Little Ingestre House

Updated 23 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Little Ingestre House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with five members of staff and the registered manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included two people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records, medication records and policies.

Updated 23 October 2019

About the service

Little Ingestre House is a residential care home providing accommodation and personal care for up to 15 people, over two floors. At the time of our inspection 12 people with a physical or learning disability were living at the home.

The service has not 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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people; this is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. For example, there were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. The home was spacious and had multiple communal areas.

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

During the inspection we observed warm and comfortable relationships between staff and people living in the home. Feedback from people and the relative we spoke with was all positive. People were encouraged and supported to maintain and improve their independence.

Medications were not always safely managed however this was immediately acted on by the registered manager and evidence of actions taken was made available following the inspection.

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.

Incident and accidents were analysed for patterns and trends. Risks to people were assessed safely, care plans were person centred and regularly updated. Care records contained important information regarding people’s histories, families, likes and dislikes. This information was used to personalise support to meet each person’s needs. People were supported by compassionate staff who respected their privacy and dignity. People were involved in regular reviews of their care and encouraged to give feedback.

The registered manager and provider made effective use of audits and other sources of information to review and improve practice. People were able to give their opinions on the care they received and a range of communication methods were in place to ensure people continued to have this opportunity.

People were supported to maintain a healthy diet and had access to healthcare professionals should they need them.

Staff were recruited following safe processes and received appropriate inductions into the service. Staff also received supervisions and attended regular meetings. Feedback from staff we spoke with was all positive and people told us how supportive the register manager was.

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.

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 11 March 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.