16 December 2018
During a routine inspection
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.
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 and were embedded within this service which worked to ensure people could live as ordinary a life as any citizen.
There was a registered manager in place. 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.
Staffing levels were based on the needs of people at the home and were under constant review. Staff told us they had the time to support people and numbers of staff were increased when people had outings and appointments to ensure there were always sufficient numbers of staff available to support people. Staff had been trained and were confident to recognise safeguarding issues which meant people were protected from harm.
Risks were assessed and well managed to ensure people's freedoms were not overly restricted and risk assessments were based on positive outcomes for people.
Staff received ongoing support from the management team through a programme of regular supervisions and appraisals and they had been trained to ensure they had the knowledge and skills to care for people. Staff were required to undertake an annual programme of training and specialist training was provided when it was needed to ensure staff had the skills required to support the complex health needs of people living at the home.
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 in the service support this practice
We found decision specific capacity assessments had been carried out for people who lacked mental capacity to consent to aspects of their care delivery. These were compliant with the Mental Capacity Act 2005 (MCA). Staff understood the principles of the MCA and how to ensure people's human rights were respected when making decisions on their behalf.
We found all the staff to be caring in their approach to the people who lived there and treated people with dignity and respect. Staff knew the people they supported very well, and we observed people were very happy in the presence of staff and there was a very positive and friendly atmosphere. Relatives were confident about the love and care provided to their relation and spoke consistently about the caring staff.
The support people received from staff was tailored to their individual needs and staff had worked extremely hard to get to know people and understand what was important to them. People were given opportunities to live fulfilled and meaningful lives regardless of their complex needs.
The service had excelled in supporting people at the end of their lives and worked closely with the local hospice. They had taken an active role in developing a tool to help support people with a learning disability at the end of their life. They had shared their learning with other organisations and presented at various conferences and groups. This truly demonstrated their passion for improving this aspect of care delivery for people with a learning disability.
People were supported to be fully involved in how their support was provided. Information was provided in an easy read format to ensure people with different abilities were provided with information in a format they could understand. Clear, easy read plans were designed to help people manage health conditions that needed monitoring. Health and social care professionals were involved with people's support when needed and their advice was included in the care provided. There was clear evidence of person-centred care and records contained information detailing people's life histories, preferences and choices to enable staff to support them. People were involved in activities based upon their established routines and preferences.
Systems and processes for ensuring the quality of the service included nationally recognised evidence-based standards to ensure they provided a quality service to people living there. The service was well-led by a registered manager who aspired to develop the service continuously and who kept abreast of best practice and developments in this field.