The Baden Powell Centre

The Baden Powell Centre is a supported living service providing personal care to 16 people in their own homes. At the time of our inspection 15 people were living in independent apartments. They had their own kitchen, bathrooms and lounge areas. There was also shared leisure space in the building; including, a small gym, a cinema room, a resource room and a lounge area. The office was in a separate building on the same site with different access to the residential property. This was a change to our previous inspection when the property had been a registered care home. There had been changes to the building because of this and also there were some changes to who lived in the properties.

The service was a larger property than current best practice guidance. However, it was a purpose-built property which had been carefully designed for people to live as independently as they wanted to or were able to with no need to use shared communal areas unless they wanted to.

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

The outcomes for people using the service strongly reflected the principles and values of Registering the Right Support by embedding choice and control, independence and inclusion as the values of the service. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. The person-centred focus ensured excellent outcomes for people which respected their diversity and promoted equality. There was a very strong ethos of listening to people, promoting their choices and advocating these on their behalf when required. Staff cared deeply for the people they supported and were clear about the values of the service.

The risks to people’s health and wellbeing were assessed and action taken to reduce them. This including supporting behaviours which could be challenging. There were systems to learn from mistakes including the detailed analysis of accidents and incidents. People were supported by staff who understood how to protect them from avoidable harm. There were enough staff deployed to keep people safe in their home and when they chose to go out. People’s medicines were well managed when they required this support.

Staff received training to enable them to do their jobs well. Assessment ensured people’s needs were clear and included best practise guidance. They were supported to maintain a healthy diet when needed. Their health and welfare were managed with referrals to other professionals made when required. 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 had care and support provided which met their preferences. Complaints were handled in line with the provider’s complaints policy. People did not currently receive end of life care.

Staff enjoyed working at the service and felt respected and valued. People could give their views about how the service could develop and improve. The provider’s quality assurance processes were effective in identifying potential risks to people’s safety. There was a continued focus on learning, development and improvement.

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 Outstanding (published 9 May 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.

The Baden Powell Centre specialises in providing accommodation and personal care for up to 16 adults who have a learning disability and autism or other associated needs. At the time of our inspection, there were 15 people living in the service. The people living at the service were all adults under the age of 40 years. The service is run by Quality Care (EM) limited, a privately owned organisation who have four care homes for adults with learning disabilities in Derbyshire and Nottinghamshire.

All the people living at The Baden Powell Centre had their own self-contained apartments, with their own bedroom, bathroom, and open-plan kitchen, dining and living room areas. People also had access to communal facilities including a gym, café, arts and crafts space and a sensory room. Separate laundry facilities were available within the main building. People had access to the service’s enclosed garden. Local independent shops were accessible within short walking distance, as were a range of leisure and entertainment facilities.

The service had a registered manager at the time of our inspection visit, and they were available throughout our inspection visit. 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 to live their lives as independently as possible, both within The Baden Powell Centre and out in the local community. Each person had support that was specifically tailored to their needs and aspirations. The service had made a difference to the lives of people living there. There had been positive changes for people since they moved to the service, which could be evidenced through their personal achievements, happiness, and opportunities to try new experiences. Staff understood how to maintain a balance between developing new skills, taking risks and being safe in order to ensure people were supported to live their lives in as ordinary a way as possible. People were able to try new activities and build on their skills by a staff team who understood their needs and knew how to balance opportunities and risks. Staff supported people to reflect on their achievements and look at what they would like to do in the future. For example, one person was looking forward to moving to live more independently, and other people were accessing community facilities such as sports clubs. The registered manager and all staff had an excellent understanding of managing risks and supporting people to maintain independence. There was a robust system in place to protect people from the risk of harm and abuse, and people, relatives and staff felt confident to raise concerns about unsafe care.

Staff were recruited in a safe way, and were well trained and supported. The provider did checks to ensure that potential staff were suitable to work with people needing care. Staff received a comprehensive induction, regular supervision and had checks on their knowledge and skills. They had training in a range of skills the provider felt necessary to meet the needs of people at the service. This included bespoke training and support to ensure people with complex needs were supported by staff with the right skills and experience. Training was based on current best practice and guidance, so staff had up to date skills and knowledge to support people effectively. All staff were encouraged to contribute to the planning of people’s care, and to put forward ideas for improving the quality of the service. There were enough staff to support people in the way they wanted, at the times they needed it.

