About the service Newlands is a residential care home accommodating up to eight adults who have a learning disability, are autistic or have mental health needs. Five people were living at Newlands at the time of the inspection.
People’s experience of using this service and what we found
People, their relatives and staff shared concerns about staffing and use of agency. The registered manager provided reassurances, although several staff had left, new staff had been recruited. Where there were vacancies, or gaps in staffing these were being covered by consistent agency staff. The registered manager was in negotiation with the local authority to review funding for three people where their needs had changed to increase staff numbers.
Systems were in place to keep people safe. Risks to people were assessed, regularly reviewed and managed well to ensure their safety and promote their independence. Staff recruitment processes were in place to ensure staff were suitable to work with people who used the service. Training was provided to staff including agency staff to ensure they had the right skills and knowledge to carry out their roles effectively.
Infection prevention and control and medicines were being managed well including risks associated with COVID-19. People and staff had received COVID-19 vaccinations and boosters to help minimise the risk of catching the infection.
People were supported to eat and drink enough to maintain a balanced diet. The registered manager and staff worked well with other professionals to ensure people had access to healthcare appointments and received the right support to manage their health needs.
People’s care plans were personalised to reflect how they wanted to be supported and what was important to them. Progress had been made to have conversations with people about their preferences regarding death and dying.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Right support:
The model of care and setting maximised people’s choice, control and Independence. Newlands is a large detached single storey house situated in Colchester and close to all amenities. The premises provide each person with their own individual bedroom and adequate communal facilities. People had been involved in decisions about the refurbishment of their living accommodation to create a more modern and homely living environment. The environment met people's sensory and physical needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to access the community, including college and places of interest.
Right care:
People’s care was person-centred. Staff were observed treating people with kindness, respect and compassion. Staff understood their responsibilities to respect people's human rights, including their right to privacy, confidentiality and to promote their independence.
Right culture:
People and their relatives told us the ethos, values, attitudes and behaviours of the registered manager and care staff ensured people using service lead confident, inclusive and empowered lives. Relatives and staff told us the culture in the service had improved under the new registered manager. People using the service were encouraged to take an active role as ‘champions’ to promote good practice, such as encouraging people, staff and visitors to maintain good hand hygiene.
Improved systems were in place to identify and manage risks to the quality of the service and drive improvement. Regular audits of the service had been carried out to identify what was working well and where improvements were needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 13 August 2019). The previous inspection identified improvements were needed to the environment, hygiene and cleanliness and to ensure people’s care plans were person centred. Additionally, improvements were needed to ensure people were supported to access appointments to ensure their physical and mental health needs were met. The service had not explored how to have end of life conversations with people living with learning disabilities.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.