20 September 2016
During a routine inspection
Cream Residential Care consists of two units. The main house accommodates ten people and The Lodge accommodates seven people. The home specialises in providing care and support to adults who have a learning disability, autism and/or a physical disability. The home has a range of aids and adaptations in place to assist people who have mobility difficulties. All bedrooms are for single occupancy. The home is located in extensive grounds with two of the provider’s other homes. Each home can access the on-site sensory room and hydro pool.
At the time of our inspection there were ten people living in the main house and seven people living at The Lodge. The people we met with had very complex physical and learning disabilities and not all were able to communicate with us. We therefore used our observations of care and our discussions with staff, relatives and professionals to help form our judgements.
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.
The management of the home promoted an open and positive culture and there was a commitment to continually striving to improve the quality of the service people received. The provider and team of staff had achieved many recognised awards for their commitment to care and of the quality of the service provided. Comments from a recent satisfaction survey had been very positive. A relative commented “Wonderful staff and a very high standard of care.” A health care professional said “I placed a patient here because I have been so impressed with the care offered.”
Staff morale was very good and there was a very happy and relaxed atmosphere in the home. People looked comfortable with their peers and with the staff who supported them. Throughout our visit we saw people seeking out staff, making physical contact and laughing and smiling. In a recent satisfactory survey, people’s families and friends described the service as “outstandingly caring.” Comments included “We would like to thank the staff and management for all their hard work, love and care. Thank you very much.” And [Person’s name] social worker reports the home “is the only home they have ever visited that really felt like home – outstanding.”
People lived in an environment where there was a strong commitment to enabling them to live fulfilling lives. The service used innovative and creative ways to enable people to make decisions. One member of staff said “It gives me so much joy if I can do something to make the guys [people who lived at the home] happy. If I can do one thing however little, that means everything. I go home happy knowing they are happy. They are amazing people.” A visitor told us “All the staff here are wonderful. They care about me too. We’re all friends. They are so, so kind.”
Staff were very skilled at communicating with people, especially where people were unable to communicate verbally. The service was using and exploring innovative ways to assist people to express their views and enhance their ability to communicate. The provider employed an assistive technology development manager who provided support and training to staff and people who lived at the home.
People received very good healthcare. There were champions within the service who actively supported and trained staff to deliver a high standard of care which meant people experienced a sense of well-being and could live their lives to the full. There was a culture of positive risk taking and of empowering and involving people whatever their disability. One example was the person centred approach to the management and administration of people’s medicines. Another example was the innovative systems in place to help people to communicate and enable staff to have a greater understanding of what a person may be thinking or feeling.
People were supported to follow their interests and be involved in community projects. The service used creative ways to enable people to do the things they wanted to do. For example the service were exploring a “driving experience” for an individual who love fast cars. Although met with many obstacles, they continued to find ways to make this possible as they knew how much it would mean to the individual.
Staff were very knowledgeable about how to ensure people’s legal and human rights were protected. There was a person centred approach to supporting people to make decisions about their day to day lives. For example offering a limited number of choices to not overwhelm the person or visually showing people choices.