Southdown Housing Association - 50a Avis Road

Southdown Housing Association – 50a Avis Road is a residential care home that provides personal care for up to six adults with complex support needs. There were six people living at the service at the time of the inspection.

The accommodation was in a large, purpose-built bungalow with communal areas and an accessible garden. 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:

Observations of care and feedback from relatives confirmed that people were safe living at the service and safeguarding procedures were in place to protect them. Staff were recruited safely, and enough staff were on duty to provide safe care. Staff had the skills they needed to support people effectively.

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. The use of restrictive practice was regularly reviewed to ensure it was proportionate and remained the least restrictive option.

Staff understood, and protected people's rights and people were treated as individuals. Support was very personalised to meet individual needs. People were encouraged to be as independent as they were able with a culture of promoting independence underpinning all care and support. Staff worked effectively with health and social care professionals to ensure people's needs were met. People had opportunities to engage in activities that gave them a sense of self-worth and achievement.

Reviews and audits of the service showed people received good outcomes and a safe and well managed service. The management team were approachable and proactive to ensure the service met the needs of the people they supported. The service had good community links that promoted inclusion.

Incident and accidents were reviewed on a regular basis to identify any trends, themes or patterns. The provider had a dedicated positive behaviour support team (PBS) alongside a PBS strategy. Each person had individual PBS guidelines and staff were clear on the steps to take to support a person during times of anxiety of agitation.

Risks associated with people's care and support were assessed. Detailed risk management plans helped staff to manage and reduce risks. People were involved in planning and reviewing their care and support. Care plans contained detailed information and clearly reflected people's individual preferences for how they wished their care and support to be delivered

Staff demonstrated commitment to ensuring that people experienced a good quality of life. They showed kindness and compassion in their interactions with people and spoke about them with warmth and respect. People enjoyed caring relationships with staff and there were laughter and smiles in their engagements with them.

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 the service was Good (Report published 29 November 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.

50a Avis Road is a purpose built care home, which provides personal care and accommodation for up to five people with complex learning and physical disabilities. At the time of this inspection there were four people using the service.

The last inspection of the home was carried out May 2014, there were no concerns raised at that inspection.

There was a registered manager at the home who had the qualification, skills and knowledge to manage the home. 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.

The registered manager was appropriate qualifications and experienced to manage the home. They had experience of supporting people with learning disabilities and continued to develop further skills and knowledge by on going training. The registered manager had managed the home for many years and had on going support from the provider and other managers within the organisation.

The culture of the service was to provide high quality person centred care for the people who used the service. The registered manager told us, “The vision of the service is that everyone no matter what their life experiences, background or challenges will have opportunities to live their lives to the full living at 50a Avis Road”.

People were supported by sufficient numbers of staff to meet their needs in an unhurried and relaxed manner. People told us they “Got help when they wanted it”. One relative felt their relative did not go out as often as they did in the past to chosen activities, but also felt their relative was “Well cared for”.

Risks of abuse were reduced because there were effective recruitment and selection processes for new staff. This included carrying out checks to make sure new staff were safe to work with vulnerable adults. Staff were not allowed to start work until satisfactory checks and employment references had been obtained.

Staff received training to understand their roles and to ensure the care and support provided to people were person centred, meeting their individual needs. People were supported by a consistent staff team who had worked alongside them for many years. Staff morale was seen to be high. Staff enjoyed working at the home and spoke positively of the support the management team provided.

Staff received supervision and appraisals and told us they felt supported by the registered manager. One relative told us, “The staff team are very skilled in their job. We see them supporting people with such skill. It is amazing care very person centred”.

Staff knew how to recognise and report abuse all staff had received training on safeguarding vulnerable adults. Staff were clear about how to report concerns and said they were confident action would always be taken to keep people safe. There were posters in the home giving people and staff details of who to contact if they felt unable to raise their concerns within the home.

Systems were in place to manage risks, safeguarding matters and medication which ensured people's safety. Where people displayed behaviour that needed additional support, behaviour support plans guided staff and helped them to manage situations in a consistent and positive way. Staff were aware of individual guidelines and how to support people appropriately.

Care plans provided information about how people wished to be cared for as well as detailed information on their physical and mental health needs. This meant staff were able to identify health concerns especially for people who were unable to communicate verbally.

People were able to take part in activities both at the home and in the local community. The home had access to two vehicles which enabled people to get out and about on a regular basis.

Systems were in place to ensure people received their medicines safely. All staff received medicine administration training and had to be assessed as competent before they were allowed to administer people’s medicines. There were suitable storage facilities for medicines which included secure storage for medicines which required additional security.