There was a strong culture of providing person-centred care and support that was tailored to each person’s needs, wishes and aspirations. People lived in safe, comfortable and homely apartments within the service. They were supported to make their own choices about their lifestyles. People were involved in planning and regularly reviewing their care to enable them to receive the service that worked for them. Staff worked in a very person-centred way, by responding to people’ individual communication and sensory needs. The provider developed creative ways of ensuring people led the lives they wished. People were supported to have choice and control over their daily lives. This meant people had a bespoke service which was tailored to their individual needs and aspirations, which was flexible to change as they developed confidence and skills.

People consented to care and support in many aspects of their daily lives, and were encouraged to make their own choices. Appropriate arrangements were in place to assess whether people were able to consent to their care, where this was needed. The provider met the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). This ensured people’s care was provided lawfully, and they had their rights respected.

People’s nutritional needs were met. They had access to a range of health and social care professionals for advice, treatment and support. Staff monitored people’s health and well-being effectively, and responded quickly to any concerns.

People felt cared for by staff who treated them with kindness, dignity and respect. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care, and were confident the provider would take action where needed. The provider had a complaints procedure to ensure issues with quality of care were addressed.

The provider had fostered positive values and a shared vision for the service with the staff team. The service was developed with people, relatives and staff. Staff were highly motivated and proud of the care and support they provided to people. There were effective and robust systems in place to monitor the quality of the service, and action was taken quickly to improve care. The registered manager understood their responsibilities, and CQC was appropriately notified of events as required.

A single inspector carried out this inspection. We spoke with one person who lived at the home and with the relatives of three others. We also spoke with three members of the staff.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were supported to make decisions and staff ensured that people's decisions were respected. All of the relatives we spoke with told us that staff supported people in a safe and effective way.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents. This meant that the service could identify the risks to people and had an adequate system of service improvement.

Procedures were in place to support staff and maintain their skills and knowledge. Staff understood the provider's procedures for dealing with emergencies, such as in the event of a fire.

Is the service effective?

People's care needs were fully assessed and written care plans were devised from these. They provided staff with the information they needed to effectively support people with their daily living and social activities and to help them achieve their individual goals and aspirations. People's individual abilities and behavioural needs had been assessed and their needs supported.

People's relatives told us they were happy with the standard of care that people received.

People were treated with respect and their dignity was maintained.

Is the service caring?

People and their relatives were positive about the standard of the care and support people received.

Staff demonstrated good rapport with the people they were supporting, who were relaxed and seemed comfortable in their surroundings.

Each person's support plan contained a section which related to their diet and maintaining a healthy lifestyle. People were encouraged to choose how they preferred their home to look and feel.

Is the service responsive?

The provider told us they had not received any complaints about the service.

People's relatives we spoke with knew how to make a complaint if they were unhappy, but said they had not needed to complain.

The provider was responsive to people's changing support needs and care was designed and delivered to meet people's individual needs. People and their relatives were given regular opportunities to comment on the way care and support was being delivered and the provider had responded to reflect people's views.

Is the service well-led?

There was a registered manager in place who coordinated and regularly checked the arrangements for people's care and support to make sure it was safe and met their needs.

The service had an effective quality assurance system. Records showed that regular audits had taken place to identify any risks to the safety of people who used the service. Where issues had been found action plans had been put in place to deal with them.

The provider kept records of all accidents and incidents in the home. These had been investigated and the cause of the issues identified. Actions plans had been put in place to reduce re-occurrence.

The provider worked well with other agencies and care services to make sure people received their care in a joined up way.

The service had officially opened on the 9 January 2013 and was made up of 16 individual apartments and a range of activity rooms and facilities.

We looked at a sample of care plans for people living in the centre and also those in place for people transitioning into the service. Care plans considered people's ability to advocate for themselves which included making choices about their care or whether they required additional support. Additional care plans were in place which considered people's likes and dislikes, gender and sexual awareness and communication.

We found that medicines were being safely administered and that appropriate arrangements were generally in place in relation to the recording of medicine.

Regular audits of the service provided were being completed and acted upon. These included monthly medication audits, audits of people's care plans, environmental audits and a monthly food hygiene audit.