Background to this inspection
Updated
20 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was undertaken by one inspector on 24 March 2018 and was unannounced.
Prior to the inspection we looked at other information we held about the service such as notifications and previous reports. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. At our last inspection of the service in December 2015 we did not identify any concerns with the care provided to people.
During this inspection we met and spent time with all seven people who lived at the service. Most of the people living at the service had complex needs which meant they were unable to communicate and tell us about their experience of being supported by the staff team. Therefore we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living in the service. We looked around the premises and spoke to the manager and three members of staff. Following our inspection we contacted two relatives of people who used the service, to obtain their feedback.
We looked at records relating to the individual’s care and the running of the home. These included four care and support plans and records relating to medication administration. We also looked at how the provider ensured the quality monitoring of the service. This included feedback, audits and maintenance records.
Updated
20 April 2018
We carried out an unannounced comprehensive inspection on 25 March 2018.
Inglenook House provides care and accommodation for up to ten people with learning disabilities. On the days of our inspection there were seven people living at the care home. In relation to Registering the Right Support we found this service was doing all the right things, ensuring choice and maximum control. Registering the Right Support (RRS) sets out CQC’s policy registration, variations to registration and inspecting services supporting people with a learning disability and/or autism.
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 did not have a registered manager; however the recently appointed manager was in the process of submitting their application to the Commission. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
At the last inspection on the 19 December 2015, the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated good:
People were not able to verbalise their views and staff used other methods of communication, for example pictures or sign language. We met and spoke with all the people during our visit and observed the interaction between them and the staff.
The Provider Information Return (PIR) states; “Our Director has owned the business for 30 years and has always promoted a positive culture that is open and person centred.”
People remained safe at the service. People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected. Staff, were recruited safely, and checks carried out with the disclosure and barring service (DBS) ensured they were suitable to work with vulnerable adults. People had their needs met by suitable numbers of staff.
The Provider Information Record (PIR) states; “We hold monthly service user forums where we discuss abuse and bullying ensuring our service users know what the term "abuse" or "bullying" means and if they felt comfortable telling us if they felt they were being bullied.”
People’s risks were assessed, monitored and managed by staff to help ensure they remained safe.
Risk assessments were in place to help support risk taking, and help reduce risks from occurring. People who had behaviour that may challenge staff or others had risk assessments in place which gave good guidance and direction to staff about how to support the person, whilst taking account of everyone’s safety. People received their medicines safely by suitably trained staff.
People were supported by staff who had received training to meet their needs effectively. Staff meetings, one to one supervision of staffs practice and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training included a section on the Equality and Diversity 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; the policies and systems in the service supported this practice.
People's health was monitored by the staff and they had access to a variety of healthcare professionals. The provider worked closely with external health and social care professionals, to help ensure a coordinate approach to people’s care.
People’s end of life wishes were not currently documented, however the manager had plans to discuss this issue with relatives, advocates and involve people as much as possible.
People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; taking into account people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history and people’s cultural, religious and spiritual needs.
People were treated with kindness and compassion by the staff who valued them. The staff, some who had worked for the company for a number of years, had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.
The service remained responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The provider had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need.
People were able to make choices about their day to day lives. The provider had a complaints policy in place and the manager said any complaints received would be fully investigated and responded to in line with the company’s policy. Staff knew people well and used this to gauge how people were feeling. The policy was not provided in an accessible format for people. However, the provider and staff demonstrated they would always act on changes in people’s presentation.
The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the provider, who had been overseeing the service in the absence of a registered manager, was very approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.
People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.