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Inspection carried out on 22 April 2021

During an inspection looking at part of the service

Stallcombe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided. The home provides accommodation and personal care for up to 33 adults who have a learning disability. At the time of our inspection there were 33 people living at the service.

We found the following examples of good practice.

Facilities were in place to wash hands or use hand sanitiser on entering and leaving the home. Visitors were supported to wear a face covering when visiting, and wash hands before/after use. All visitors were screened for symptoms of COVID-19 before being allowed to enter the home. There was prominent signage and instructions to explain what people should do to ensure safety. Information was easily accessible on arrival and before visits to ensure visitors followed guidance, procedures and protocols to ensure compliance with infection prevention control.

The registered manager and members of the management team communicated with people, staff and health and social care professionals regularly to make sure everyone had an understanding of precautions being taken, and how to keep people safe. The home was following government guidance regards to visitors.

Due to the needs of people living at Stallcombe House and their limited understanding of following social distancing measures, the home had adapted visiting arrangements in line with government guidance which states: ‘The guidance is there to help care homes get the balance right between keeping everyone as safe as possible, while providing as much safe visiting as they can. However, we realise that every home and every resident is different. There will be some situations where a slightly different approach is needed because of the needs of the resident. Any changes to the rules need to be agreed by everyone involved.’

As a result, and agreed with all parties through meetings and surveys, visits were taking place in the summerhouse for three weeks after people have had their second COVID-19 vaccination. Health professionals commented: “Stallcombe House have done a fantastic job keeping their vulnerable residents safe and free from Covid infection this last 12 months. The residents are treated as individuals and have had COVID-19 restrictions explained in many formats. Their range of intellectual abilities has added to the complexity of keeping the residents safe. The management team have listened to families and implemented national guidance” and “I was reassured by Stallcombe’s attempt to work in partnership with families to direct their decision making, promoting feedback in relation to their risk management approach before concluding their policies/decisions. From meeting today with (management team) I have discussed the guidance with them and in turn feel confident they have reviewed the guidance and applied it to Stallcombe to the best of their ability.”

Staff were following current infection prevention and control guidance to help people to stay safe. There were suitable risk assessments and an up to date infection control policy and procedure in place. The registered manager ensured staff understood why every measure was essential.

Personal Protective Equipment (PPE) was readily available around the building. We saw there was a good supply of PPE for staff to use. Staff were observed to be wearing PPE appropriately and disposed of it in clinical waste bins. Whole home testing was undertaken, with frequency of testing people and staff in line with current guidance.

Staff had completed training to ensure staff knew how to keep people safe during the COVID-19 pandemic. Staff had also been supported by external health professionals to ensure safe infection prevention and control measures were in place.

Infection prevention and control audits were carried out to ensure the premises was meeting infection control measures. A cl

Inspection carried out on 19 March 2019

During a routine inspection

About the service: Stallcombe House provides accommodation for up to 33 people. The service is situated in the village of Woodbury near Exeter in Devon. The service consists of the main Stallcombe House which looks after 27 people with a learning disability, within four 'zones' within the house. The Willows is a separate unit which looks after six people with severe autistic spectrum disorder. At the time of our inspection there were 31 people living at Stallcombe House.

People’s experience of using this service:

The values set out in the Registering the Right Support include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. This location may not be ideal for some people who would want to access the local community independently. However, people were given plenty of choices and their independence and participation within the local community was encouraged and promoted.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This guidance was implemented in 2017 after the service had registered with us. It would be unlikely that we would register this model of services now when considering applications for services for people with a learning disability and/or autism. This was because the home was situated in a rural area and supported 33 people. The registering the right support provides guidance in respect of the size of home and the promotion of values such as inclusion and empowerment.

However, the service had mitigated some of these areas, because the main house had been divided into four areas, so people could live in smaller groups of six or eight. Whilst there was a bustling atmosphere it was not evident that there were 27 people living at Stallcombe House due to each area having their own dining area, kitchenette and lounge areas.

