We carried out a review of the data available to us about Blythson Limited - 5 Ashley Avenue 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 Blythson Limited - 5 Ashley Avenue, you can give feedback on this service.
Blythson Limited - 5 Ashley Avenue is a residential care home registered to provide accommodation and personal care for up to three people. There were three people living at the service at the time of this inspection. People had a range of learning disabilities and they all required support with their personal care.
The service is in a quiet road, close to local shops and the sea. The service comprised of large living and dining areas, a kitchen, three bedrooms, several bathrooms and accommodation for sleep night staff.
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.
The building design fitted into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People felt safe and at the service. People were treated with dignity and respect and their lifestyle and equality needs and choices were understood and respected. The deputy manager told us, “We know each person very well and are clear about the support they want”. People told us they were happy with the support they received. People had privacy when they wanted it.
People were protected from the risks of harm and abuse and any concerns they or staff had, were listened to and acted on. Risks had been assessed with people and family members acting on their behalf. People were supported to remain independent and as safe as possible in ways that had been agreed.
Staff supported people to remain healthy. People enjoyed a balanced diet which met their needs and were supported to lead active lives. People’s medicines were managed safely. People were protected from the risk of infection.
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 had planned their care with staff and were supported to maintain their routines. They were supported to take part in a range of activities they enjoyed. People had been offered the opportunity to share their end of life preferences and these had been documented.
The provider and registered manager had oversight of the service. They completed regular checks on the quality of care people received. People, staff and relatives were asked for their views about the service. These were listened to and acted on to improve the service.
The registered manager understood their legal responsibilities and had shared information with us and others when they needed to.
There were enough staff to support people when needed. Staff had the skills required to care for the people and were supported by the management team. Staff were recruited safely.
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.
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.
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 31 January 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.
There was a registered manager in post who was available in the service Monday to Friday and was included in a telephone on call rota at weekends to advise staff if needed. A registered manager is a person who is 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.
Relatives spoke positively about the high quality of the care and support provided. Their feedback informed our findings which were that people were provided with a safe, clean environment that was maintained to a high standard. All safety checks and tests of equipment and installations were routinely completed.
There were enough skilled staff to support people and provide continuity of care. The provider implemented safe recruitment procedures to ensure the suitability of new staff. New staff were inducted into their role and received appropriate training for this. All staff received regular mandatory training and additional specialist training to ensure they had the skills and knowledge to support people appropriately and safely.
Staff were given opportunities to meet regularly with the registered manager on an individual basis and with other staff in staff meetings. Staff performance, development and training was monitored through annual appraisal. Staff said that they felt valued, well supported and listened to. They understood how to keep people safe and protect them from harm; they understood how to respond to emergency situations that required them to evacuate people, or keep them safe until help arrived.
People’s mental capacity was assessed and there was a clear culture of least restrictive practice, people were encouraged and enabled by staff to make every day basic care and support decisions for themselves but staff understood and were working to the principles of the Mental Capacity Act (MCA) 2005. The MCA provides a framework for acting and making decisions on behalf of people who lack mental capacity to make particular decisions for themselves.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. All three people had been referred to DoLS and two authorisations received to date. The registered manager had a clear understanding of the criteria for making an application and ensured the service was meeting the requirements of the Deprivation of Liberty Safeguards.
Risks were appropriately assessed to ensure measures implemented kept people safe. Strategies were in place to guide staff in their support of peoples whose anxiety affected their behaviour from time to time. People were supported and enabled to develop their independence and learn new things within the limitations of their abilities and at a pace to suit them.
People were placed at the centre of the service and the involvement of their relatives and other people important in their lives was clearly embedded. Relatives were able to contribute their thoughts and views through reviews and in informal discussion. Professionals and relatives were also surveyed for their feedback and relatives said they thought their comments were acted upon.
People were treated with dignity and respect. Staff understood people’s methods of communication and their interactions with people were gentle, patient and respectful. People could not use the complaints procedure but staff understood how they expressed their sadness and unhappiness and would look for the causes of this. Relatives said they felt confident that if they did need to complain this would be dealt with and addressed immediately.
