We carried out a review of the data available to us about Felbrigg House 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 Felbrigg House, you can give feedback on this service.
Felbrigg House is registered to provide personal care and accommodation for up to 11 people in one adapted building. There were 11 people using the service at the time of our inspection who had a range of health and support needs, these included learning disabilities. Some people had additional conditions such as sensory impairment, epilepsy and autism.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
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.
People could communicate with staff and understand information given to them as staff supported them consistently and understood their individual communication needs.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Care:
People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff understood and responded to their individual needs
People's care, treatment and support plans reflected their range of needs and this promoted their individuality, wellbeing and enjoyment of life. People could take part in activities of their choosing at the service or in the wider community and pursue their own interests. Staff received training and support to provide care effectively.
People were provided with meals and drinks to maintain their wellbeing. People were supported by health care professionals who worked in partnership with the service to maintain people's health and wellbeing. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right Culture:
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff placed people's wishes, needs and rights at the heart of everything they did. The stable management and core staff team supported people to receive consistent care from staff who knew them well. People received compassionate and empowering care which was tailored to their needs.
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. All the relative we had contact with were complimentary and positive about the service and the care and support their loved ones received.
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 on 24 August 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Felbrigg House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Felbrigg House is a privately owned service providing care and support for up to 11 people with different learning disabilities. People may also have behaviours that challenge and communication needs. The service is a detached property close to the centre of Dover. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.
Rating at last inspection
At the last inspection, the service was rated Good.
Rating at this inspection
At this inspection we found the service Good.
Why the service is rated Good.
The registered manager had good oversight of everything that happened at the service. They promoted the ethos of the service which was to give personalised care and support to people. To support them to achieve their full potential and be as independent as possible.
People indicated that they were happy and felt safe. They were settled, contented and relaxed in the company of staff. People were safeguarded from abuse and protected from the risk of harm. Staff had been trained in safeguarding adults and knew what action to take in the event of any suspicion of abuse.
Risks to people’s safety were assessed and managed appropriately. Assessments showed how risks could be minimised. People were supported to take risks and not be restricted by them. The staff carried out regular environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review any accidents and incidents and make any relevant improvements as a result. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.
Before people decided to move into the service their support needs would be assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People indicated that they were satisfied and happy with the care and support they received. People received care that was personal to them. People, and those close to them, were involved in planning and reviewing their care and support. Care plans contained a lot of duplicated information and where cumbersome. Information was difficult to locate. The registered manager was addressing this. This is an area for improvement.
People received their medicines safely and when they needed them. They were monitored for any side effects. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services.
People were encouraged to access the kitchen whenever they wanted and were able to prepare their own drinks whenever they wished. They were supported to shop for and prepare meals of their choosing. People were encouraged to eat a healthy and nutritious diet.
People’s privacy was respected. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. The service was planned around people’s individual preferences and care needs. People were given support in the way they preferred. People had many opportunities to go out and about. People were encouraged to try new experiences and develop new interests to enrich their life and increase their confidence and self-esteem. People’s confidence had developed to enable them to make more choices and decisions themselves and become more independent. People led active lives and they showed us pictures of the things they enjoyed doing.
There was a close relationship and good communication with people's relatives. Relatives felt their views were listened to and acted on. People and their relatives felt comfortable about complaining. When they did raise concerns they were taken seriously and their concerns were looked into and action was taken to resolve them.
Staff received appropriate training and were supported by the registered manager to carry out their roles effectively. There was always enough staff available to keep people safe. Staff were recruited safely. Safety checks were carried out before staff started to work at the service. This was to make sure that the staff employed to support people were fit to do so.
The registered manager and the provider’s representative completed a range of checks on the service, including care plan reviews, environmental checks and audits of medicines to ensure people were safe.
The registered manager had sought feedback from people and their relatives about the service. Staff had given verbal feed-back about what was going well and what areas could be improved. The provider had not requested feedback from other stakeholders. This is an area for improvement.
The Care Quality Commission had been notified of important events within the service, as required by law.
Further information is detailed in the findings below.
The accommodation is set over two floors with bedrooms on both floors. There are good sized communal areas. The home was clean, tidy and well decorated.
Rating at last inspection
At the last inspection, the service was rated Good overall and Requires Improvement in the ‘responsive’ domain.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 24 August 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Person Centred Care. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Felbrigg House on our website at www.cqc.org.uk
At this inspection we found the service remained Good overall and is now rated Good in the ‘responsive’ domain.
Why the service is rated Good
The service had improved since the last inspection. People’s care plans had more detail in them and guidance was in place for staff to support people with their health conditions. People had plans to move towards their goals and there were records of what they had achieved. People had access to a variety of activities. The breach of Regulation 9 found at the last inspection had been met.
