Maer Lane

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The service operated from a large home, bigger than most domestic-style properties and larger than current best practice guidance recommends. However, the building’s design helped reduce any negative impact to people living at the service, by blending into the surrounding residential area, which included other similarly sized homes.

The provider completed checks to the physical environment. However, these checks did not identify some needed attention including risk assessments for free standing furniture, incorrect window restrictors and some missing fire signage in the premises. However, the provider corrected these by the conclusion of this inspection.

People had assessments of their care and treatment. Where a person was not able to consent, staff involved those important to people to make decisions in their best interests. However, some documentation was unclear about the outcomes of certain capacity assessments and the decisions made. The provider took action to rectify this. Not all known risks had been assessed. For example, where people were living with diabetes there was a lack of information on how to identify changes in condition or what to do in the event of an emergency. Where people had a diagnosis of dementia, the information for staff was minimal. Once raised with the management team they provided this information to staff.

People were supported by enough staff with the right skills and experience. People’s medicines were managed safely. Staff followed safe practices for medicine administration, however, the provider needed greater oversight in the use of as required (PRN) medications to ensure all appropriate action had been taken prior to the administration of such medicines.

Although the provider had checks in place these were not always effective in identifying and rectifying the issues we found at this inspection.

The home was generally tidy, and staff followed best practice with infection prevention and control. However, some areas of the home needed improvement. For example, we saw some bathrooms where mould was starting to appear and exposed plaster on walls. This hampered staff members attempts to effectively clean these areas. The registered manager shared with us an improvement plan where this had been identified and works were scheduled. However, they informed us these improvements were overdue.

People were involved in assessments of their needs and when it was needed those close to them were also included. These assessments took account of their communication styles, personal needs and preferences.

People felt safe to raise concerns as the provider had a good, open and transparent learning culture. People were protected from the risks of abuse by staff who understood and managed risks.

People were treated with kindness by staff who protected their dignity. People were treated as individuals by staff who knew their personal preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff members’ wellbeing was supported by the provider, and they had ongoing access to training.

People, relatives and healthcare partners felt comfortable to give feedback and were confident the service took it seriously and acted on it.

Staff had a shared vision and culture based on listening and learning. The management team were approachable and supportive. Staff felt supported to give feedback and were treated equally, free from bullying. Staff understood their roles and responsibilities.