Background to this inspection
Updated
18 July 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
The inspection was conducted by one inspector.
Service and service type
1 Johnson close 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 that 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
We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us. Some people could also become anxious and so we wanted staff to have time to prepare people for our visit.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. 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. This information helps support our inspections.
During the inspection
People were not always able to talk to us to share their views of the service, due to complex communication and support needs. Therefore, we also observed four people’s experiences living at 1 Johnson close, including meal-times, medicines practice, activities and interactions with staff. We spoke with four members of staff including the deputy manager, and three care staff. We observed and used alternative communication methods to understand people’s views of the service and staff. This included Makaton, a form of sign language.
We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment, training and support. A variety of records relating to the management of the service, including policies and procedures were reviewed. We also pathway tracked two people. This is where we check that the records for people match the care and support they receive from staff.
After the inspection
We phoned the registered manager after the inspection as they were not able to be there on the day. We also spoke with one health and social care professionals and one relative about their experience of the service and the lives of people.
Updated
18 July 2019
About the service
1 Johnson Close is a residential care home providing accommodation and personal care for up to four people. At the time of inspection, four people were living at the service. People were living with learning disabilities and autism as well as other health conditions.
The building was situated over two floors. Bedrooms were spacious, and person centred, with ensuite facilities and there were large, homely communal areas for people to relax in. There was also an accessible garden that we saw people using throughout the inspection.
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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The outcomes for people reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.
From what people told us and what we observed, people were safe. Staff knew risks to them well and took action to reduce areas of concern. Risk assessments were detailed and individual to people. Regular health and safety audits were completed by staff, management and external professionals to ensure that the building was safe. There were always enough staff to meet people’s needs. Before staff started working at the service, their previous experience, character and safety checks were reviewed to ensure they were suitable to work with people.
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; the policies and systems in the service supported this practice.
Staff all received robust training, which included areas required to meet people’s specific health and social needs. Their competency to provide the right care was regularly checked and monitored by management. People’s nutritional needs were consistently met, and they had regular involvement from health and social care professionals to promote their wellbeing.
Everyone we spoke to was complimentary about the staff team at 1 Johnson Close. We observed people to have built good relationships with staff. A relative told us, “Staff are absolutely fantastic. They are very patient and give my relative time to process things. In my opinion they are so much better than other homes.” Staff emphasised the importance of maintaining people’s independence and worked with them to improve skills. People’s dignity and respect was promoted and encouraged.
People received personalised activities based on their preferences and goals. Each activity was reviewed by people, so they only took part in activities they enjoyed. They were encouraged to spend time in the community, building links and relationships. They saw the people that were most important to them regularly.
Additional visual tools were used to support people to be able to make complaints. Any complaints made were managed in a professional and timely way, ensuring people were happy with outcomes. Staff knew people’s communication needs well and had considered this when obtaining people’s views. A new process for recording end of life wishes had been introduced so that information could be gathered in a way that would not upset people.
Everyone we spoke was complimentary about the registered manager and felt the service was well-led. Staff felt encouraged and supported in their roles with regular supervision and team meetings. A team working ethic was promoted. One staff member said, “I think what we do best is listen to people. We work as a team and pool together ideas to make things better for people.” The registered manager continually reviewed ways of working and introduced new ideas that had been adopted by managers from other services.
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 September 2016)
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.