We carried out a review of the data available to us about Summerwood 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 Summerwood, you can give feedback on this service.
Summerwood is a residential care home providing personal care to people with learning disabilities and/or autism, some of whom were not able to tell us about their views of their care. The service was registered to provide support to up to 8 people. There were 8 people using the service at the time of our inspection.
People’s experience of using this service and what we found
People we spoke with using interactive communication tools told us they were happy living at Summerwood. Relatives told us they were encouraged to be involved and were very happy with the care and support their loved ones received.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence. For example, support is flexible so people are able to choose activities and go out when they want to. People are encouraged to be as independent as possible to develop life skills and confidence.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights. For example, the provider meets the requirements of the Mental Capacity Act 2005 so appropriate assessments and best interest decisions are made on people’s behalf. Staff advocate for people to ensure they are not discriminated against and their human rights are protected.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Putting people at the heart of their support is embedded within the ethos of the home. Support workers empower people so they can feel confident and included.
Staff understood their responsibilities under safeguarding and whistle blowing, to identify and report any concerns of abuse or suspected abuse. People’s individual risks associated with the health conditions, such as seizures, were assessed and measures were in place to mitigate these. Medicines were managed safely.
Staff received regular training and assessment to ensure they had the skills and knowledge to support people and their specific needs. Health and care professionals told us staff had engaged with training sessions they had delivered to help one person with their communication. Regular supervision sessions ensured staff had formal opportunities for on-going support and guidance.
The provider had systems in place to monitor the quality and safety of the service. We found some issues during the inspection which meant these systems were not always sufficiently robust. The registered manager took action to address these promptly. Staff told us they were very happy working at Summerwood and felt supported by the management team.
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 outstanding in June 2020.
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
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.
Summerwood is a residential care home providing personal care to people with learning disabilities and/or autism, some of whom were not able to tell us about their views of their care. The service was registered to provide support to up to 8 people. There were 8 people using the service at the time of our inspection.
The service is larger than recommended by best practice guidance. However, we have rated this service outstanding because they arranged the service in a way that ensured people received person-centred care and were supported to maximise their independence, choice, control and involvement in the community. 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
People we spoke with told us they were happy living at Summerwood and relatives consistently told us they were exceptionally happy with the excellent care their loved ones received. They told us the registered manager, provider and staff were “absolutely brilliant,” “fantastic,” “they saved our life” and were “completely outstanding.”
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 focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People and relatives told us they thought the service was very safe and said staff had an excellent understanding of their loved one’s needs and risks. Robust risk assessments and risk management plans enabled people to live least restrictive lives and enjoy their community, develop confidence, skills and self-esteem as all citizens should expect. People who had, in previous placements, been restrained or unable to take part in the community were now enjoying these freedoms. Equality, diversity and human rights were lived and promoted by staff within the home and within the wider community.
People were supported by compassionate, friendly and committed staff led by an experienced and passionate management team with a pro-active, solution focussed ‘can do’ attitude which led to exceptional outcomes for people. They promoted an exceptionally open and person-centred culture in which the well-being and growth of people was the focus, and this was shared by the staff team and embedded in all care practices. Relatives, health and care professionals and staff spoke extremely highly about the management of, and the ethos within the home. This was recognised by various national and local awards the provider, nominated individual and staff had received for their innovation, commitment to, and outcomes for people with learning disabilities and autism.
A robust reporting structure ensured the nominated individual and the provider had up to date and regular oversight of the home. The flat management structed meant the nominated individual and provider had direct contact with the registered manager and provided support and hands on assistance with developing the home. Regular checks of safety and quality were made to ensure people were protected and information was used to improve the environment and the quality of the service.
Staff knew people exceptionally well and communicated information to health and care professionals effectively to support clinical decision making. This was confirmed by health and care professionals who told us, “I’m very impressed,” and “They went above and beyond on a daily basis with their care.” Staff went to exceptional lengths, which included providing training and advice to the local community to ensure the people they supported were not discriminated against or excluded from community activities due to their complex behaviours.
People at Summerwood were living with a learning disability or autism. Some people were not always able to make some decisions about their care and support. Where this was the case, the service protected their rights and delivered care in the person’s best interests. Staff ensured people had the support and information in a way they could understand which empowered them to make choices. This was sensitively handled during end of life care for one person by staff who sat with them and supported them to understand their illness and treatment with easy read booklets and social stories. Staff provided compassionate, caring one to one end of life support. Physical changes were made to the home environment to ensure a person could have their wish to stay at home at the end of their life. A health professional spoke extremely highly of the exceptional support from Summerwood staff which they said, without this, it would not have been possible for the person to remain at home.