People were supported to make choices and had control of their lives. Staff supported people in the least restrictive way as possible. This was kept under review. Staff were aware of the legislation to protect people’s rights in making decisions.

People were cared for in a way that respected their privacy, dignity and promoted their independence. Staff knew people extremely well enabling care to be delivered effectively, responding to people’s changing needs. Many of the people had lived at Stallcombe House for many years and had built positive relationships not only with the staff but with each other. There was a vibrant and lively atmosphere in the home.

People led extremely full lifestyles. There were opportunities for people to participate in the variety of activities within Stallcombe House from gardening, pottery, weavery, animal care, cooking, arts the list was endless list. People also were very much part of the local community attending church, going swimming and visiting places of interest. Regular trips to the local pub were organised and clubs such as gateway a club for people with a learning disability and a drama group. People were involved in raising money for local charities as well as fund raising events for Stallcombe House.

Staff interactions with people were kind and caring. People were supported by staff that were familiar to them taking into their consideration their preferences.

There was a clear management structure with staff being supported by shift leaders, the registered manager and the head of the charity. Since the last inspection, there had been a change of leadership. Staff were positive about the changes that were being made. Staff described the change of management as being seamless.

Rating at last inspection: Rating at last inspection: Good (report published October 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. We found the service continues to meet the characteristics of g

Inspection carried out on 3 October 2016

During a routine inspection

This unannounced inspection took place on 3 October 2016. We returned on 4 October 2016 to complete the inspection. At our last inspection in February 2014 we found the service was meeting the regulations of the Health and Social Care Act (2008) we inspected.

Stallcombe House provides accommodation for up to 33 people. The service is situated in the village of Woodbury near Exeter in Devon. The service consists of the main Stallcombe House which looks after 27 people with a learning disability, within four ‘zones' within the house. The Willows is a separate unit which looks after six people with severe autistic spectrum disorder. At the time of our inspection there were 33 people living at Stallcombe House.

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 2008 and associated Regulations about how the service is run.

People were safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate. People engaged in wide variety of activities on site and spent time in the local community going to specific places of interest.

There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development.

A number of effective methods were used to assess the quality and safety of the service people received and make continuous improvements.

Inspection carried out on 18 February 2014

During a routine inspection

There were 27 people living at Stallcombe House and six people living at the Willows unit on the day of our visit. We spent time in both areas. Due to the complex needs of people in the Willows unit, we were unable to speak with the majority of them in a meaningful way. People living in the main house were able to voice their experiences to us and gave us their views and experiences of the service. We spent much time speaking with people inside the home, whilst undertaking activities or spending time outdoors.

There was a welcoming, friendly and homely atmosphere. Throughout our visit we saw that people in all areas of the home appeared comfortable, relaxed and at ease with staff. There was much humour at times. The main house was very busy with many activities, hobbies and interests taking place. People were well cared for by skilled, experienced and committed staff. People told us "I like it here - I'm really happy" and "I like the staff, especially X (keyworker)".

Plans of care were in place for each person with suitable assessments of risk completed. Specialist advice was sought from the appropriate professionals.

Menus were planned for people which were varied and appealing.

People lived in a home with grounds that were extensive and offered them a safe environment to undertake their preferred activities.

Before people began work at the home, they had the necessary recruitment checks completed. There was a suitable complaints procedure in place.

Inspection carried out on 27 February 2013

During a routine inspection

People told us that they liked living at the service. They said such things as �I like it here� and �It�s good�.

People told us that they enjoyed the meals that were served to them and that they were able to say what was going to be on the menu.

People told us that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

People received health care support. Community services were accessed to support people when necessary.

Staff talked of their awareness of how to keep people safe from harm. They told us about the training that the service had arranged so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally.

People we spoke with said their comments were listened to.

Reports under our old system of regulation (including those from before CQC was created)