We carried out a review of the data available to us about Conifers on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Conifers, you can give feedback on this service.
We found the following examples of good practice.
The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread COVID19. Information and instructions for visitors were clearly displayed and explained in person on entry to the home.
We observed staff wearing the required PPE correctly whilst supporting people at the home.
People were supported to see their visitors following the latest guidance, where visits were not possible people were supported to speak to their families via video call.
The provider had clear policies on admissions of people to the home. There was clear information which effectively reduced the risks of transmission of COVID19 within the home.
Conifers is a care home which provides short and long-term respite services for up to nine people who are over 18 years old and require support with learning and physical disabilities. People who use the service have associated conditions that may include, autism, sensory and communication difficulties. At the time of the visit there were eight people staying in the service. Two people were on long term respite.
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. Registering the Right Support principles 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.
People’s experience of using this service and what we found
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 asked to consent to care. Staff had received training and were knowledgeable about the principles of the Mental Capacity Act 2005.
People and their relatives told us they felt safe and received their medicines on time. Staff knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to. Accidents and incidents had been reported and medical attention sought where required. The registered provider continued to operate robust recruitment procedures and staffing levels delivered responsive support to people. The home was well maintained, clean and staff had access to protective equipment to protect people from the risk of infections.
Staff continued to receive training and supervision throughout their employment to ensure they had the skills to provide effective care. Staff felt very supported by the registered manager and management team. People’s nutritional needs were assessed and met. Staff worked with community health professionals to ensure people received effective care.
Staff treated people with dignity and were respectful. We saw lots of caring and positive interactions between people and staff.
Care plans contained personalised information on people’s health and communication needs plus their likes and dislikes. People were provided with activities of their choice to keep them active in the community. There was a complaints policy that supported positive engagement and timely action. The provider needed to establish systems for supporting people towards the end of their life.
The service was well led. People’s relative’s and staff spoke positively about the registered manager and management team. There was a positive culture throughout the service which focused on providing care that was individualised.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
Rating at last inspection
The last rating for this service was good (published 10 March 2017).
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.
Cambian Conifers provides is a respite service in the Borrowash area of Derby. The service offers personal, social and respite care for a maximum of 9 people with a learning disability. Some people have associated conditions that may include, autism, sensory and communication difficulties. At the time of the inspection, there were two people who had stayed there for over a year and three people in the morning and four in the afternoon staying for respite.
At the time of our inspection there was a registered manager at the service. 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.
People were supported by staff who understood their role and responsibilities in keeping them safe. Staff were aware of the need to keep people safe and to protect them from the risk of avoidable harm. Staff and the registered manager understood procedures in relation to safeguarding and ensured any allegation of abuse was recorded and reported in the appropriate manner.
The provider had recruitment procedures in place to ensure staff were of good character and able to work with vulnerable people. Recruitment procedures were safe and included Disclosure and Barring service (DBS) checks.
Medicines were safely managed and stored. Staff had taken part in training relating to safe administration of medicines and competency assessments were carried out. Staff felt supported by the management team. They received training and supervision to support them in providing people with the care they needed to meet their needs.
People were encouraged and supported to take part in activities of their choice. Care and care plans were personalised to meet people’s needs, choice and preference. Information was provided to people in different formats, to ensure they were included.
The principles and requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards had been met. Best interest decisions and capacity assessments had been completed when required and were in people’s care plans.
People’s right to privacy and dignity was respected by the staff. Staff were kind, caring and compassionate; they promoted and supported people to be involved in their care.
People’s nutritional needs were met and dietary needs were catered for. Staff understood people’s health needs; people were supported to access relevant health care professionals and any recommendations were followed.
Information was available to signpost people and relatives to the relevant agencies should it be necessary to raise a concern or complaint; complaints were taken seriously and actions taken to resolve them.
Effective auditing systems were in place to assess and monitor the quality of the service. People and relatives were asked for their opinions and views of the service and how it could be improved.