We carried out a review of the data available to us about The Palms 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 The Palms, you can give feedback on this service.
The Palms is a residential care home providing personal care and support to seven younger adults with learning disabilities, or associated conditions. There were seven people using the service at the time of the inspection.
People’s experience of using this service and what we found
The service was provided from one house and was registered to support seven people. It therefore conformed with current best practice guidance.
The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.
The vision of the service reflected these principles ensuring people with learning disabilities have opportunities and choice and are supported to achieve their aspirations. Staff adopted the ethos to provide person-centred care that enabled individuals to develop skills and behaviours to live independent lives, whatever the level of need.
Some of the people who used the service had complex needs and they did not express their views verbally about the service. During the time we spent with people we saw they appeared comfortable with staff.
There was a busy, lively environment and the building was well-maintained. Staff knew the people they were supporting well. Care plans were in place detailing how people wished to be supported. Staff had developed good relationships with people, were caring in their approach and treated people with respect. Systems were in place to protect people from abuse.
There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated everyone with respect and dignity. Staff received training and support to help them carry out their role
Communication was effective and staff and people were listened to. Staff said they felt well-supported and were aware of their rights and their responsibility to share any concerns about the care provided.
Relatives were kept informed and involved in decision making about people's care. There were opportunities for people to follow their interests and hobbies. They were supported to be part of the local community and to go on holiday. Arrangements for managing people's medicines were safe. People received a varied and well-balanced diet.
Information was accessible to involve people in decision making about their lives. 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.
The registered manager monitored the quality of the service through audits and feedback received from people, their relatives, staff and external agencies.
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 18 January 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.
The Palms is registered to provide accommodation and personal care for up to seven people who have a learning disability or autistic spectrum disorder.
There was a registered manager in post at the time of our inspection. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. Four people living at the service had been assessed to have their freedom lawfully restricted under a DoLS authorisation and were waiting on the DoLS authorisation to be issued.
Staff undertook appropriate risk assessments for all aspects of a person’s care to keep them safe from harm inside and outside of the service. Care plans were developed to support people’s individual needs. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. People received their prescribed medicine safely from staff that were competent to do so. The registered provider ensured that there were always sufficient numbers of staff on duty to keep people safe.
People were supported to have a healthy and nutritious diet and hot and cold drinks and snacks were available throughout the day. People had their healthcare needs identified and were able to access healthcare professionals such as their GP and dentist. Staff knew how to access specialist professional help when needed. People had insight into their health needs and could tell us about the things treatment and care that made them feel better.
People were at the centre of the caring process and staff acknowledged them as unique individuals. Relatives told us that staff were kind and caring and we saw examples of outstanding care practice. People were always treated with dignity and respect. People were cared for by staff that were supported to undertake training to improve their knowledge and advance their skills to enable them to perform their roles and responsibilities effectively.
People were supported to have an active life and were encouraged to take part in hobbies and interests of their choice. Relatives commented that their loved ones were well looked after and their wellbeing had improved since moving into the service.
People where able were supported to make decisions about their care and treatment and maintain their independence. People had access to information in an easy read format about how to make a complaint. Relatives told us that they could approach staff with concerns and knew how to make a formal complaint to the provider.
The registered provider had robust systems in place to monitor the quality of the service and make improvements. Staff had access to professional development, supervision and feedback on their performance. People, their relatives and staff found the registered manager approachable.
Relatives told us they were happy with the service provided. One relative complimented staff's commitment and ability to communicate and understand the needs and wishes of their relative stating, 'They get on their wavelength.' Another told us their relative was 'Happy to be there and stay there'
We saw care was planned on the basis of assessments of individual care needs for people which reflected the wishes and aspirations of people who used the service. We observed that care was delivered by care staff with warmth and in a way that protected people's privacy and confidentiality.
People told us that they knew how to raise concerns and complaints. One relative told us 'They listen to xxx and they listen to us'
We saw that medicines were managed and administered safely. Staff told us that they felt supported to deliver effective care by good management, peer support and training opportunities.
We noted that care records were well written and organised and the secure storage of these records protected people's privacy and confidentiality.
People in the home said they were treated with dignity and respect and supported to be as independent as possible. They said they had access to all the leisure activities they wanted although one person told us they wanted to go to church. The operations manager said she would arrange this for them.
People told us they liked living in the home, they felt safe and staff were kind and friendly and knew what they were doing. They also said they could get access to a doctor or other health professional if they needed to.
People also said they knew what to do if they wanted to complain about anything and felt sure something would be done about it.
People told us they were asked for their opinions about the home. We saw evidence that the quality of care in the home was monitored.