Stoke House

Stoke House is a care home service that provides care for up to 12 people with learning disabilities and autistic spectrum disorder. At the time of the inspection there were 11 people living at the home.

The care home accommodates 12 people across two buildings. One building has one self-contained flat which accommodates one individual. The second building comprises of three communal lounges, a kitchen and dining room, individual bedrooms and two shared bathrooms to accommodate 11 people. There is also a communal garden area. This home is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. 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.

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

People were exceptionally well supported with access to health care services. The staff and management team had a clear understanding of the importance and benefits of ongoing health screening and oral care in maintaining people’s health. The staff and management team had worked in partnership with healthcare professionals to support people to access healthcare services in a kind and supportive manner with positive results for people.

People’s emotional and psychological wellbeing was treated with equal importance as their physical health. The staff and management team understood the impact that reaching goals and ambitions had on emotional well-being and promoting independence. People were well supported with their goals and ambitions and had achieved positive outcomes including academic success and work experience opportunities.

Staff were well trained and supported. Specialist training had taken place for both people and staff to ensure they worked together well as a team and understood and respected each other as individuals. Healthy relationships with food were encouraged by using Imaginative ways to engage and interest people in healthy foods and cooking with positive results.

People were safe, risk assessments were in place and considered risk to people as well as risk in the environment, they were reviewed regularly to ensure safe care continued. Staff and people had received training and could recognise signs of abuse, they had access to a safeguarding lead if needed to help with reporting. The home was clean, smelt fresh and was well maintained. Staff had access to gloves and aprons which they used when providing personal care, ensuring people were protected from the spread of infection.

Staff were recruited safely, recruitment procedures ensured only suitable staff were employed. Medicines were managed, stored and disposed of safely. Senior staff were trained and responsible for giving people their medicine. Regular medicine checks ensured that any errors could be identified and managed quickly. Staff were trained and had the skills needed to do their job. They received regular training updates and support and were well supervised.

People received personalised care and were involved in the care planning process. People's choices, lifestyle, religion and culture as well as their personal, emotional and health care needs were all considered and planned into care delivery.

Pre-admission assessments and visits took place to ensure the service could meet people's needs prior to them moving into the home. People and staff had access to a complaints procedure and complaints were responded to in line with the providers policy.

The provider, management team and staff had developed an open and honest culture and had good knowledge of their responsibilities. The registered manager and provider had good oversight of the service from the quality monitoring processes in place and analysed findings for learning and improvement.

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 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.

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 19 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.

At our last inspection in January 2015 the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’ for being safe, effective, caring responsive and well-led.

People continued to receive safe care. Suitable staff were recruited and there were enough suitably skilled and experience staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. The training and support staff received focused on the needs of the people using the service. People were supported to maintain good health and nutrition.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had positive relationships with the staff who were providing their care and staff treated people with respect, kindness and dignity.

People had plans of care that were focused on them as individuals. This allowed staff to provide consistent support in line with people’s personal preferences. People and their relatives were able to raise a concern if they had one. The provider had effective procedures to manage any complaints that they may receive.

The service had clear aims and objectives which were to support people to achieve and experience things that were important to them. People and staff told us that they felt confident that they could approach the registered manager and that they would listen.

There were quality assurance systems in place to monitor and review the quality of the service that was provided. The registered manager was supported by highly qualified staff at the provider’s head office.

Further information is detailed in the findings below.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff demonstrated an understanding of the support required to enable people to make choices about their daily lives and their care. People received an assessment of their needs to identify any areas of risk in delivering their care. Staff reviewed people's risk assessments to ensure any changes to people's health and well-being were identified promptly. The provider completed a range of monthly safety checks to ensure fire detection equipment and systems had been regularly tested and maintained.

However, we saw that there were a number of repairs needed at the home. This included a broken window and broken items of furniture which were stored in the garden area and presented a risk to people who used the service. This meant there was a breach of the Health and Social Care Act regulations. A compliance action has been set and the provider must tell us how they plan to improve.

Is the service effective?

People's health and care needs were assessed with them, and they and their family members were involved in writing their plans of care. People told us that they were happy with the level of care provided and liked living at Stoke House. We observed that people attended a range of activities and they told us they liked going out into the community. People also told us that they undertook daily tasks such as cleaning their bedrooms and participated in making the evening meal. We saw that a detailed programme of social and daily living activities were available to meet people's needs.

Is the service caring?

People were supported by kind and attentive staff. People told us that they were happy living at Stoke House. One person said 'The staff here are kind'. Another person said 'The staff are all nice and they care about me'. We observed that staff supported people in a caring and respectful way and people enjoyed being with the staff working at the home.

Is the service responsive?

Staff had responded appropriately to a range of medical needs and we saw that medical professionals such as the G.P, psychiatrist and dentist were regularly involved in people's care. People also told us that the food was good at Stoke House. One person said 'We have plenty of food and I like the chips'. We observed staff prepare a home cooked meal which looked nutritious and appetising and people told us staff supported them to have a healthy diet.

We also observed people were excited about attending an evening disco. Some people told us the staff supported them to attend social activities of their choice which included going to local football matches.

Is the service well-led?

The service had a quality assurance system and included gaining regular feedback about the quality of service from people who used the service. We saw that the service worked well with other agencies to make sure people received their care in a joined up way.

Staff told us that the standard of care at the home had improved since the registered manager had joined the service. One member of staff told us that the registered manager was, 'Nice and professional and does what needs to be done'. People also told us that they liked the registered manager. One person said 'They are very kind and they listen to me'.

The service had clearly defined 'aims and objectives' in place and included making sure people were respected, involved in their care planning, had a comfortable environment to live in, and were supported by a committed and well trained team of staff.

We had a minor concern that the quality assurance system in place to monitor and record how complaints were dealt with had not always been managed effectively.

We did, however, observe that the people living at 'Stoke House' were relaxed in the presence of staff and that the staff on duty were knowledgeable about the needs of each person and provided them with the support they needed.