Little Wakering House

About the service

Little Wakering House is a care home providing personal care to people with a learning disability and autistic people. At the time of our inspection there were 13 people receiving care. The service is set in the community in an adapted building with a large garden.

People’s experience of using this service and what we found

People told us they were happy living at the service. One person said, “I have been at a lot of services, but I am the most happy here.” A relative said, “It is a really brilliant service I am very impressed.”

Right Support:

Care and treatment were planned and delivered in a way which was intended to ensure people's safety and welfare. There were enough staff to meet people’s needs. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medicine was dispensed by staff who had received training to do so and assessed as competent.

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.

Right Care:

Care was person-centred and promoted people’s dignity, privacy and human rights. The registered manager enabled staff to develop the skills they needed to provide good quality care and support. People were supported to access health professionals to maintain their health and well-being.

Right Culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services led confident, inclusive and empowered lives.

Care was focused on supporting people to remain independent. Staff supported people to engage in their local community. Care was personalised to people’s needs and staff reviewed and adapted support as people’s needs or wishes changed. The registered manager had systems in place to monitor the service and outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating at the last inspection was good (published 6 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Visitors were required to wear personal protective equipment (PPE) supplied by the service and followed the protocols in place.

People that used the service had received their own computer tablets as part of a project to enhance communication.

Regular phone or video calls and photograph exchanges were arranged with people that used the service and their family and friends. A safe visiting place had been created in the garden area.

People who would be isolating at the service had their own dedicated staff to meet their support needs.

Innovative methods had been used to encourage people that used the service to be comfortable with mask wearing. This included using masks on one person’s figurines which supported them to feel comfortable with themselves or staff wearing masks.

The registered manager had created a messaging group for other learning disability managers in Essex and supported them with documentation required to manage the pandemic, the group shared best practice and promoted wellbeing.

The registered manager told us they were very proud of people that used the service for managing and coping with the changes to their lives. He told us “They have taken it in their stride and adapted really well.” He was also proud of the staff team for pulling together throughout the outbreak and added, “They were a strong team, but I believe they are now a stronger team due to COVID 19.”

Further information is in the detailed findings below.

At the last inspection the service was rated Good. At this inspection we found the service remained Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post. 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.

Systems were in place to ensure people remained safe whilst promoting their independence. Risks to people had been adequately identified and measures put in place with guidance for staff to mitigate the risk of harm.

Staff were trained and supported to meet people's needs. Staff were available when people needed assistance and had been recruited safely. People were involved in the planning of meals and menus. They received appropriate nutrition and hydration support to maintain their health and wellbeing.

There was a system in place to receive and manage complaints with guidance written in a format which met people's needs. People were supported and encouraged to express their views and opinions about how the service was provided and how they lived their daily lives.

People were supported by staff to lead fulfilling lives, ranging from gaining education and employment to achieving their goals. The service was committed to ensuring that people were able to engage with their hobbies and interests as much as possible.

There were systems in place to monitor the quality and safety of the service. Staff spoke very positively about the leadership and the open and positive culture of the service, and felt supported by the registered manager and provider.

Further information is in the detailed findings below

Little Wakering House is registered to provide accommodation and personal care without nursing for up to 12 adults who have a learning disability and/or mental health needs. There were 11 people living in the service at the time of the inspection.

There was a registered manager in post. 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 consistently received their care and support in a way that ensured their safety and welfare. Staff knew how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely.

The service employed sufficient numbers of staff to care for people appropriately. Staff had been safely recruited, were well trained and supported to meet people’s needs and aspirations. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The registered manager and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed.

People had enough to eat and drink to meet their individual needs. People’s care needs had been assessed and their care plans provided staff with the information needed to meet their needs and preferences and to care for them safely. People’s healthcare needs were monitored and staff sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and knew the people they cared for well. They ensured that people had the privacy they needed and maintained their dignity at all times. People expressed their views and opinions and they participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were made to feel welcome. There were advocacy services available where people did not have family members to support them to have a voice. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

The service had an effective complaints system in place and people consistently told us they were confident that their concerns or complaints would be listened to and acted upon appropriately. The registered manager strived to make life better for people. Staff were confident and shared the registered manager’s vision to provide people with excellent care that met their individual needs and aspirations. The service consistently sought people’s views and opinions and used them to drive improvements in the home. The quality assurance system was effective and well implemented. The registered manager and provider monitored the service and recognised when improvements were needed and swiftly took action to make them.

Staffing levels had been increased, there was a clear induction programme in place and training had improved. Safeguarding procedures were good and safeguarding issues had been dealt with appropriately. Staffing levels had been greatly increased throughout the day to ensure that there were sufficient staff to work with people on a one-to-one basis. Staff told us that the training had improved and that they were well supported by the manager.

Staff records and other records relevant to the management of the service were accurate and fit for purpose. People spoken with were positive about the service, their comments included: 'I am very happy here', 'always someone around when I need them', I go out all the time', 'the food is good'.

People told us that they felt safe, they said that staff were kind and caring and that the manager was very responsive to their needs. This showed that the service is safe, caring, responsive and well led.

We found that staff interactions with people who live at the service were positive and staff were seen to have a good rapport with individuals. People told us that they liked living at Little Wakering House and found staff to be kind, caring and supportive. Staff on duty at the time of our visit were observed to have a good understanding and awareness of people's support needs. Staff confirmed to us that they liked working at the service and that team work and morale was very good.

Our findings showed that improvements were required to ensure that people who use the service received meaningful activities in line with their commissioned one-to-one hours. We also found that improvements were required to ensure that staff working at the service received training in core and specialist subject areas relevant to their role and completed a comprehensive induction.