Staff were exceptionally well trained, skilled and supported. Staff received bespoke training when required, to enable them to better support people’s individual needs, challenges and health conditions. They worked closely with people, their families and other professionals to overcome challenges, risks and promote their independence. People, and their families described the staff as being exceptionally caring, kind and friendly and the atmosphere of the home as relaxed and engaging. Health and care professionals consistently told us staff were thoughtful and went over and above to ensure people and their families were happy and supported.
Robust and detailed assessments ensured effective person-centred support from the start of the placement. The service was extremely responsive to people’s current and changing needs, finding creative solutions when things didn’t go according to plan or risks changed. For example, with eating and drinking. People and their relatives were involved in assessments, support planning and regular reviews which ensured people were at the centre of their support.
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 outstanding (published 3 August 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 inspection was unannounced and was carried out on 13 and 19 June 2017 by one inspector.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.
There was a positive, can do culture within the home, led by the registered manager’s excellent example. This was consistently commented on by relatives and health and care professionals who told us that the staff were extremely responsive and provided personalised support that met people’s complex needs. Staff were exceptionally positive about working at Summerwood and felt very well supported by the registered manager who they said provided clear and strong leadership and direction. Staff told us they learnt a lot from the registered manager’s example and felt listened to and involved in the development of the service.
Staff were skilled in promoting people’s independence and found creative ways to communicate which ensured people felt valued and listened to. Relatives and health and care professionals consistently told us the staff found appropriate ways to explain things in a way people understood. For example, the use of PECS (picture cards) and ‘Now and next’ books which put events or activities into sequence to help prepare people for what to expect during the day.
Staff understood the importance of empowering people to make choices and take control of their lives which had a positive impact on people’s behaviours that challenged themselves and others. There was an excellent focus of person centred support. Staff were exceptionally committed and determined in finding ways to help people learn about and understand aspects of daily life, such as money and activities, which would enable them to have more independence, increase self-esteem and achieve excellent outcomes.
Detailed initial assessments and complex, multi-disciplinary transition periods were undertaken with people by staff, health and care professionals and families before people moved into the home to ensure their needs could be met. Solution focussed planning enabled the registered manager to support people whose previous placements had been unsuccessful.
People received person centred, individualised support that enabled them to achieve excellent outcomes and increase their self-esteem. People were encouraged to take part in a wide choice of activities, both at home and in the community, which increased their skills and independence. People were also supported to be involved in their local community where relationships and opportunities were pro-actively sought, such as an election workshop.
Staff were extremely kind and caring, treated people with dignity and respect and ensured their privacy was maintained. The registered manager had restructured the home to meet the changing needs of a person who could no longer use their upstairs bedroom. Their commitment to enabling the person to remain at the home was greatly valued by the person’s relatives.
The provider had joined ‘John’s Campaign’ a national initiative to promote positive relationships between care homes and families. People were encouraged and supported by staff who were committed to helping them maintain relationships with family and friends and visitors were welcome at any time. Families felt valued and welcomed the kindness and care shown to them as well as their loved ones.
Robust record keeping enabled staff and health professionals to monitor the quality and effectiveness of people’s care and support. Health professionals commented extremely positively on the quality of reports provided to them for people’s reviews.
People, their families and staff had opportunities to feedback their views about the home and quality of the service being provided, to help drive improvement. All comments seen were extremely positive and complimentary. Robust systems were in place to monitor and assess the quality and safety of the home and these were kept under review by the registered manager and senior management team.
Easy read complaints procedures were available and complaints were appropriately addressed. People and relatives, and others, were encouraged to give their views about the service and help to drive improvements.
People and staff told us they felt the home was safe. Staff had received safeguarding training and explained the action they would take to report any concerns. Easy read information was available to people who knew what to do if they were worried about their safety.
Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Regular safety checks were carried out on the environment and equipment to keep people safe. Plans were in place to manage emergencies and personal evacuation plans were in place for people.
Effective systems were in place for the safe storage and administration of medicines, including controlled drugs. People received their medicines from staff who were appropriately trained and regularly assessed to ensure on-going competency.
