Three Sisters

Three Sisters is a residential care home for up to 10 people. At the time of the inspection 9 people lived at the home. The service provides care, support and accommodation to people living with learning disabilities or autistic spectrum disorder.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to have maximum choice and control of their lives. Staff encouraged people to enhance and maintain their independence and encouraged people to make decisions for themselves. Processes were in place to enable staff to support people in the least restrictive way possible. However best interest decisions were not always reviewed by relevant external representatives.

Risks to people were assessed, monitored and managed. Staff had the necessary skills, knowledge and experience to provide safe and effective care. Overall there were enough staff to meet people's needs. However we recommend the provider reviews the night time staffing levels to ensure they remain safe and appropriate to people’s needs.

People's medicine support was managed safely, and staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. People had a choice about their living environment and were able to personalise their rooms. Some aspects of the home needed refurbishment and the provider was taking action to address this.

Right Care:

Care was person-centred and delivered in a way which promoted people's dignity, privacy and human rights. Staff offered people choices and involved people in making decisions about their routines and how care was provided. Information was provided in formats which met people’s individual needs. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Staff worked alongside partnership agencies to assess and develop the care and support people received. This collaborative approach helped ensure people achieved good outcomes. Staff understood how to protect people from poor care and abuse and worked well with other agencies to do so.

People received care that supported their needs and aspirations and was focused on their quality of life. People’s equality characteristics were celebrated and respected. Staff identified people’s circles of support and involved them to help promote people’s wellbeing and enjoyment of life.

Right Culture:

The provider’s audit systems did not always identify and drive improvements in the quality of care. The ethos, values, attitudes and behaviours of leaders and care staff ensured people using the service lead confident, inclusive and empowered lives. People were supported to identify and develop individual aspirations. Staff adapted their support to help people pursue their interests and to achieve their life goals. Staff valued and acted upon people’s views. Staff ensured risks of a closed culture were minimised so people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 25 July 2019 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Recommendations

We have made recommendations to the provider about ensuring best interest decisions are reviewed with input from external representatives and to ensure staff always have the most up to date policies. We have also made recommendations to the provider to review night staffing levels and their audit systems to ensure areas for improvement are consistently and promptly identified and addressed.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.