Background to this inspection
Updated
21 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.
The inspection took place on 19 November 2018 and was unannounced. The inspection was carried out by two inspectors.
Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. This enabled us to ensure we were addressing potential areas of concern at our inspection.
As part of our inspection we spoke with one person who lived at the service and observed the care and support provided to people. We spoke with the registered manager and two staff members. Following the inspection we spoke with, or received feedback from four relatives and one professional.
We reviewed a range of documents about people’s care and how the home was managed. We looked at two care plans, medication administration records, risk assessments, complaints records, policies and procedures and internal audits that had been completed.
Updated
21 December 2018
Stiperstones is registered to provide accommodation with personal care for up to eight adults with physical and learning disabilities. At the time of our visit eight people lived at the service.
Stiperstones 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, and both were looked at during this inspection.
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. These values 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.
At out last inspection, the service was rated Outstanding. At this inspection we found the service had not sustained the outstanding rating in all domains. We found the service was good.
People had access to activities, however due to staffing issues, people were not participating in as many individual outings as they could do. We found that staff did not always support people to work towards goals to increase their life skills and independence. We have made a recommendation to the registered provider in this respect.
People were supported by sufficient, skilled staff to meet their needs. Staff had been through a recruitment process before commencing at the service and they received on-going training and supervision to support them in their roles. However, morale within the staff team was low due to provider-level changes. Although this did not have an impact on the care people received as staff remained professional and caring, it had resulted in some key staff leaving the service which in turn meant people were not able to go out as much.
Staff were aware of their responsibilities in safeguarding people from abuse. Risks to people’s safety were identified and control measures implemented to keep people safe. People received their medicines safely and in line with prescription guidelines.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principals of the Mental Capacity Act 2005 were followed to help ensure this.
People received support from staff who knew them well and positive relationships had been developed. On the whole staff treated people with kindness and were aware of their preferences and staff demonstrated a good understanding of people’s communication styles. However, we did observe occasions when staff could have been more attentive towards people.
The service worked closely with healthcare professionals to ensure that people’s healthcare needs were met. People had access to food of their choosing and people’s individual dietary needs were met. People’s care records were completed in detail and end of life wishes were being collected from people.
Systems were in place to monitor the quality of the service provided and ensure continuous development. The service worked proactively with other agencies. There was a complaints process in place and the registered manager submitted notifications to CQC in line with their registration requirements.
People lived in an environment that was clean, checked for its safety and adapted for their needs.