Ravensknowle Road

Ravensknowle Road is a residential care home providing accommodation and personal care to up to 8 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 8 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance Care Quality Commission (CQC) follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

The provider assessed risks to people and demonstrated safety was always effectively managed. People were involved in planning their care, making decisions about what they wanted to do and had recently attended reviews.

People were supported to receive their medicines safely. Records were well completed and showed medicines were administered as prescribed.

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.

Right Care

People were very happy living at Ravensknowle Road. On both days of the inspection there was a nice atmosphere and people were comfortable in their surroundings.

The provider ensured there were sufficient numbers of suitable staff. Staff knew people well and provided a consistent and reliable service. People told us there was always enough staff available to support them and staff were good at their job.

People’s support plans had detailed personalised information and easy read supporting documentation to ensure they had accessibility to their records.

The service worked effectively with external stakeholders.

Right Culture

Staff had a good awareness of safeguarding processes and knew how to take action if they had concerns. People felt safe living at Ravensknowle Road. Relatives provided consistently positive feedback.

The service had clear visions and values which were shaped by the registered manager and provider. Staff told us they were proud to work at Ravensknowle Road and received good support.

The provider had a range of effective systems and processes to monitor the quality of the service and drive improvements.

Everyone had opportunities to share their views. Regular meetings were held where people discussed the service. One person said, “We have meetings and talk about going on holiday and the fire alarm and people's birthday. We write down what we like. We sit round in the living room and look at books to choose what we can cook.”

During the inspection we identified a small number of areas to improve such as consistency in daily records and staff to complete a recommended training course. The registered manager was very responsive and took immediate action to address these issues.

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 (19 January 2018).

Why we inspected

We inspected due to the length of time since the last inspection.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Ravensknowle Road on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Donning and doffing stations were situated in the service and personal protective equipment (PPE) was available throughout the building. Staff had designated areas to change into their uniforms. All staff had received training in IPC and PPE in relation to COVID-19.

People were informed about preventing the spread of COVID-19 and IPC using videos and accessible communication tools.

The manager had created a hospital pack for each person in case of the need to be admitted to hospital in an emergency including photographs of possible hospital procedures people might encounter, to support hospital staff to communicate with people. The pack also contained the persons easy read hospital passport, disability distress tool, mask use information, medication records and COVID-19 care plan and risk assessment.

Four people spoken with told us staff always wore their masks and PPE and praised all the staff highly for the care they had provided during the outbreak.

Numerous activates had taken place in the home and garden whilst people were shielding to maintain physical and emotional wellbeing.

People were supported to maintain regular contact with friends and family through video calls, telephone calls and visits at the window. One person was supported to attend their church service on line each week.

A robust process was in place for professional visits. All visitors had their temperatures checked and were required to complete a questionnaire and lateral flow test if it was essential they entered the building. People and staff received regular COVID-19 tests and staff had received the COVID-19 vaccine.

The service conducted regular infection control audits, to ensure infection prevention and control (IPC) processes were robust.

The home was clean and well ventilated. Cleaning processes had increased throughout the service. High touch surfaces were regularly cleaned, and a fogging machine was used to deep clean the home regularly.

This inspection took place on 6 December 2017 and was unannounced. The service was previously inspected on 27 August 2015 and was at that time not meeting the regulations related to consent. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question effective to at least good. We found improvements had been made at this inspection to meet the relevant requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Ravenskowle Road 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 home had a registered manager. 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.

On the day of our inspection there were eight people living in the home.

The care service has 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.

People told us they felt safe and happy. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence. Robust emergency plans were in place in the event of a fire or the need to evacuate the building.

A system was in place to ensure medicines were managed in a safe way for people. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse.

Sufficient staff were on duty to provide a good level of interaction, and safe recruitment and selection processes were in place.

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

Staff told us they felt supported. Records showed they had received an induction, role specific training, plus supervision and appraisal.

People told us they enjoyed their meals. People’s nutritional needs were met and they were supported to access a range of health professionals to maintain their health and well-being. The service worked in partnership with community professionals and used good practice guidance to ensure staff had the information they needed to provide good quality care.

People we spoke with were delighted with recent improvements in their independence which had been promoted by the registered manager. This had improved people’s sense of control and autonomy.

People and relatives told us they were very happy with the care and we saw the home had a warm and happy atmosphere where mutual respect and friendship were promoted.

Self-advocacy and involvement was promoted within the home. People were involved in arranging their care and support and staff facilitated this on a daily basis.

Individual needs were assessed and met through the development of detailed personalised care plans which considered people’s diverse needs and preferences.

People had access to social and leisure activities in line with their preferences and interests, and were therefore supported to live fulfilling lives.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

The home was welcoming and comfortable and people told us they were happy. The registered manager had an overview of the service and knew people’s needs well. Relatives and staff were positive about the registered manager’s input.

The service was led by an enthusiastic registered manager whose values and skills were reflected in the quality of the support provided. People who used the service and their relatives were asked for their views about the service and these were acted on.

The registered provider had an effective system of governance in place.

Further information is in the detailed findings below

The manager of the home was on holiday when we visited the home. During our visit we spoke with three support workers, and five people who lived at the home.

We heard staff asking people who lived at the home what they would like to do and explaining what was happening.

People looked well dressed and cared for, the atmosphere in the home was calm and relaxed.

We looked at two people's care records and found that showed people using the service received additional support when required for meeting their care and treatment needs.

During our visit we observed people looking comfortable when interacting with staff.

We found staff were knowledgeable about local safeguarding procedures and knew what actions to take if they suspected abuse was taking place.

We looked at three sets of staff records and found that effective recruitment and selection processes were in place.

Documentation also showed the home had effective systems for auditing the quality of service.