People knew how to complain and any complaints received were responded to appropriately.
This inspection took place on 15 and 17 July 2015, was unannounced and was carried out by two inspectors.
Felbrigg House is a privately owned service providing care and support for up to 11 people with different learning disabilities. People may also have behaviours that challenge and communication needs.
The service is a detached property close to the centre of Dover. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.
There was a registered manager working at the service. 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 supported us throughout the inspection.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLs authorisations for people who were at risk of having their liberty restricted. They were waiting the outcome from the local authorities who paid for the people’s care and support. There were records to show who people’s representatives were, in order to act on their behalf if complex decisions were needed about their care and treatment.
Before people decided to move into the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People were satisfied with the care and support they received. The care and support needs of each person were different and each person’s care plan was personal to them. People or their relative /representative had been involved in writing their care plans. Most of the care plans recorded the information needed to make sure staff had guidance and information to care and support people in the safest way. However, some parts of the care plans did not record all the information needed to make sure staff had guidance and information to care and support people in the way that suited them best and kept them safe. The care plan folders contained a large amount of information and staff did not use them to refer to when supporting people with their day to day needs, partly because it would take their attention away from the person for too long. Staff knew people well but some of the care, for example developing independence skills, was unspecific and therefore it was difficult to measure if people were achieving and developing.
Potential risks to people were identified. There was guidance in place for staff on how to care for people effectively and safely and keep risks to a minimum without restricting their activities or their lifestyles. People received the interventions and support they needed to keep them as safe as possible.
People had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. People knew who their key worker was and had a choice about the key workers who worked with them. People had key workers that they got on well with. Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff. When people could not communicate verbally, staff anticipated or interpreted what they wanted and responded quickly.
People were involved in activities which they enjoyed and told us about what they did. Planned activities took place regularly. People had choices about how they wanted to live their lives. Staff respected decisions that people made when they didn’t want to do something and supported them to do the things they wanted to.
People said and indicated that they enjoyed their meals. People were offered and received a balanced and healthy diet. They had a choice about what food and drinks they wanted and were involved in buying food and preparing their meals. If people were not eating enough they were seen by dieticians or their doctor.
People received their medicines safely and when they needed them. They were monitored for any side effects. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable.
Staff had support from the registered manager to make sure they could care safely and effectively for people. Staff said they could go to the registered manager at any time and they would be listened to. Staff had received regular one to one meetings with a senior member of staff. They had an annual appraisal, so had the opportunity to discuss their developmental needs for the following year.
Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people’s needs. When staff had completed induction training they had gone on to complete other basic training provided by the company. There was also training for staff in areas that were specific to the needs of people, like epilepsy, autism and diabetes. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.
A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed. There were enough staff to take people out to do the things they wanted to so that people were involved in activities which they enjoyed.
People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns both within the company and to outside agencies like the local council safeguarding team. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed. The provider responded appropriately when concerns were raised. They had undertaken investigations and taken action. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire or a gas leak the staff knew what to do.
Staff were aware of the ethos of the service, in that they were there to work together to provide people with personalised care and support, and to be part of the continuous improvement of the service.
The registered manager had sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on wherever possible. Staff told us that the service was well led and that the management team were supportive.
The registered manager notified the Care Quality Commission of any significant events that affected people or the service. Comprehensive quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to implement improvements
The complaints procedure was on display in a format that was assessable to people. People, their relatives and staff felt confident that if they did make a complaint they would be listened to and action would be taken.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.
People told us that the service responded to their health needs and that staff talked to them regularly about their care and any changes that may be needed. People said that they were happy with the care they received and got on well with the small team of staff.
All of the people spoken with expressed a great deal of satisfaction from living at the service and did not have any concerns about their quality of care. People told us that they felt safe and that if they were not happy or concerned about anything they would speak to the manager.
People were happy with the arrangements for receiving their medication and were involved with this process at a level that suited them.
There were effective processes to assess and monitor the quality of service that people received and to identify, assess and manage risks to the health, safety and welfare of the people using the service.
People told us they received care from a small team of staff and were happy with the care received and had no concerns relating to the home.
All spoken with expressed a great deal of satisfaction from living within the service and did not raise any concerns about the quality of care. All said if they were not happy they would speak to staff or the manager.
A relative spoken with was very complimentary of the quality of care provided. She commented that 'I can't fault them at all, staff are very good'. She also said 'They are always taking people out' and I am kept fully informed'.
People told us that they were involved in making choices about their care and were encouraged to be as independent as possible.
People's relatives told us that they thought the service was 'Excellent'. They said that they had seen improvements in their relatives since they had been at the service.