Isabella Court

Updated 1 October 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

This 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

Isabella Court 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 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from professionals who work with the service. 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. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We also spoke with seven members of staff (some of whom were assistant managers) and the registered manager for this service.

We reviewed a range of documents. This included three people’s care plans and multiple medicine administration records. We looked at three staff files including training and supervision, and a variety of records relating to the management of the service, including policies and procedures.

After the inspection

Following the inspection we received feedback from two health professionals and three relatives. We incorporated their feedback into our findings and judgements.

Updated 1 October 2019

About the service

Isabella Court is registered to provide care and accommodation for up to 9 people with learning disabilities and/ or autism and associated complex needs. At the time of our inspection 7 people were living at the service.

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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

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 did not use any restrictive intervention practices at the time of our inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. People were provided with information they needed and were encouraged to be involved in all aspects of their care. Staff asked for people’s consent before they delivered care and support.

People communicated positive feedback about the service and staff. Health professionals feedback demonstrated a responsive service. Staff were attentive to people’s needs and knew individuals well. Staff spoke passionately about the people they supported and worked to uphold their rights. The service achieved positive outcomes for people through attentive care, understanding and responsiveness to the needs people communicated to them.

These qualities demonstrated a service working to achieve positive outcomes for people, which reflected the principles and values of Registering the Right Support. This included; Taking time to support people to express themselves when making decisions and involving their preferred representatives; championing people’s rights and choices to maintain independence and control of their lives; holistically assessing people’s needs to ensure the right support is accessed; and encouraging new activities and sensory opportunities. These impacted positively on people’s quality of life in terms of their physical, mental and emotional health.

Care plans included historical information and guidance on all aspects of care provision. Changes in people’s needs were communicated promptly meaning staff could deliver consistent, personalised and responsive care to people. People had a choice of activities and events that were meaningful to them. Staff understood people’s interests and often had similar interests themselves. This helped them to build trust and support the development of people’s other relationships with friends and family.

Staff received regular support to enable them to deliver person centred care. This included; specific training around people’s individual needs, supervisions that encouraged learning and development and regular communication methods such as staff meetings and handovers. The service worked in partnership with other agencies and health professionals. Best practice tools were utilised to support positive outcomes for people and responsive care practices.

Safeguarding systems protected people from abuse or avoidable harm. Recruitment procedures were thorough and staffing levels ensured people’s immediate needs were responded to. Risk assessments were detailed and clearly informed staff of the steps to take to mitigate future risks to people.

People, relatives and staff provided good feedback about the management of the service. They were confident that concerns were dealt with and resolved to their satisfaction. Staff told us the registered manager supported them at all times and had an ‘open-door’ policy.

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 Good (published 15 February 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.