Background to this inspection
Updated
11 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 29 June 2018 and was announced. We gave the registered manager 48 hours’ notice of the inspection because the service is small and staff are often supporting people with activities in the community. We did this to ensure that both staff and people who use the service were on site. The inspection team consisted of one inspector.
At the last inspection on 29 March 2016 the service was rated Good. At this inspection we found the service remained Good.
Before the inspection, we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR) in March 2018. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We also checked the information that we held about the service and the service provider. This included previous inspection reports and statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events, which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.
As people used various methods of communicating, it was difficult to obtain people's views regarding the quality of the service, so we spent time observing people in areas throughout the home to see interactions between people and staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke to two people, looked at medication procedures, observed activities, and the breakfast. We spoke with the registered manager and three care staff. We also contacted external professionals and stakeholders to obtain feedback about the care being given to people. We spoke with one relative following the inspection.
We reviewed all four people’s care records, looked at four staff files and reviewed records relating to the management of medicines, complaints, training and how the registered person monitored the quality of the service.
Updated
11 August 2018
A comprehensive inspection took place on 29 June 2018 and was announced. We gave the registered manager 48 hours’ notice of the inspection because the service is small and staff are often supporting people with activities in the community. We did this to ensure that both staff and people who use the service were on site.
The service had a registered manager in post. The current manager was registered in May 2016. 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.
16 Hawthorn Crescent is a 'care home.' People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is situated in a residential area of Worthing, adjacent to another service run by the provider. The two services share a garden to the rear of the property.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
16 Hawthorn Crescent is registered to support up to four people with learning disabilities, physical disabilities or other complex needs. At the time of the inspection there were four people living at the home. The home provided personal care and support to male adults of various age groups.
16 Hawthorn Crescent is a detached property with a communal area over one floor. There was a large kitchen and dining area that also served as a communal area for people who used the service. There was a small purpose-built extension adjacent to the kitchen that served as an office for the registered manager. The property held four ensuite bedrooms, a laundry room and staff bathroom.
At the last inspection on 29 March 2016, the service was rated as good in the areas of Effective, Caring and Responsive and Well-led. The service was rated as requires improvement in the area of Safe but the overall rating for the service was Good. Following the last inspection on 29 March 2016, we asked the provider to complete an action plan to show us what they would do and by when to improve the key question of Safe to at least good. At the last inspection we found that the provider was not fully mitigating the risks to people’s wellbeing and safety, specifically around bowel monitoring. We also found that some information relating to each person’s needs and risks to their health had not always been consistent and up-to-date. The provider had sent us an action plan as to how they intended to improve this area. At this inspection we found the evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People received safe care and treatment with risks to their health and safety being properly assessed and mitigated.
People’s medicines were well managed by staff at the service.
Staff knew people well and had a good understanding of their needs and how best to support these to achieve the desired outcomes. We saw staff treating people with dignity and respect and being patient and considerate when providing different elements of care.
People were involved in their care and support and were encouraged to be active in the running of the service.
People’s health needs were monitored well and staff were responsive in seeking treatment and maintaining regular health appointments.
People were supported to have sufficient food and drink and were involved in the decisions about the food they ate.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible, the policies and systems support this practice. Staff understood how people's capacity should be considered and had taken steps to ensure that their rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).
The service was well led by the registered manager who has support from the provider in ensuring that quality assurance systems were effective.