We carried out this unannounced inspection on the 18 and 26 June 2015. At our last inspection in July 2014 we found that the laundry environment was unsafe which posed a risk to infection control at the home. At this inspection we found improvements were still required.
Victoria Court provides accommodation for up to six people who had a learning disability, autism and or mental health needs and who require personal and/or nursing care. At the time of our visit there were six people living at the home. Victoria court is set over two floors. The ground floor has two bedrooms, along with two communal lounges, the laundry room, a dining area, kitchen and access to the outside patio area. The first floor has four rooms, the manager’s office, staff sleeping area, and medication room. All bedrooms are en-suite.
There was 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. The registered manager was present during the inspection.
Improvements had been made to ensure people were better protected from the risks of infection. The laundry room had a new floor, skirting boards and tiles. Mops had been replaced with steam cleaners and the extractor fan had been cleaned. There were still some concerns relating to poor use of personal protective equipment and the handling of soiled and contaminated laundry.
Not all staff had received appropriate pre-employment checks before commencement of employment. However, the manager had systems in place which ensured staff did not work on their own with people until their competence was checked. We found these risks were not being managed with an appropriate risk assessment.
Not all risk assessments for keeping people safe were accurate and up to date. One person required their risk assessment to be updated and review dates to be added. The evaluation process in place had failed to identify this shortfall. These risks were reduced because staff knew people well.
People had detailed behaviour support plans in place. Staff knew how to support people well. For example, we saw positive interactions with a member of staff and how they supported someone who became upset with anxiety.
People told us they felt safe and that staff knew them well and were kind and caring. Staff knew about different types of abuse and what they should do if they suspected abuse.
The principles of the The Mental Capacity Act 2005 code of practice including the Deprivation of Liberty Safeguards were being followed and we saw appropriate paperwork in place.
All staff confirmed they felt they received adequate training. Not all staff had received refresher training in relation to safe administration of medicines, Safeguarding adults and The Mental Capacity Act. The manager confirmed actions had been take to address this. There was a good staff induction and we saw new staff received training relating to their role.
People had enough food and drink. There was enough choice and control with their meals including the times that they chose to have their meals. All people we spoke with confirmed they were happy with these arrangements.
Referrals to health care professionals were made for people when required. All people we spoke with were happy with the support they received. One health care professional we spoke with confirmed they were happy with the service.
Staff felt they received enough supervision meetings and were supporting by the manager. There were daily hand over meetings and staff there had been a recent staff meeting.
Staff interacted with people in a kind, caring and polite manner. People were happy with the care that they received.
Care plans included peoples life histories and staff we spoke with knew people well. People confirmed how they made their own choices and care plans confirmed their wishes.
People were supported with their choices, for example, when they wished to get up in the morning and access the community.
People had support to follow interests and activities that were important to them.
Care plans contained various pre assessments and important information relating to people. Care provided was person centred.
People had regular reviews and key workers were responsible for co-ordinating and liaising with people when their needs changed.
There was a complaints policy in place along with an easy read version but there was no overview of actions taken to resolve complaints. Following our inspection, the manager sent us a copy of the plans they were going to implement to address this.
We found at times there were duplicate records that were out of date. This included records relating to pen portraits, personal evacuation plans, fire plans and risk assessments.
Not all areas of the health and safety audit identified areas of concern found on the inspection. This included staff practice relating to personal protective equipment, handling of soiled and contaminated laundry and one area of the home that had paper peeling off the wall and evidence of damp coming through.
There was a system for logging all incidents and accidents in the home and we saw that these were reviewed and actions taken when required.
There was a system in place to ensure people and relatives were sent an annual survey. Most people were happy with living at the home. We found there was no overall analysis of actions taken following the comments received about the home.
We found three breach's of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.