East View Housing Management Limited - 20 Newlands Close

We found the following examples of good practice.

At the time of our inspection, people were being cared for in their bedrooms. Staff had worked with people to help them to understand why they needed to isolate. Staff had used one person’s calendar as an aid to help them understand and count down to when their isolation period could safely end.

Each person had an individual COVID-19 isolation support plan. This plan assessed each person’s needs and told staff how to support each person through their period of self-isolation. The guidance included arrangements for personal care, activities, medication, eating and drinking, family contact and health monitoring.

The registered manager had produced clear guidance for staff on how to safely move around the home and support people following infection prevention and control (IPC) guidelines. This guidance detailed correct procedures for putting on and taking off personal protective equipment (PPE), hand washing guidelines and information about where people should be supported to wash and dress during the outbreak to minimise the risk of spreading the virus.

Staff monitored people’s physical health and recorded this on a weekly monitoring form. This included people’s temperatures and oxygen levels, which were taken twice a day, more often if needed. Some people felt unwell and did not want to eat and drink but could not explain why. The registered manager told us staff isolating at home had reported their tongue felt like it was burning and were eating ice lollies to help with this. Following this, the registered manager bought ice lollies for people, which helped to relieve their discomfort and improve fluid intake.

Staff were wearing PPE in line with government guidance. The registered manager had worked with people living at the home throughout the pandemic to help them to understand handwashing procedures and staff needing to wear PPE.

Further information is in the detailed findings below.

20 Newlands Close is a residential care home providing personal care for up to seven people with learning disabilities. At the time of inspection, seven people were living there.

20 Newlands Close is a bungalow. There were spacious bedrooms, some with en-suite facilities. There was also a large garden which people used 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 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.

People told us they felt safe living at 20 Newlands Close. Any risks to their wellbeing had been identified and actions taken to reduce ill health or incidents occurring. Staff were aware of these risks and monitored them closely. People received their medicines safely from trained and competent staff. The environment was kept clean and safe with regular checks from staff and professionals. Staff were recruited safely and there were always enough to meet the needs of 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.

People told us, “Staff know me well” and, “They know everything.” Staff attended a variety of training courses tailored to meet people’s needs. This gave staff the skills and knowledge to support people with their health and social wellbeing. Staff said that induction was robust and further support was provided in supervisions with management. People’s needs were continuously reviewed with involvement from health and social care professionals. People’s nutritional and hydration needs were met and healthy eating was promoted.

People, their relatives and relatives told us that staff were kind, genuinely caring and respectful of people. One relative said, “My relative is so happy there. Staff are caring and lovely and they look after them brilliantly.” The atmosphere in the home was positive and friendly. Staff and people joked with one another and appeared to enjoy each other’s company. A staff member said, “I really like it here. I go home with job satisfaction. People have such happy lives and I love being a part of that.” People’s privacy, dignity and independence was always promoted. Their choices and preferences were respected by staff.

People’s care was personalised to their wants and wishes and regularly reviewed with them and their loved ones. People enjoyed activities they did with staff and shared photographs and artwork with us. Activities were centred around people’s interests and involved building relationships with the community. People and their relatives told us they had never had to complain but they knew who to speak to if they had any concerns. Although no-one was receiving end of life care, the registered manager and deputy manager had started a project to develop people’s knowledge of end of life and gain their wishes for future care.

People were complimentary of the registered manager and deputy manager. They described them as, “Lovely” and, “Wonderful” and were happy to see them. Relatives, staff and professionals also spoke positively about the management team. One staff member said, “They help me do my job better. I can’t fault either of them.” The registered manager had good oversight of the service and valued feedback given. They were passionate about improving the lives of people and working in partnership with others to achieve good outcomes.

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 October 2016).

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.

We last inspected East View Housing Management Limited – 20 Newlands Close in May 2014. The service met all the regulations we checked at that time.

There was a registered manager in post as required. 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, their relatives and healthcare professionals were positive about the service and the quality of care and support. The staff team worked effectively to ensure people had a positive experience of the service.

