Cascade (Stiles House)

Updated 21 December 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 inspection took place on 2 and 5 November 2018, was unannounced, and carried out by one inspector.

Prior to the inspection we gathered and reviewed information we held about the service, such as feedback from the local authority, and statutory notifications (events, changes or incidents the provider is legally obliged to tell us about within required timescales).

We reviewed 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.

As part of the inspection we spoke with two people who lived at the service to find out about their experiences of the care and support they received. We also 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 looked at documents relevant to people's care. This included two people's care plans, medicines administration records, risk assessments and other documents related to the management of the service such as quality assurance and health and safety records. We spoke with one visiting relative, and ten staff members including six care staff, the registered manager, group compliance manager, community liaison officer and educational director. In addition, we received feedback from two healthcare professionals and a further relative after the inspection.

Updated 21 December 2018

This comprehensive inspection took place on 2 and 5 November 2018 and was unannounced on the first day.

Cascade Residential/Short Breaks 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 service can accommodate up to a maximum of eight people. The main house had three floors and accommodated four people at the time of this inspection. Some people had their own bedroom and shared communal areas and a kitchen, and others had their own flat.

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.

At the last comprehensive inspection in March 2016, the service was rated good overall. 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.

At this inspection we found the service remained good in four of the five key questions, improving to outstanding in the effective question. This means the overall rating for the service remains good.

The service had a registered manager in post at the time of our inspection. 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.

This service was extremely effective and staff were proactive in ensuring people were supported to live a heathy, meaningful and fulfilling life. The service embraced supporting people to develop and regain their independence. There was a broad range of learning and social opportunities for people. As a result of this, people had recognised positive improvements made to their lives.

The service worked proactively in partnership with other professionals to develop care based upon good practice. This demonstrated there was a truly holistic and individual approach to assessing, planning and delivering peoples care and support.

People benefitted from a service which had an open and inclusive culture. Staff were very happy working at the service and spoke to us with knowledge and passion about their roles, and were clear about their responsibilities. Staff were trained and supported to carry out their roles.

Care plans were very person centred and detailed, and provided clear guidance to staff on how to support people. People's diverse needs were identified and incorporated into their care plans where required. Information was provided to people in an accessible format.

Staff supported people in line with their individualised care plans to manage individual risks and care needs.

Medicines were managed safely.

Safe recruitment practices were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There was enough staff on duty to meet people's needs.

Checks were made to ensure that the environment was a safe place for people who lived there.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were consulted and involved in decisions about their care and support; they were treated with dignity and respect.

People knew how to complain and staff knew the process to follow if they had concerns.

Quality assurance processes were in place to drive continuous improvement. Events, such as accidents, safeguarding and complaints, were monitored by the registered manager and group compliance manager for any developing trends.

Further information is in the detailed findings below.