Where people lacked capacity to make decisions we checked whether the service was working within the principles of the Mental Capacity Act (MCA) and whether any conditions on authorisations to deprive a person of their liberty were being met. Records showed where a person lacked capacity to make a decision relating to their health, best interest meetings had been held

People’s nutritional needs were assessed to make sure they received a diet in line with their assessed needs. Where people required support to eat and drink this was provided in a discreet and dignified manner.

Staff monitored people's health and sought advice from healthcare professionals to meet people's specific needs. People had access to equipment to assist them to maintain their independence and to ensure their comfort. People were supported by a consistent staff team in a relaxed and unhurried manner.

There were effective quality assurance systems in place to monitor care and plan on going improvements. Audits and checks were in place to monitor safely and quality of care. Quality assurance visits by the provider had been effective in identifying shortfalls in the service and ensuring on going improvement. All accidents and incidents which occurred at the home were recorded and analysed.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

People who used the service were protected from abuse because the service had systems in place to ensure that any possibility of abuse was identified, and the appropriate action was taken to prevent abuse from happening.

We found that there was a comprehensive safeguarding policy and procedure in place at the service. The discussions we had with members of staff indicated that they were aware of safeguarding issues as well as the Whistle Blowing Policy and that they would be able to raise a safeguarding alert if required.

CQC monitors the operation of the Deprivation of Liberty safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit it.

We found that there were adequate numbers of staff with a good skill mix and experience on duty during the inspection. We noted that there were on call arrangements in place in case of emergencies, and good support from the management team to ensure that people's needs were met.

Is the service effective?

Where people did not have the capacity to consent, decisions made on their behalf had their best interest and human rights taken into consideration. People were supported to make choices and decisions and have control over their lives.

We observed that staff spoke with people and gained their consent before providing support or assistance. This was done in a respectful manner and it was apparent that people felt at ease in expressing their choice.

People had their individual needs assessed and reviewed on a regular basis. We noted that each person had a key worker who would work with them to ensure that the individual understood their rights and importance in making their own decision.

People who used the service had benefited from care and treatment that had been tailored for the individual. Relatives of people who used the service commented about the relaxed and supported care delivery from care staff. They told us that staff were courteous, treated people as an individual and attended to their needs with minimal fuss.

Is the service caring?

We observed how people who used the service were treated with respect and dignity by staff. We found that people were involved in all aspect of the care and supported in their decision making. Feedback from relatives confirmed how well their loved ones were treated and cared for by the staff team. They felt that there was a relax atmosphere at the service and people were encouraged and supported to lead a fulfilling life as much as possible.

Everyone living at the service had a person centred plan that had been reviewed on a regular basis. This meant that people received appropriate care and treatment to meet their current needs.

Is the service responsive?

There was a range of activities on offer at the service. These activities were people led rather than service led. The service provided a mini bus and adapted vehicles for people who used the service, enabling them to access a range of outdoor activities.

People who used the service were supported to maintain links with their family and friends.

Is the service well-led?

The service had a comprehensive quality assurance system. We saw evidence that an action plan had been written and implemented in a timely fashion as result of feedback from satisfaction survey sent to relatives.

We saw minutes from team meetings and action plans were in place to ensure that where shortfalls had been identified, they had been addressed within an acceptable time scale. This helped to ensure that the service was continuously improving and people's views had been taken into consideration.

It was apparent that the staff team were committed and well led by management. Staff told us that they were aware of the importance of the various audit tools in place. This meant that staff and management of the service were monitoring the quality of service delivered to ensure that people who used the service were having a good quality of service at all times.

Care workers had developed awareness and a sound understanding of each individual's care and support needs. We found that comprehensive and well maintained person centred support plans enabled care workers to meet people's assessed needs in a structured and consistent manner.

People using the service were cared for by staff who were appropriately trained to meet their needs. Care workers received supervision of their practice and had their performance appraised regularly.

A range of activities were available promoting social stimulation and community involvement. A relative told us: 'They have a better social life than we do'.

None of the people using the service were able to communicate verbally. However positive comments from their relatives indicated a high level of satisfaction with the home and the services provided.

'I'm very happy with the home. It is such a stimulating environment and the staff are dedicated, professional and understand the needs of the residents'.

'My daughter is settled, safe and very happy. She has everything she needs there'.

Appropriate arrangements were in place in relation to storing, administering handling and recording medicines.

People were confident that their comments and complaints would be listened to and dealt with effectively.