This inspection took place on 4, 5 and 10 May 2016 and was unannounced. Ranworth House provides care and support for up to nine people with a learning disability and/or other complex needs. The home is a large detached house with two lounges, a sensory room, dining room, kitchen and surrounding garden. Each person had their own en-suite bedroom. There were nine people with an age range of 22 to 30 years living in the home at the time of our inspection. 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.
People experienced excellent care and support. They were supported to live safe, fulfilled and meaningful lives in the way they wanted to. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Risks to individuals were extremely well managed and people were able to stay safe without having their freedoms restricted. Managers and staff promoted peoples independence and encouraged positive risk taking. If an incident or accident did occur, they were well reported and investigated. Staff understood the importance of learning from incidents, so they could make sure they did not re-occur.
There was always enough staff on duty. Staffing levels were regularly assessed and care workers were flexible about the hours they worked. Staff turnover was very low and relatives said how important this was to their family member. Staff knew people well and understood how to meet people’s complex needs. Recruitment practices were robust.
People’s medicines were exceptionally well managed. Staff were very well trained and people received their medicines safely and on time. The registered manager had liaised with the pharmacist to ensure some medicines were dispensed in different ways, to make sure people got their full dose of medicines safely. Staff understood when they needed to give people medicines on an ‘as and when basis’, and how some people communicated non-verbally this was what they needed.
The registered manager and staff had a good understanding of the Mental Capacity Act (2015) (MCA) and gained consent from people in line with legislation. Deprivation of Liberty Safeguards (DoLs) referrals had been made to the appropriate authorities. Where best interest decisions had been made on behalf of a person, all of the relevant people were involved.
People were well supported to eat and drink enough. Food was homemade and nutritious and people were involved in making decisions about menus. People were supported with healthy eating and to maintain a healthy weight, with specialist diets when required.
The registered manager and staff ensured everyone was supported to maintain good health. They took a proactive approach to ensuring people’s complex health needs were always met, and consistently ensured that when people needed specialist input from health care professionals they got it.
Staff were extremely caring and always ensured they treated people with dignity and respect. They had an excellent understanding of the care and support needs of every person living in the home. People had developed very positive relationships with staff and there was a friendly and relaxed atmosphere in the home. People were well supported to do the things that were important to them, such as going to college, playing football or voting. Staff were well supported with training, supervision and appraisal which helped them to ensure they provided effective care for people.
People and those important to them, such as their relatives or GP, were asked for feedback about the quality of the service. Any feedback received was acted on, and any concerns were dealt with quickly before the formal complaints procedure was needed. The registered manager and staff knew what they should do if anyone made a complaint.
Person centred care was fundamental to the service and staff made sure people were at the centre of their practice. Care plans focused on the whole person, and assessments and plans were regularly updated. People’s individual preferences, needs and choices were always taken into account by the caring and compassionate staff.
The service was exceptionally well led. There was a clear set of values in place which all of the staff put into practice. The registered manager and provider regularly completed very robust quality assurance checks, to make sure the high standards of care were maintained. There was an open culture and staff said they felt well motivated and valued by all of the managers.