There were safe recruitment procedures in place and sufficient staff were deployed, including one to one and two to one staff support. People were supported by staff who had received appropriate induction, training and supervision and had the necessary skills and knowledge to meet people’s individual needs.
People were supported to maintain their health and well-being and were referred to healthcare services when they needed them. People were offered enough to eat and drink to meet their specific dietary needs.
People’s rights were protected because staff understood the principles of the Mental Capacity Act 2005 and ensured decisions were made in their best interests. The registered manager understood the Deprivation of Liberty Safeguards and had submitted requests for authorisation when required.
Summerwood is a small residential home for up to eight people with a learning disability and autism. The home has bedrooms on the ground and first floor. There are two larger rooms on the top floor which provide more self-contained accommodation. There is a small, enclosed garden surrounding the house which provides facilities for growing vegetables, playing games and exercising on a trampoline.
The home had a registered manager. 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 liked and respected by people, staff and relatives. There was good morale amongst staff who worked as a team in an open and transparent culture. Staff felt respected and listened to by the registered manager. Regular staff meetings meant that staff were involved in the development of future plans. There was a positive and caring atmosphere in the home and effective and responsive planning and delivery of care and support.
Staff had received safeguarding training. They told us they understood how to recognise the signs of abuse and knew how to report their concerns if they had any. There was a safeguarding policy in place and relevant telephone numbers were displayed in the registered manager’s office. Relatives told us their relative felt safe and people behaved in a way which indicated they felt safe.
Risks had been appropriately identified and addressed in relation to people’s specific needs. Staff were aware of people’s individual risk assessments and knew how to mitigate the risks.
Medicines were stored safely and administered by staff who had been trained to do so. There were procedures in place to ensure the safe handling and administration of medication.
People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. This meant that people’s mental capacity was assessed and decisions were made in their best interest involving relevant people. The registered manager was aware of his responsibilities under the Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications for people using the service.
Relatives told us they were very happy and that staff understood people’s preferences and knew how to interact and communicate with them. People behaved in a way which showed they felt supported and happy. Dietary preferences were encouraged and supported by staff, ensuring people felt comfortable and safe in their own home.
Care plans were detailed and included a range of documents covering every aspect of a person’s care and support. The care plans were used in conjunction with person centred planning ensuring that people’s wishes and skills were recorded along with their support needs. We saw this reflected in the support observed during the visit. There was evidence in care plans that the home had responded to behavioural and health needs and this had led to positive outcomes for people.
Systems were in place to assess and monitor the quality of the service. Regular checks were carried out in relation to the environment and equipment, and procedures were in place to report any defects. Learning took place from incidents and accidents which were recorded, investigated and action taken to minimise the risk of re-occurrence.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people who use the service, the staff supporting them and looking at records.
Is the service safe?
People we spoke with told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they supported.
People told us that they were treated well by staff and that they felt listened to and their wishes respected.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints and concerns.
The registered manager supported staff to understand any triggers to people's behaviour that may have presented a risk to themselves and others. Risk assessments had been completed to guide staff in managing and minimising risks to people.
Is the service effective?
People's health care needs were assessed with them, and they were involved in writing their care plans. Specialist input, such as occupational health, was provided to support the planning and delivery of people's care.
People's care plans and risk assessments were updated to reflect people's changing needs. People told us that they achieved their goals at Summerwood, such as completing a college course.
Is the service caring?
We spoke with two people being supported by the service and asked their opinions about the staff who supported them. Feedback was positive. One person told us that staff 'Treat me well' and another said 'Staff always help me.'
We observed that staff spoke to people with kindness and respect. It was clear that staff knew people well and responded to them positively when supporting them.
Is the service responsive?
People knew how to make a complaint if they were unhappy. We saw that the service had received one complaint and this had been investigated and responded to in line with the complaints policy.
The service worked well with other agencies and services, such as care management and GPs, to ensure that people received appropriate care and support.
We saw that when people's needs changed, the service responded in a timely way and communicated this to staff and other agencies on a need to know basis.
Is the service well led?
The service has a quality assurance system and records showed that any identified issues, or opportunities for improvement, were addressed promptly.
Staff meetings took place which enabled staff to discuss and plan improvements within the service.
The registered manager and senior staff held supervision meetings with care staff to identify training needs and monitor staff performance. Staff told us that they were clear about their roles and responsibilities. They told us that they received training which supported them to carry out their roles.