We carried out a review of the data available to us about Alan Atchison - 2 David's Close 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 Alan Atchison - 2 David's Close, you can give feedback on this service.
We found the following examples of good practice.
Visitors had their temperature taken, completed a health questionnaire and wore personal protective equipment (PPE).
The home had an ample supply of PPE. All staff had received training in the correct use of PPE, and how to take it off and put it on safely.
People were supported to have regular contact with their families and friends through video and telephone calls. People were also supported with ‘drive-by’ visits so that they could see their family members from a distance.
Testing for COVID-19 was carried out on both people living in the home and staff on a regular basis. Staff had received training in how to undertake the rapid tests to ensure they, as much as possible, obtained an accurate reading.
Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection. There were ample supplies of cleaning equipment to reduce the spread of infection.
The service supported staff to travel to work safely without the need to use public transport. If necessary the service paid for staff to access work and home using a private taxi, which had a screen in place separating the driver from the passenger.
The service had been running for many years prior to the Registering the Right Support best practice guidance. The registered manager told us on the second day of inspection they had become aware of this guidance after our first inspection day. However, we saw the service had 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
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 a senior support worker, in the registered manager’s absence at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service did support people effectively in line with positive behaviour support principles. Staff told us they were trained to support people using positive behaviour support during their autism awareness training.
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.
Although the registered manager at this inspection was not aware of the guidance of Registering the Right Support, the service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
We have made a recommendation about keeping up to date with best practice guidance.
People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
The support and care provided by staff at the service made people feel safe. Staff understood their duty to report any concerns they had about poor care and potential harm to people. Staff had information available to them to refer to on how to monitor and reduce people’s individual risks. Staff worked in conjunction with guidance from external health care professionals such as the speech and language therapist team and a hospital consultant to help support and maintain people’s well-being.
Staffing levels were looked at and determined to make sure they met the needs of the people using the service. This included support for people who required one-to-one or two-to-one support within the community. Trained staff safely managed people’s medicines.
Records showed that not all staff had completed their mandatory training, including a new staff member. Staff told us they had supervisions and a yearly competency check to monitor their skills and knowledge.
We have made a recommendation that staff’s training be completed by a set timeframe to make sure staff are competent and confident to deliver effective care and support.
People were supported to maintain their independence where appropriate. Staff promoted people’s food and drink intake. Staff respected people’s privacy and dignity. Staff knew the people they supported well. People had developed caring relationships with staff who understood their individual and sometimes complex care and support needs and wishes.
People told us staff were kind. People’s personal information was kept confidential in the service’s office. People, where possible, and their relatives or an advocate service were involved in discussions and reviews of their, or their family member’s, care. There had been no complaints recorded. A guide on how to complain was available in a pictorial easy read format. This helped aid people’s understanding.
Staff felt supported by the registered manager and other staff colleagues. Audits were carried out to monitor the service and address any improvements required.
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 2 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.
At the last inspection the home was rated good. At this inspection on 12 April 2017 we found the home remained good.
People were cared for by staff who provided care and support that ensured people's safety and welfare. People were cared for by staff who had been recruited and employed only after appropriate checks had been completed. People's needs were met by sufficient numbers of staff.
Medication was administered by staff who had received training and their competency had been checked.
People were supported to have as much choice and control of their lives as possible. Staff supported them in the least restrictive way possible; the systems in the home supported this practice. People were cared for and supported by staff who had received appropriate training to support and meet people’s needs. People were supported to maintain a balanced diet with suitable food and fluid. People were referred to any health professionals when required.
People were cared for by staff who were kind and caring. Staff had a good understanding of people's preferences in areas of their care and welfare. People were supported to be as independent as possible.
People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were encouraged and supported to follow their interests and participate in social activities. The registered manager knew how to respond to and investigate complaints.
There were systems in place to assess, monitor and improve the home and these were reviewed on a regular basis.
Further information is in the detailed findings below.
Alan Atchison – 2 David’s Close is registered to provide accommodation, support and personal care for up to nine people who have a mental health condition or learning disability. The home is not registered to provide nursing care. There were eight people living in the home when we visited and one person was in hospital.
The last inspection was on 22 April 2013 where we found the provider was meeting all the regulations we looked at.
This unannounced inspection took place on 13 January 2015.
There was a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.
Staff knew how to recognise and report abuse so that people’s risk of harm was reduced.
There were a sufficient number of staff to safely meet the needs of people who lived in the home. Relatives of people in the home said they were kept up to date about their family member’s health and welfare and felt included in any meetings.
Staff understood the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and the impact for people in the home who could be subject to the Act. People who lacked capacity to make specific decisions were cared for in line with any best interest decisions that had been agreed.
People’s health and wellbeing was monitored by a variety of health professionals who visited the home when needed and who provided information or advice that was implemented by staff in the home.
People’s individual needs were recorded in their support plan so that staff had the information they needed to provide consistent care. Support plans were reviewed regularly so that people’s needs were kept up to date and support changed as necessary.
People were offered a variety of activities to participate in and were encouraged by staff to pursue their own hobbies and interests.
Relatives advocated on behalf of people in the home, but independent advocates could be found for them if required. People knew how to complain and were sure the registered manager would deal with any complaints.
The provider had an effective quality assurance system in place which was used to help drive improvements to the quality of people’s care provided and the home that they lived in.
Our review of four people's plans of care demonstrated to us that regular reviews were completed. This ensured that people who used the service were provided with the most up-to-date care and support to meet their needs.
We checked a sample of people's Medicines Administration Records (MARs) and found that these were without error or omission. People were assured that they would receive their medicines when they needed them and by staff who were trained in the safe administration of people's medicines.
Staff were supported to gain additional care qualifications. Staff who we spoke with told us that the manager's door was always open and that they could discuss any work issues with them at any time. Checks of staff's recruitment files demonstrated to us that staff were only employed at the service after their identity and previous employment records had been verified.
We reviewed the home's records for the satisfactory completion of water and electrical safety checks and found that these were up-to-date. People's care records contained detailed and accurate information on how each person who used the service was to be supported and cared for.
We saw that people were quite relaxed and happy, and either engaged in activities such as reading or helping to cook the evening meal. People were able to express themselves meaningfully and responded well to staff engagement.