Medicines were well managed. People were encouraged to eat healthily and menus were devised specifically from their known preferences, Staff enabled people to experiment with new types of food and people enjoyed a range of food including from time to time takeaways which they enjoyed. People’s health and wellbeing was monitored closely and referrals were made to health professionals if and when required.
People were supported to develop relationships and maintain those that were important to them, there was excellent support for them to use new technology to do so and one person regularly used face time to engage with their relatives.
People were offered a wide range of activities and stimulation tailored to their specific interests and preferences, staff ensured people had a community presence most days.
A comprehensive system was in place for the assessment and monitoring of all aspects of the service to ensure service quality was maintained. The provider kept themselves informed about changes that impacted on the future of learning disability care services and ensured policies and procedures guiding the support of staff were kept updated.
We undertook an unannounced inspection of this home on 14 October 2014. We previously inspected this service in August 2013 and there were no concerns. The home provides care and accommodation to three people with learning disabilities.
At 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 and associated Regulations about how the service is run.
Three people were living in the home at the time of the inspection. The home is a semi-detached house located in a residential street close to shops, local facilities and public transport. Each person had their own bedroom and had access to shared lounge, dining, and bathroom facilities. We used a number of different methods to help us understand their experiences of living in the home, because they had complex needs and were unable to tell us themselves. We observed how people spent their time during the day, how staff met their needs and how people communicated and engaged with staff.
Staff demonstrated an in depth knowledge and understanding of each person’s needs and their methods of communication. We observed that people were comfortable in the presence of staff that were seen to be compassionate, patient and caring in their contacts with people. Safe procedures were in place for the recruitment of staff, who received induction to their new roles and regular training to ensure they had the right skills. There were enough trained staff to ensure people always received support when they needed it
People were provided with lots of opportunities to go out in the community and to do activities that they liked. Their care records showed that their representatives were consulted about the care they received. People saw health and social care professionals when they needed to and staff recorded the outcomes of these appointments and made sure other staff were aware of important changes. Minor improvements were needed to ensure that appropriate and safe systems were in place for the safe management of medicines.
The home provided a clean well-maintained and homely environment for people to live in. Risk assessments and safety checks of equipment, gas, electrical and fire systems ensured people were kept safe from harm.
The provider visited the home regularly and was known to staff and the people living there. To help drive improvements a range of weekly audits were in place and the provider also visited unannounced three times each year, and had implemented performance monitoring and targets for the home to achieve. Representatives, and other professionals were asked for their views about the service and their comments were acted upon.
We found the home was meeting the requirements of the Deprivation of Liberty Safeguards.
We recommend that the provider considers NICE guidance in relation to the safe management of medicines
People were treated with respect and dignity. Records showed that they were supported to make decisions about their day to day lives and things that were important to them. People could choose what to do and what to eat each day and staff respected their choices.
Staff understood people's needs and their preferred individual methods of communication. People were supported to be as independent as they could.
People were supported to eat healthily and people's food preferences were accommodated.
Staff told us they had supervision every month, where they were encouraged to raise care and treatment concerns and suggest improvements, which may benefit the people they care for.
The service had processes and procedures in place to regularly check on the quality of the service people received and to keep them safe.
People were treated with respect and dignity. They were supported to make decisions about their day to day lives and things that were important to them. People chose when to get up and go to bed, what to do and what to eat and staff respected their choices.
People could choose how to spend their time at home and were provided with activities at home and in the community. They were helped to make their choices with the use of pictures and I pods.
We saw that staff had a good understanding of people's needs and their individual methods of communication and that people were relaxed with staff. There were enough staff on duty to support people safely.
People were encouraged to be as independent as they could by helping with tasks such as preparing meals in line with their individual skills and abilities.
People's rooms were personalised with pictures and toys for example a disco ball and indicated that they liked the rooms.
The provider made regular checks of the service to make sure that people were getting the support they needed and the service was safe. These included asking relatives for their views.