People received their medicines safely as prescribed People received the treatment and healthcare they needed to keep as well as possible. Staff sought and received people’s consent to the care and treatment they received. The service upheld people’s rights in line with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

The provider used a robust recruitment procedure to ensure people received support from staff vetted as suitable to work with vulnerable people. There was sufficient staff on duty to meet people’s needs and to ensure people had the support to follow their individual interests.

Staff assessed risks to people and their needs and support plans were put in place to keep them safe and ensure they received the support they needed. People were supported to be as independent as possible. The service involved people, their relatives and healthcare professionals in planning people’s care and support.

Staff understood how to protect people from possible harm. There was sufficient guidance for staff about what to do if they suspected abuse and how to report this.

Staff understood their roles and responsibilities to provide care to people effectively. Staff received training and support through regular supervision and appraisals which enabled them to meet people’s needs.

Staff knew people well and had the skills and knowledge to provide their care. People were treated with dignity and respect. Staff provided people’s support in a caring and compassionate way. People had sufficient food to eat and drink and enjoyed the choice of food provided at the service.

The registered manager monitored incidents and accidents and put plans in place to prevent a recurrence. The service sought people’s and their relatives views about the service and acted on their feedback about the way the service was run. People felt able to raise any concerns with staff or the management team. The registered manager made checks on the quality of the service and any necessary improvements were made.

Below is a summary of what we found. The summary describes what people using the service and staff told us, our observations during the inspection and the records we looked at.

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

Is the service safe?

People were protected from bullying, harassment, avoidable harm, abuse and breaches of their human rights. Staff we spoke with knew about safeguarding of vulnerable adults and what action to take if they needed to. Records showed that all staff had received training about this. People who lived at the service said that they felt safe. One person told us, 'I am very happy here, I feel safe and happy."

CQC monitors the operation of the Deprivation of Liberty safeguards (DoLS) which apply to care homes. This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted, we found that suitable policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Feedback was sought from people and their relatives and acted upon. Systems were in place to make sure that staff learnt from events such as accidents and incidents, complaints and concerns. Records kept by the service ensured that risks were identified and reviewed. This helped reduce risks to people and enabled the service to improve.

Is the service effective?

People told us they were happy with the care delivered and that their needs had been met. People understood that they had given their consent to receive the care and support provided and knew that they could change their minds about decisions that they had made. Documents in people's life plans showed that their mental capacity had been assessed in areas such as day to day decision making.

Our observations and speaking with staff showed that they had a good understanding of people's care and support needs and that they knew them well. One person told us, 'I get support how I like it, I speak to the staff, I don't want anything changed."

Is the service caring?

People told us that the staff were kind and attentive. Care records contained personalised information which helped staff to know the people they supported and how to meet their needs. We saw that care workers showed patience, compassion and understood how to support people as individuals. One person told us, 'I think it's lovely, I enjoy living here." Our observation found that staff knew how to communicate effectively with people and we saw how this helped to reduce people's anxiety and meet their needs.

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests, goals and diverse needs had been recorded and support had been provided in accordance with people's wishes. People had regular review meetings with keyworkers to make sure that changes in needs were identified and action taken.

Is the service well-led?

Staff had a good understanding of their roles in the service and felt supported by the manager. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service had been given opportunities to express their views.

We met two staff in addition to the manager. We observed staff interacting in a friendly and companionable manner with the people who lived in the house, providing support and prompts where needed.

In discussion with the people that lived in the house we were satisfied that they were provided with opportunities to be consulted about the development of their care plans, their medicine regimes and influence over household routines, for example development of the weekly menus. People's dietary needs were understood and catered for.

People we spoke with were confident that if they were unhappy or upset they would feel able to raise these concerns with the manager or other staff.

Staff said they felt well supported but the manager provided support across other home, meaning that the frequency of staff supervision meetings had not been maintained.

Although the person spoken with expressed reservations about how new people coming in might impact on those already living there. Overall they thought it was a good thing, and looked forward to having more people around. They told us: 'I really love what they (staff) have done to my room,'and 'It's like a show house, it's really lovely.'

We met two staff during our inspection and also met and spoke with the registered manager who was present. We viewed a range of documentation including support plans for two of the people living there, information about safety checks and health and safety, information about staff and also how monitoring of service quality was undertaken.