Archived: Shandon

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. 'Registering the Right Support' CQC policy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service: People and their relatives told us they felt safe living at Shandon. Risks to people’s safety had been assessed and measures implemented to keep them safe. A positive approach to risk taking was followed to ensure people’s independence was maintained. Staff were aware of their responsibilities in safeguarding people from abuse and had developed open and trusting relationships with people.

Staff had received training and support from healthcare professionals with regards to people’s individual health needs. This had enabled staff to provide people with individualised support in these areas. People told us they enjoyed their food and were offered choices in how they spent their time.

People and relatives told us that staff were caring and treated them with respect. People were supported to maintain relationships which they told us was important to them. Staff had worked at the service for many years and positive relationships had developed between people. There was a warm and homely atmosphere and people were clearly comfortable living at Shandon.

People received a personalised service and were involved in developing their care plans. Staff knew people’s life histories, preferences and routines. Activities were based around people’s choices and people were supported to take part in the running of their home.

There was a positive culture within the service where people, staff and relatives felt listened to. The registered manager felt supported by the provider and this flowed through the service. Quality assurance systems were in place which ensured high standards were maintained.

Rating at last inspection: At the last inspection the service was rated Good (report published on 17 August 2016)

Why we inspected: This was a planned comprehensive inspection to confirm the service remained Good.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

Shandon is a small care home providing personal care for up to three adults with learning disabilities. The home is a bungalow and there are three single bedrooms on the ground floor. At the time of our inspection, there were two people using the service.

There was an established registered manager who had worked in the service for many years. 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 and their relatives told us they felt safe and well cared for. Staff respected and understood people's need for privacy and promoted their independence. People were supported to maintain their hobbies and interests at home and in their local community.

At the time of our inspection people living at Shandon had capacity to make decisions about their care. Their rights were protected because the registered manager and staff understood the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This is legislation that protects people who are not able to consent to their care and support, and ensures people are not unlawfully restricted of their freedom or liberty.

People's needs were assessed and reviewed to ensure they received all the support they needed. The care plan records included important information on how each person liked to live their life. People were fully involved in reviewing and providing feedback on the care and support they received. They were encouraged to set personal goals and were supported to achieve these.

Staff knew people well and knew when people were unhappy and how to respond to them. People and their relatives knew how to complain and make suggestions, and were confident their views would be acted upon by staff and the registered manager.

People were supported to keep healthy and their nutritional needs and preferences were met. Any changes to their health or wellbeing or accidents and incidents were responded to quickly. Referrals were made to other professionals as necessary to help keep them safe and well.

Shandon was safely maintained and people lived in a home that met their assessed needs. Individual bedrooms were furnished to comfortable standards and homely. The standards of décor and personalisation by people who used the service confirmed this.

Staff understood how to protect people from harm and provide safe care. Staff knew how to recognise and respond to abuse correctly and had received safeguarding training. The service encouraged people to take positive risks whilst promoting their independence. Where risks were identified, there was guidance on the ways to keep people safe in their home and in the local community. Medicines were managed safely and people had their medicines at the times they needed them.

Staffing levels met the present care needs of the people that lived at the service. Staff received a structured induction and essential training to support them in their role. This was followed by ongoing refresher training to update and develop their knowledge and skills. Staff also undertook training specific to the needs of people they supported. The provider recruited staff safely which helped ensure that people were protected from unsuitable workers.

The registered manager had been in charge at the service for a long time. She knew people and staff well and had good oversight of everything that happened at the service. The registered provider had values for the service, which were known and shared by the staff team. There was an open and inclusive atmosphere in the service and the manager showed effective leadership. Staff felt supported in their roles by the registered manager. Regular staff meetings were held for staff to share any concerns or ideas they had to continuously improve their service.

The provider carried out regular audits and quality assurance measures to ensure people received a high quality level of care. There were ongoing checks to monitor the health and safety of the service. Where improvements were needed or lessons learnt, action was taken.

We saw people's care records were person centred meaning that they contained personal and up to date information specifically about the person and their needs and choices about their care. The care records had the information in them that staff required to support the people appropriately.

During the inspection we spoke to the staff on duty. We found the staff to be supportive and caring of all of the people and they had a good understanding of their care and support needs. We observed the staff and their interaction with people and saw that they involved them in all aspects of their care and support by offering them choices about activities and meal options.

Staff had received the appropriate training to support the people, some of whom could become easily upset. Staff had knowledge of adult safeguarding procedures and how to report concerns. This meant that they were able to recognise suspected harm or abuse and what action to take to reduce the risk of harm and how to deal with it if it happened.

We saw that there was a variety of activities planned to meet the needs of people using the service and they were able to choose whether or not they wanted to take part in the activities. Planned activities included a range of options including music groups, baking, art and drama. We evidenced that the provider had sourced a number of community led activities as to ensure that people's individual preferences were met. One person who uses the service told us that they were supported to take a full part in their community.

The provider had an audit framework and audits were carried out monthly to ensure that the quality of the service was maintained to a high standard and that actions to rectify concerns were taken within reasonable timescales. We looked at completed surveys from representatives and could not evidence any concerns about the service. One representative commented 'I have tried hard to think of a way in which Shandon can improve the service but I am unable to do so'.

We spoke with one care worker who told us they always provided varied meal choices throughout the week and people who used the service participated in making decisions on meals choices by helping with weekly shop.

We spoke with two people who used the service who confirmed that they were able to choose what they ate and there was always plenty of choice and variety.

Two care staff told us they supported people who use the service to keep their rooms tidy and encouraged them to make decisions about their daily care routine such as clothing and participating in various leisure activities.

One person who used the service told us they attended an art club at a local day centre and enjoyed helping with shopping and domestic jobs around the home, for example cleaning the communal car and vacuuming.

We spoke with one person who used the service who told us 'The staff are wonderful they look after me well.'

We spoke with two people who use the service who told us they felt safe at the home and they felt able to speak to staff if they had any concerns.

We spoke to one care worker who told us they were aware of the companies safeguarding and whistle blowing policy and had attended training in the last three months.