Archived: Touchwood

Updated 3 September 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

One inspector carried out the inspection.

Service and service type

Touchwood is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service did not provide nursing care.

The service had a manager registered with the Care Quality Commission. This means 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

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service and reviewed the PIR the provider had completed. The PIR 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. We also sought feedback from the local authority and professionals who work with the service for their views on the care and service given by the home.

During the inspection, we met three of the people who used the service and spent some time with them. We observed and listened to how staff interacted with people and spoke with four relatives. During the visit we spoke with the registered manager, the managing director and three members of staff.

We observed how people were supported and, to establish the quality of care people received, we looked at records related to people’s care and support. This included two people’s care plans, care delivery records and four people’s Medicine Administration Records (MAR). We also looked at records relating to the management of the service including: staffing rotas, staff recruitment, supervision and training records, premises maintenance records, quality assurance records, training and staff meeting minutes and a range of the provider's policies and procedures.

After the inspection

We sought clarification from the provider to validate evidence found and received written feedback from a health professional who regularly visited the service.

Updated 3 September 2019

About the service

Touchwood is a care home registered to provide accommodation and personal care for up to five people diagnosed with autistic spectrum disorders and learning disabilities. At the time of this inspection there were four people living at the home.

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.

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 the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people .

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People’s experience of using the service:

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People’s support focussed on them having as many opportunities as possible for them to gain new skills and become more independent.

People told us they felt safe and enjoyed living at Touchwood. People were relaxed and happy with staff, who knew them very well. Staff treated people with patience, kindness, dignity and respect. Relatives told us the service had greatly improved since the current registered manager had been employed.

Staff spoke knowledgably on how to identify and report abuse and were well supported in their roles. Staff received regular supervision and annual appraisals to enable them to carry out their roles competently. People were supported by staff who had received appropriate training to carry out their roles.

Risks to people’s health, safety and well being were regularly assessed, reviewed and updated. People and their families were fully included and involved in their care and support. People's views and opinions were listened to and acted upon wherever possible.

People’s health care needs were met and staff supported them to see healthcare professionals when appropriate. Medicines were managed, stored and administered safely. People were supported to take their medicines safely by staff who had received the appropriate levels of training.

People were supported by safely recruited staff and there were enough appropriately trained and experienced staff to support people in ways that suited them. Communication styles and methods were tailored to individual people and staff supported people to understand the choices available to them.

People received healthy, nutritious meals which they enjoyed planning and preparing. Meal times were a social occasion where people could choose to spend time with others or in their bedrooms if they preferred.

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 were supported to lead active lives and were encouraged and enabled to pursue hobbies and get involved in activities in the wider community. A variety of in- house activities were provided based on people’s interests and choices.

The service worked collaboratively and closely with health care professionals to ensure people received the best care and support at all times.

There was a complaints policy in both a text and pictorial format which gave clear guidance for all people. People and relatives told us they knew how to make a complaint if the needed to and felt any concerns would be taken seriously and action taken straight away.

There was a clear management structure and people, relatives and staff spoke highly of the registered manager who ensured there was an open, supportive, friendly, professional culture at the home.

There was a system of ongoing quality assurance systems in place to drive improvement and ensure the home offered a safe, effective, caring and responsive service.

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

This last rating for this service was requires improvement (published 14 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.