Background to this inspection
Updated
31 August 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
This was a targeted inspection to check concerns we had about restrictive practice following an inspection at another service run by this provider.
Inspection team
One inspector carried out the inspection.
Service and service type
Dorset Learning Disability Service – 23 Birch Way is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Dorset Learning Disability Service – 23 Birch Way is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 20 July 2022 and ended on 8 August 2022. We visited the home on the evening of 20 July 2022.
What we did before inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We reviewed all the information we had received about the service since our last inspection. We used all of this information to plan our inspection.
During the inspection
We met the four people who lived in the home. We spoke with them about the choices they make.
We spoke with a member of staff. We also spoke with the registered manager, and a senior representative from the provider.
We reviewed a range of records. This included records related to two people’s care records and staff training records.
Updated
31 August 2022
We carried out an unannounced comprehensive inspection on 14 April 2018.
Dorset Learning Disability Service – 23 Birch Way provides care and accommodation for up to four people with learning disabilities. On the day of our inspection there were four people living at the care home. In relation to Registering the Right Support we found this service was doing all the right things, ensuring choice and maximum control. Registering the Right Support (RRS) sets out CQC’s policy registration, variations to registration and inspecting services supporting people with a learning disability and/or autism.
The service did not have a registered manager; however a manager had been appointed and was in the process of submitting their application to the Commission. 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. At the last inspection on the 2 June 2016, the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated good:
People were not able to fully verbalise their views and staff used other methods of communication, for example pictures or visual choices. We met and spoke with three people during our visit and observed the interaction between them and the staff. One person was away with family.
People remained safe at the service. People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected. Staff, were recruited safely, and checks carried out with the disclosure and barring service (DBS) ensured they were suitable to work with vulnerable adults. People had their needs met by suitable numbers of staff.
People’s risks were assessed, monitored and managed by staff to help ensure they remained safe.
Risk assessments were in place to help support risk taking, and help reduce risks from occurring. People who had behaviour that may challenge staff or others had risk assessments in place which gave good guidance and direction to staff about how to support the person, whilst taking account of everyone’s safety. People received their medicines safely by suitably trained staff.
People were supported by staff who had received training to meet their needs effectively. Staff meetings, one to one supervision of staff practice and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the Equality and Diversity and the Human Right needs of people.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People's health was monitored by the staff and they had access to a variety of healthcare professionals. The manager worked closely with external health and social care professionals, to help ensure a coordinate approach to people’s care.
People’s end of life wishes were not currently documented, however staff told us how they had supported one person during their end of life last year. This included offering support when this person was admitted to hospital to help ensure they had people familiar to them at the end.
People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; taking into account people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history and people’s cultural, religious and spiritual needs.
People were treated with kindness and compassion by the staff who valued them. Staff had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.
The service remained responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The provider had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need.
Staff adapted their communication methods dependent upon people’s needs, for example using simple questions and information for people with cognitive difficulties and information about the service was available in an easy read version for those people who needed it.
People were able to make choices about their day to day lives. The provider had a complaints policy in place and it was available in an easy read version. Staff knew people well and used this to gauge how people were feeling.
The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the manager and team leader, who managed the service on a day to day base, were very approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.
People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.