Lincolnshire House Association

Lincolnshire House is a residential care home providing personal care to 34 people with physical disabilities and related conditions at the time of the inspection. The service can support up to 37 people, which includes three respite placements in purpose built fully equipped shared bungalows.

People’s experience of using this service and what we found

The service continued to be outstandingly responsive and celebrated people's achievements in a way that helped people to grow in confidence. Staff successfully promoted people's independence and as a result, some people had become much more independent and had much richer lives.

The provider had continued to ensure people received care and support that was exceptionally personalised, very well planned and particularly responsive to their needs. People's individual support plans were very person centred and well designed to meet people's needs. Staff sought opportunities for people to have different experiences and to do things in the community. People had their own interests and hobbies and took part in many activities. We saw instances where employment opportunities had given people a sense of self-worth and confidence. People were supported to maintain their family relationships and friendships and make new friends.

People were kept safe from the risks of harm and abuse. Staff knew how to recognise and respond to concerns of abuse and people had risks assessments in place to guide staff to mitigate risk. Robust recruitment processes were in place which enabled the provider to make safe recruitment decisions. Where people required assistance with their medicines, this was well managed. Accidents and incidents were used to reflect on practice and lessons learned were shared with the staff team. Personal evacuation plans were not in place to support people to leave the building safely in case of emergency.

We have made a recommendation about the introduction of personal evacuation plans.

Staff received supervision and training which enabled them to deliver effective care. People's needs were assessed before their care package commenced to identify and agree the care they required. People were supported by staff to eat and drink where required. 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. The environment promoted people’s wellbeing and maintained their independence.

People and their families spoke positively about the care provided and the friendly nature of the staff team. Staff knew people well, they spent time having meaningful conversations to find out about their past and what was important to them. Staff understood people’s communication abilities which enabled them to be involved in decisions about their day to day lives. Staff understood the importance of respecting people, ensuring dignity and finding ways to enable independence. People knew how to make a complaint and felt assured complaints and issues raised would be responded to accordingly.

People, their families and the staff team spoke positively about the management of the home, describing the management team as visible, supportive and caring. Staff understood their roles and responsibilities,

felt involved and able to share ideas. Quality assurance processes were comprehensive and included the voice of people, families and staff and drove continuous improvement.

For more details, please see the full report which is on the Care Quality C omission (CQC)website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 May 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.

Lincolnshire House is a registered charity based in Scunthorpe, North Lincolnshire, providing accommodation and personal care for up to 37 adults with physical disabilities and related conditions. The service also provides day and respite care services. Accommodation is provided in nine purpose built fully equipped bungalows, with adapted kitchens, dining rooms, lounges and bathrooms. Adaptations include overhead tracking, portable hoists, adapted bathing and showering facilities, adapted bathroom lighting, automatic key coded entrance doors and wide door access. Day services are provided in an independent fully adapted day service facility, based in the grounds of the service.

The philosophy of the service is to empower people with disabilities and this is achieved by personalised programmes of care and flexible staffing to enable people to be as independent as possible in all aspects of their lives.

This inspection took place on three days 5, 6 and 7 April 2017 and was unannounced on the first day. At the last inspection in January 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

The service was safe. People told us they trusted the staff and felt very much included in decisions about their care and support. Assessments were carried out to ensure people were protected from potential harm and staff took steps to minimise risks without taking away people’s right to make decisions. Sufficient numbers of staff were available to meet people’s needs and we observed they worked together well as a team to enable people’s independence to be promoted. People’s environment and equipment was well maintained, clean and safe and free from unpleasant smells. Staff were recruited safely and regular checks were carried out to ensure they did not pose a risk to people. Staff had received training to ensure they knew how to recognise and report potential abuse. Systems and policies were in place to ensure potential risks were managed and ensure people received their medicines in a safe way.

The service was effective. Staff were provided with a range of training, development opportunities and support to enable them to meet people's needs. People were assisted to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible; policies and systems in the service supported this practice. The nutritional and dietary needs of people were assessed and they were supported to plan and prepare meals, which they said they enjoyed. People's medical needs were monitored with support and guidance from a range of health care professionals whose recommendations were followed.

The service was caring. People were involved and included in decisions about the way their support was provided and their friends and relatives were welcomed by the service. People were treated with dignity and respect and staff provided their support in a kind and considerate manner. People were consulted about decisions affecting their lives and their opinions and views were valued to enable the service to learn and develop.

The service continued to be highly responsive to people’s wishes and preferences and provided their support in an individualised way that was personalised to meeting their needs. People’s views and opinions were highly valued by the service which involved them in an open and inclusive way. People participated and were involved in making decisions about their lives and their support reflected their wishes and choices and was reviewed and updated on a regular basis. People were provided with an extensive range of activities to participate in, both in house and in the local community. People who used the service spoke positively about the support they received and confirmed their comments and concerns were responded to appropriately and systems were in place to enable their feedback to be sought.

The service was well-led. The service had an open and inclusive ethos and people, their relatives and staff were positive about the way it was managed. Systems were in place to ensure the quality service delivered to people was assessed and monitored to ensure it could continually improve.

Further information is in the detailed findings below.

Residents confirmed that they were asked for their consent. One resident commented, 'I gave my consent to be here.'

Residents and their relatives spoke positively about the care provided. One resident told us, 'It's a marvellous place and care is great. Everything is done on a personal level, and with dignity.' A relative said, 'They do one-to-one care very well.'

People were protected from the risk and spread of infection. Residents told us: 'I think it's clean; very much so,' 'Cleanliness is good. Staff come round every day to clean,' and 'I think cleanliness is immaculate. When I come into my room everything is clean and tidy and the way I want it.' A relative said, 'Cleanliness is spot on, you can't fault it.'

There were effective recruitment and selection processes in place and people spoke positively about the staff that worked with them. One resident said, 'The staff are fantastic.' Another resident told us, 'Residents are involved in the recruitment process. Staff are all very good and it is a good induction system.' A relative said, 'The staff are spot on.'

Residents we spoke with were clear about how to make a complaint. One resident said, 'I haven't got anything to complain about, but if I had I would complain to the manager. All residents are given information about complaints in a booklet on arrival.'