We inspected the service on 20 November 2018. The inspection was unannounced. 429 Warwick Rd is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates seven people who are living with a learning disability.
On the day of our inspection there were six people using the service.
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.
There was a registered manager at this. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.
The care service had not originally 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. Part of this best practice approach is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, people were given choices and their independence and participation within the local community is encouraged.
People felt safe around the staff supporting them. Staff understood how to keep people safe and had received training to support this. Staff knew the risks to people’s health and how to manage these risks safely. People were able to access support from staff when needed, and staff were happy with the staffing levels at the service. Recruitment processes included background checks on staff. People were supported with their medicines when needed. Checks were also in place to ensure people received their medicines safely. Staff understood how to keep the spread of infection to a minimum. Accidents and incidents were recorded and monitored so that people’s care could be adapted as appropriate, and learning from any untoward incidents was shared with staff.
Staff training was based on best practice and the individual needs of people living at the service. Training was monitored so that staff had skills in line with people’s needs. People were supported to make decisions about their care where this was needed. People were supported to access help from medical professionals and advice was incorporated into people’s care plans. People were offered choices in their meals and were offered support to develop their own menu plans.
People liked and valued the staff supporting them. Staff had a detailed knowledge of the people they were supporting. People were supported to develop their independence where possible and were treated with dignity. Where appropriate, end of life plans were developed in consultation with the relevant people.
People were involved in developing their care through regular meetings with key workers. When people’s care needs changed, care plans were updated to reflect these changes. Important information about what people wanted to achieve was captured in their care plans. Staff supported people to work towards achieving these plans. People felt assured they could complain if they needed to, and that their complaints would be taken seriously.
The registered manager promoted an inclusive approach to providing care for people living at the service by involving people and staff in making decisions about people’s care. People were involved in developing their care in a number of ways. Staff were empowered to provide good care to people by the support they received from the management team.
Staff were encouraged to share ideas and contribute to care planning and their views were acted on. Effective communication at the service enabled the team to understand people’s care needs and staff felt part of a team that worked well together.
The registered provider worked with the registered manager in ensuring that all the necessary checks were completed. This supported continual improvement people’s experience of care. The registered manager worked with other managers to understand best practice and to support and develop people’s friendships.