Livability Wall Street, a 10-bed care home for adults with learning and physical disabilities in Hereford, was rated Good across all five key questions at its November 2023 inspection. The service demonstrated person-centred, safe and well-led care with a motivated staff team, robust governance and strong promotion of independence and community inclusion.
Strengths
· People felt safe and staff were knowledgeable about safeguarding, with one person stating 'The staff are as good as gold. I feel safe here.'
· Personalised, holistic and strengths-based care plans regularly reviewed with people and their relatives.
· People supported to maximise independence, including self-managing medicines and accessing the community.
· Highly motivated staff team with positive relationships; described service as 'Friendly, warm, inviting, like a family with residents and staff.'
· Effective quality assurance systems including regular audits, accidents/incidents monitoring and trend analysis.
Quality-Statement breakdown (25)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candour; continuous learning and improving careGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
Livability Wall Street received a Good rating across all five key questions at its June 2019 inspection, maintaining the same rating as its previous inspection in 2016. The service demonstrated strong person-centred care, effective multi-agency working, and a positive inclusive culture, with only a minor concern noted around limited bank staff availability for domiciliary care cover.
Concerns (1)
minorStaffing levels: “Staff providing care to people in their own homes expressed some anxiety about the lack or limited number of bank staff to cover staff annual leave and sickness absences.”
Strengths
· People were protected from abuse by staff who understood how to identify and report concerns, with in-depth safeguarding training including police officers and doctors.
· Staffing levels enabled people's needs to be met safely, providing a consistent and reliable service in supported living settings.
· Staff received effective induction, ongoing training and management support, with relatives expressing 100% confidence in staff competence.
· Person-centred care plans supported individual needs and preferences, with people involved in decisions about their care.
· Positive and inclusive culture promoted by an approachable management team, described by a community professional as 'second to none'.
Quality-Statement breakdown (25)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
Wall Street, a 10-place residential service for people with physical disabilities, was rated Good across all five key questions at its May 2016 inspection. The service demonstrated safe, person-centred care with strong leadership, effective staff training and supervision, and meaningful involvement of people in their own care and the running of the home.
Strengths
· People felt safe and staff demonstrated clear understanding of safeguarding procedures
· Safe recruitment practices including DBS checks and employment references were followed
· Medicines were stored, administered and disposed of safely with periodic staff competency checks
· Staff received effective induction, ongoing training adapted to individual learning styles, and regular one-to-one supervision
· Staff demonstrated good understanding of the Mental Capacity Act 2005 and applied it in daily practice
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood