The Care Quality Commission
  • Care Home
  • Care home

Walsingham Support - 1 Ashley Close

Overall: Requires improvement read more about inspection ratings

1 Ashley Close, Hemel Hempstead, Hertfordshire, HP3 8EH (01442) 219091

Provided and run by:
Walsingham Support

All Inspections

2 February 2021

During an inspection looking at part of the service

Walsingham Support – 1 Ashley Close is a care home providing accommodation and personal care for up to six people with a learning disability. At the time of our inspection, there were five people living at the service.

We found the following examples of good practice.

¿ The service was receiving professional visitors with clear infection control procedures in place. Visitors were screened and had their temperatures checked by staff on arrival. Alcohol gel was made available and all visitors were required to wear personal protective equipment (PPE). Guidance for the use of PPE was seen to be displayed in the building.

¿ The service had been providing ‘screened’ visits for people and their families within the conservatory at the service. Visits were pre-arranged, with timings scheduled to avoid potential infection transmission between visitors. Guidance and PPE was provided for all visits. At the time of our inspection, visits had been temporarily suspended due to an outbreak of COVID-19 at the service.

¿ The service was clean and hygienic. Cleaning schedules were in place, which were methodically completed throughout the service.

¿ Risks to people and staff in relation to their health, safety and wellbeing had been thoroughly assessed. There was support for staff in place which included provision of training, management support and financial assistance should they become unwell.

¿ The provider had developed a package of policies and procedures in response to the COVID-19 pandemic, which the registered manager had used to implement safe systems of work at the service.

12 June 2019

During a routine inspection

About the service

Walsingham Support is a residential care home providing personal care for six people with a learning disability at the time of the inspection.

Walsingham Support accommodates six people in an adapted building. Each person has an individual bedroom and communal space which consists of kitchen, lounge, dining room, bathroom, conservatory and laundry room. There is an on-site office where the registered manager is based.

The service has been developed and designed in line with most of the principles and values that underpin Registering the Right Support and other best practice guidance, this was based on the building as well as the engagement of the community. Registering the Right Support 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.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home, however the building is situated on a hospital site. 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 were not always safe and were at risk of harm. This was in relation to poor moving and handing as well as poor practice relating to people who were at risk of aspiration.

Risk assessments did not reflect all risks identified and did not detail how staff could support the person safely.

There was a quality assurance system in place however, these systems did not identify the risks identified at the time of the inspection.

As part of the inspection we requested information from the registered manager relating to governance, supervisions and training records, however these were not produced. Although, staff felt they had the training and support needed for their role. Robust recruitment and pre-employment checks were completed for all staff.

People were encouraged to go to a centre where they could be involved in meeting people. People’s care plans identified likes and dislikes. When observing the support and speaking to staff not everyone living at the service were encouraged to be involved in activities which would encourage their independence. At the time of the inspection we had one example of a person helping to empty the bins.

People and relatives said they felt the staff were always kind, caring and they felt safe in the home. Observations showed that staff were attentive to people’s needs.

The provider had accessible information which was provided for all their services, this was an easy read guide. Due to the people’s communication and support needs not all people living in the home would be able to understand this.

We recommended the service looks at developing different ways to communicate with people, so they are able to make choices or to be involved in decision making.

The registered manager ensured there was regular involvement from health professionals.

People were not always supported to have maximum choice and control of their lives, however staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 (published 14 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walsingham Support on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to safe care and treatment for people being supported and a breach in relation to good governance at this inspection.

Please see the actions we have told the provider to take at the end of this report.

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.

21 June 2016

During a routine inspection

We undertook an unannounced inspection of Walsingham, 1 Ashley Close on the 16 June 2016.

The service provides accommodation and personal care for up to six people with a learning disability. On the day of our inspection, there were six people using the service.

The home had a registered manager in post. 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.

In our previous inspection carried out on 1 August 2014, we found that the provider had not met a required standard and was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. During this inspection we found that the provider was now meeting the required standards.

There were systems in place to ensure that staff had undertaken risk assessments which were regularly reviewed to minimise potential harm to people using the service.

