the quality of services. Monitoring arrangements did not provide adequate assurance that people’s care needs were being regularly assessed or that the care provided reflected their current needs. There was also a lack of assurance that the findings from audits that had taken place were always acted on.

People told us they were happy with the care and support they received and that it made a difference to their everyday lives. People told us that they were treated with respect and that care staff maintained their privacy and dignity.

During the inspection people who were using the service provided the following comments:

“It’s very good here.”

“Staff are always here to help me and I have more freedom than the last place.”

“I go to visit Mum and she comes here.”

“I get up and go to bed when I feel like it.”