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Blythson Limited - 5 Ashley Avenue Good

Inspection Summary

Overall summary & rating


Updated 10 March 2017

The inspection was unannounced and took place on 31 January 2017. We previously inspected this service in October 2014 and there were no concerns. The service provides care and accommodation to three people with learning disabilities. People have their own bedrooms located on the first floor. Communal areas are located on the ground floor but the service is unsuitable for those with mobility issues that affect their use of stairs.

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 complai

Inspection areas



Updated 10 March 2017

The service was safe.

The premises were clean and well maintained required servicing and checks were undertaken. Emergency procedures in the event of fire or other events were in place and staff were provided with out of hours support.

Staff understood how to keep people safe from harm and risks were appropriately assessed. Staff took appropriate action and understood the reporting process for when incidents and accidents occurred.

There was good staff continuity and enough staff on duty with the right knowledge and skills. The recruitment process ensured checks were made of staff suitability.



Updated 10 March 2017

The service was effective.

Systems were in place to ensure staff received the right induction and training for their role and could discuss their training and development needs, staff felt supported and listened.

Staff understood people’s methods of communication and knew how to support them when they expressed anxiety through behaviour. People were supported in line with the principles of the Mental Capacity Act 2005; people were helped by staff to make decisions and choices and these were respected.

Staff understood people’s health needs and requirements and supported them with health appointments. Staff understood people’s food preferences and included these in the meals offered.



Updated 10 March 2017

The service was outstanding in providing caring staff to support people. All staff were committed to providing a strong and visible person-centred culture.

People’s relationships with staff were positive and supportive. Relatives felt staff went the extra mile to provide care that was enabling, compassionate and provided people with opportunities to live a fulfilling life.

Staff continuity ensured staff had developed a comprehensive knowledge and understanding of each person’s needs and how they made these known. Staff were enthusiastic to support people with new experiences but mindful this should always be at a pace to suit the person.

Staff respected and valued people in the way they responded to them, they were discreet in their support of people’s privacy and dignity and supported them to maintain the important relationships in their lives and to make new ones.



Updated 10 March 2017

The service was responsive.

A comprehensive system was in place for the assessment and transition of new people to the service to ensure their needs could be met. Staff demonstrated an in depth knowledge of people’s needs and wishes and this was reflected in care plans that guided staff support, relatives were consulted.

People were provided with lots of opportunities for activity and stimulation inside and out of the service, activity planners were tailored to their own preferences. Staff monitored people’s level of interest and offered alternatives.

A complaints procedure was in place but people lacked capacity to use it staff understood however, how people expressed their sadness and unhappiness and would look for causes for this when they became aware of it.



Updated 10 March 2017

The service was well led

Staff found the provider and registered manager approachable and easy to talk with. Staff were given opportunities to meet and felt able to express their views, they felt listened to, valued and able to influence change.

A comprehensive system of assessment and monitoring of all aspects of the service was established at staff, registered manager and provider level. Actions were taken to address shortfalls identified from these audits to ensure service quality was maintained and improved upon.

Relatives were surveyed for their views and were confident action would be taken if improvements were needed. Updated policies and procedures were in place to guide staff support. Business continuity plans were in place.