Archived: Botchill House

Updated 30 August 2019

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.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Botchill House 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 had a manager registered with the Care Quality Commission. 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.

Notice of inspection

The inspection was announced. We gave short notice because some people living with autism need time to process information about a new person visiting their home. The staff were given time to prepare social stories and the inspector supplied a photo of themselves prior to the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection-

We spent time and spoke with three people living at the service and three relatives. We spoke with six staff including the registered manager, care workers and domestic 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 reviewed three care plans and their associated risk assessments. We also looked at medicine administration records and three staff files. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 30 August 2019

About the service

Botchill House is a residential care home providing personal and without nursing for up to 15 people with learning disabilities.

The service is in a rural setting and accommodation is provided in one adapted building with bedrooms on the ground and first floor.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people. Ten people were using the service with no plans to increase these numbers. All ten had previously lived together in a ward in a large hospital and moved together to this service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People could not directly tell us about their experience of living at Botchill due to their complex needs and communication difficulties. We observed people moving freely around the house, enjoying each other’s and staff company. People were relaxed and enjoying the warm weather. There were lots of different seating areas set up outside, some with shade. The garden provided people with lots of safe space to wander.

People’s relatives were positive about the care and support people received. One said “We are very happy (name of person) is here. She is settled and happy.”

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. Although the service was in a rural location, people were supported throughout the day to enjoy trips out to the local town. A small group also went on a trip to a local zoo on the day we inspected.

Outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were encouraged to take part in activities of daily living such as helping with meal preparation.

Staff were skilled at understanding people’s communication needs and this helped people to make their views known by various ways.

Staff were knowledgeable about people’s needs, preferences and wishes. They ensured a person-centred approach through detailed and collaborative care planning. People’s privacy and dignity was respected.

The service used individualised communication tools to assist people to make choices and make their needs known. The provider ensured best practice guidance was followed. They were signed up and contributors to a range of national organisations who promoted best practice for people with learning disabilities.

People were supported to enjoy a wide variety of meals, snacks and drinks. Staff were observant to ensure people had good hydration. Where people may be at risk of choking, staff closely monitored them when eating and drinking.

People’s healthcare needs were well met. Staff used a variety of national tools to ensure people’s particular health issues were closely monitored. Each person had a hospital passport which had important information about how best to communicate and care for the person.

People were protected because risks had been assessed and any measures needed to mitigate these were fully documented. New staff were only recruited once they had all their checks to ensure they were suitable to work with vulnerable people. People’s medicines were safely managed.

There were quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (report published December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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.