There were appropriate numbers of staff employed to meet people’s needs and provide a safe and effective service. Staff we spoke with were aware of people’s needs, and provided people with person centred care. Staff were well supported to deliver a good service and felt supported by their management team.

The provider had a robust recruitment process in place which ensured that staff were qualified and suitable to work in the home. This also included agency workers. Staff had undertaken appropriate training and had received regular supervision and an annual appraisal, which enabled them to meet people’s needs. Medicines were administered safely by staff who had received training.

Staff cared for people in a friendly and caring manner and knew how to communicate effectively with people. Staff spent time with people and engaged in meaningful activities that were good for people’s mental and physical wellbeing.

People were supported to make decisions for themselves and encouraged to be as independent as possible. Where people were not able to make decisions for themselves, best interest decisions were made on their behalf which involved advocates and other professionals. People’s choices were respected and we saw evidence that people, relatives and/or other professionals were involved in planning the support people required. People were supported to eat and drink well and to access healthcare services when required.

The provider had a system in place to ensure that complaints were recorded and responded to in a timely manner as well as an effective system to monitor the quality of the service they provided.

01 August 2014

During a routine inspection

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced.  When we inspected the service on 24 January 2014 we found that the service satisfied the legal requirements in the areas that we looked at.

Walsingham, 1 Ashley Close provides accommodation and personal care for six people who have a learning disability. The registered manager has been in place since November 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that the service had complied with the requirements of MCA and DoLS.

People were not cared for in a clean, hygienic environment which was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Relatives of people who lived at the home and healthcare professionals who had contact with the home said that people who lived there were safe. People who lived at the home were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who lived at the home. There were enough qualified, skilled and experienced staff to meet people’s needs.

People were cared for by staff who were supported to deliver care safely and to an appropriate standard. Staff members had regular supervision meetings with the manager and an annual appraisal meeting at which development goals were set.

Staff members communicated with people effectively and used different ways of enhancing that communication, including touch, body language and facial expressions.  Staff members received training in MAKATON, a recognised communication tool for some people who have a learning disability.

People were encouraged to eat a healthy diet.  People were also supported to maintain their health. Contact with the GP and other healthcare professionals, such as the dietician and occupational therapist, was made on people’s behalf when needed. 

Before people moved into the home a full assessment of their needs had been completed. This was to ensure that the provider could meet their assessed needs. Care records included information about what was important to the person, how to support them well and their likes and dislikes.

Care records were personalised and detailed. People and their relatives had been encouraged to contribute to the development and review of their care and support plans. The care records showed that assessments of people’s capacity to make decisions about their care and welfare had been completed. Regular reviews of aspects of people’s health and well-being had been completed in accordance with their care plans.

Staff members were caring and respectful toward people who lived at the home and protected their dignity and privacy.

The manager was responsive to changes in people’s physical abilities and worked with others, such as the deputy manager of a day care centre, to maintain people’s independence.

People were supported in promoting their independence and community involvement.  Each person had a daily planner that detailed the activities in which they were scheduled to participate.

The service had asked relatives for their opinions on the care and services provided at the home and relatives were given the opportunity to comment on any aspect of the home.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

The registered manager had been in place since November 2012 and operated an ‘open door’ policy for staff. They were supported by a regional operations manager and worked closely with the local learning disabilities team to ensure that people who lived at the home received the correct support.

The manager held monthly staff meetings at which staff members were able to discuss any matters about the running of the home or concerns about the people who lived there.

The provider had a system to regularly assess and monitor the quality of service that people received. The manager had completed a number of quality ‘spot check’ audits both during the day time and at night. However, these audits had failed to identify the areas in which cleanliness and infection control standards had not been maintained.

24 January 2014

During a routine inspection

The people who lived at No 1 Ashley Close, had no verbal communication skills. Therefore, they were unable to tell us about what it was like living there. We observed staff care for people and saw that this was done with gentleness and kindness.

We saw evidence that people's needs and wishes were recognised and met. We saw that choice had been offered and the staff waited until the person indicated their choice.

The home had a core of well-established staff who knew and understood the people's needs and wishes. We saw that communication between the staff and the people was effective. Care plans and risk assessments had been kept up to date and reflected the person's needs and wishes.