We carried out a review of the data available to us about St Peters Row Delarue Close 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 St Peters Row Delarue Close, you can give feedback on this service.
St Peters Row Delarue Close is a small residential care home which is made up of three small houses. Each house has its own front door and own staff team. The service provides personal care to 15 people with learning disabilities or autistic spectrum disorder at the time of the inspection. The service can support up to 15 people.
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
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 were happy living at the service. Relatives said, “[Person] has lived there at least five years, she classes it as her home. She comes home to us every two weeks for a week and says she likes having two homes. We don’t worry at all” and “They meet her needs wonderfully, I could not ask for better.”
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.
Staff recognised that people had the capacity to make day to day choices and supported them to do so. People were encouraged and supported to be independent. People were engaging in the community, for example utilising their local community to use ordinary community resources, shops, access day services and activities to ensure they had a good day. People were also supported to take holidays both in the UK and abroad.
The registered manager and staff continued to be responsive and worked continuously to make improvements to the service and provide people with high quality care. The registered manager and staff demonstrated a detailed knowledge of the people they supported. Over time they had developed trusting relationships, so that people felt safe receiving support. The provider had been responsive to people’s changing needs. People were happy and smiling. Relatives were extremely happy with the service.
The service continued to provide good quality care and support to people enabling them to live fulfilled and meaningful lives. The service was innovative and used assistive technology to enable people to be as independent as possible, such as electronic tablets, movement sensors and epilepsy alarms. People were able to have privacy and independence with staff accessible nearby if support was needed.
Staff had a full understanding of people's support needs and had the skills and knowledge to meet them. Staff had received training, regular supervisions and appraisals. Staff were encouraged to continuously learn and develop by completing qualifications and additional learning. The provider continued to work with other organisations to ensure staff received current and best practice training and information.
Staff were extremely positive about the support they received from the registered manager and the provider. Every staff member enjoyed working with people at the service, this was evident as many staff had worked for the service for many years. Every staff member demonstrated passion and commitment to providing the best possible care and opportunities for people to live life to the full. This had led to a positive workplace culture, with staff feeling their voices were listened to. Staff told us they were proud of working for the organisation.
People had positive relationships with staff that knew them well. There were enough staff available to meet people's needs and give individual care and support. Staff had been recruited safely. There was a strong emphasis on person-centred care. People were supported to plan their support where possible and they received a service that was based on their individual needs and wishes. The service was flexible and responded to changes in people's needs.
Support plans detailed people’s preferred routines, wishes and preferences. They detailed what people were able to do for themselves and what support was required from staff to aid their independence wherever possible. People were involved in review meetings about their support and aspirations. They were involved in setting goals and targets and were supported by staff to achieve these.
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 23 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.
Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.
Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people while their independence was actively promoted.
There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.
People were appropriately supported with the management of their medicines, attending appointments and were promptly referred to health care professionals when needed.
Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.
Staff promoted people’s independence, encouraged them to do as much as possible for themselves and make their own decisions. A local authority case manager who oversaw the wellbeing of some of the people in the service told us, “The care the staff provide is of a high standard, they always appear caring and put the person at the centre.”
Personal records included people’s individual care plans, likes and dislikes and preferred activities. These records helped staff deliver support that met people’s individual needs. Staff knew about people’s dietary preferences and restrictions, and involved them in choosing menus.
The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was an effective system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and support.
Further information is in the detailed findings below.
This inspection was carried out on 08 and 09 June 2015 by one inspector and an Expert by Experience. It was an announced inspection. Forty-eight hours’ notice of the inspection was given to ensure that the people who lived in the service were prepared to receive unfamiliar visitors.
Not all the people living at the service were able to express themselves verbally. Some people used specialised equipment to express themselves and others used body language.
The service is registered to provide accommodation and support for up to 15 people with learning disabilities who require nursing or personal care. There were 15 people living there at the time of our inspection. The accommodation was split into three separate units within the same building. One unit accommodated people who had higher dependency needs.
There was a 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 2008 and associated Regulations about how the service is run.
Staff were trained in how to protect people from abuse and harm. They were aware of the procedures to follow in case of abuse or suspicion of abuse, whistle blowing and bullying.
Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.
There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs and ensured continuity of one to one support. Thorough recruitment practice was followed to ensure staff were suitable for their role.
Staff were trained in the safe administration of medicines. Records relevant to the administration of medicines or the supervision of medicines were monitored. This ensured they were accurately kept and medicines were administered to people and taken by people safely according to their individual needs.
Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before care was provided and were continually reviewed. This ensured that the staff could provide care in a way that met people’s particular needs and wishes.
Staff had completed the training they needed to support people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions to ensure they were supported while they carried out their role. They received an annual appraisal of their performance and training needs.
All care staff and management were trained in the principles of the Mental Capacity Act 2005 (MCA) and were knowledgeable about the requirements of the legislation. People’s mental capacity was assessed and meetings were held in their best interest when appropriate.
Staff sought and obtained people’s consent before they provided support. When people declined or changed their mind, their wishes were respected.
Staff supported people with their planning of menus, activities and holidays. They ensured people made informed choices that promoted their health. Staff knew about people’s dietary preferences and restrictions.
People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their support was delivered. Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs.
People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of care, likes and dislikes and preferred activities.
The registered manager and the staff’s approach promoted people’s independence and encouraged them to do as much as possible for themselves and make their own decisions. Comments from relatives included, “This is an excellent place.”
People’s privacy was respected and people were assisted in a way that respected their dignity and individuality.
People’s individual assessments and care plans were reviewed regularly with their participation or their representatives’ involvement. A relative told us, “We are invited to participate in reviews”. People’s care plans were updated when their needs changed to make sure people received the support they needed.
The provider took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. The provider sent questionnaires regularly to people, their legal representatives and healthcare professionals. The results were analysed and action was taken in response to people’s views.
Staff told us they felt valued and supported under the manager’s leadership. The 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 how the service could improve and action was taken to implement improvements.
We spoke individually with six people who used the service, the registered manager, four members of staff and a social care professional.
People had given their consent to the care and support they received. They told us they were aware of their care records and that staff had consulted them about how they preferred to be supported.
People told us they liked living at the service. They said 'it's good, I love it' and 'I love living here'. People said they did activities they liked at home and in the community. One person said 'I do dancing and was in a dance show' and another 'I have afternoon tea in Tonbridge or Tunbridge Wells'.
People told us they were being supported to be as independent as they could. One person was shortly moving to supported living and another person said 'I clean and tidy my room myself'.
People told us they liked the staff and they were satisfied with the support they received. They said they knew they could go to staff if they had any concerns. We saw that when this had happened their concerns had been addressed.
People's records were stored securely and were detailed. However we found that some information in them had not always been reviewed when it should have been.
We spoke with four people using the service. They said they liked living at St Peters Row and liked the staff. Comments that people made included. 'I like the staff '.
People said they chose what to do during the day. They told us about some of the activities they did during the day and during evenings and weekends and said they enjoyed them. They said they went to activities at the on site day centre, in the community, to evening clubs and to work. People told us about holidays they had been on this year and had enjoyed. Two people said they had especially enjoyed a disco when they were on holiday.
People said they liked their bedrooms, they chose their own colour schemes and items for the rooms.
People said they liked the meals, showed us samples of menus and explained that staff had information so they knew what people liked and what was on the menu each day. They told us they chose what to eat.