50 Vassall Road

We found the following examples of good practice.

• There were signs and prompts around the home to remind people of hand hygiene and social distancing. Visitors were shown an advice sheet, describing the measures in place to minimise the risk of transmission and to keep people safe.

• Staff took the temperatures of any visitors entering the home and collected details for test and trace purposes. Visitors used a back entrance to the home to minimise movement through the premises.

• There was a designated area for donning and doffing PPE. Staff wore masks at all times in the house. No concerns were reported about the supply of PPE.

• People’s wellbeing was supported by maintaining contact with loved ones through phone calls and outside visits when weather allowed.

• There were contingency plans in place to manage an outbreak. Isolating and zoning was challenging within the building given people’s needs and the set up of the house, however there was a plan in place to manage this, in the event of an outbreak.

• Cleaning schedules were in place to ensure good hygiene was maintained. Staff signed to conirm when cleaning had been carried out.

• Testing of staff and people in the home was undertaken regularly to ensure any cases of Covid were identified and action taken accordingly. There were measures in place to support staff in taking time off, if needed.

Further information is in the detailed findings below.

The service is registered to provide residential care for up to six people with learning disability or mental health conditions. At the time of our inspection six people were using the service. 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. This means people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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 felt safe at the home and with the staff who supported them. People were protected from abuse and avoidable harm. This was because staff had been on training and had the knowledge and awareness they required to do their job effectively and help to keep people safe.

People’s medicines were managed safely within the service and where people wanted to they were supported to be responsible for their own medicines.

Risk assessments and care plans helped promote the safety of people when they were out in the community and within the home.

People were very well supported to exercise choice and control of their lives. The staff team supported them in the least restrictive way they could. There were policies and systems in use that helped the staff to do this. People were supported with their health needs and staff monitored their wellbeing.

People were supported to with enough to eat and drink to maintain good health. Menus were planned based on each person’s likes and dislikes.

The requirements of the Mental Capacity Act were met for people at the home. People were supported to have as much choice and control of their lives and staff supported them in the least restrictive way possible. There were policies and systems in the home that supported the staff and people who lived there.

People were encouraged and supported by the staff to maintain their independence. The staff team respected people’s privacy and dignity. People were cared for by a staff team that knew and understood their individual needs extremely well. People felt very relaxed about talking with staff members and raising any concerns or worries with them.

The service was very flexible and responded creatively to people’s individual needs or wishes. Activities were highly individualised to fully reflect people’s interests, wishes and choices. Care plans contained personalised information to help staff provide high quality care and support.

People received care based on their needs and preferences. They were supported to be fully involved in all aspects of their care and were supported to lead their lives in the way they chose. . People’s views and opinions were proactively sought and listened to. Feedback from people receiving support was taken constructively to drive improvements.

The home was very well run and people, staff and professionals all spoke extremely highly of the registered manager. The registered manager was extremely inclusive in the way that they ran the home. The registered manager was very positive in their approach about the care being provided for people and this was evident throughout our visit. The registered manager was a very strong role model for staff. They showed they had a very caring and generous approach with their team and the people who lived at the home. For example, they always made plenty of time for people whenever they wanted to speak with them. The staff we met also told us that the registered manager always gave them a great deal of time and support both formally and throughout the day. The staff and people in the home felt they were very supportive accessible and enabling to them.

There was a culture of mutual respect between the registered manager, staff and those who lived at 50 Vassall Road. People enjoyed interacting with the registered manager and the team. The atmosphere in the home was very relaxed, comfortable and homely. The registered manager, staff and people living in the home worked very hard to provide a service that was safe, caring ,effective and extremely responsive to people’s needs .

People, their relatives and professional’s involved in people’s care gave very positive feedback about the service. Quality monitoring and assurance systems were in place to help drive improvements and ensure a safe and high standard of care and service for people.

Staff always sought people's consent before doing anything and followed legal procedures when making decisions in people's best interests. People were actively supported by staff who explained things carefully when seeking consent. People's right to refuse was respected.

People had individualised care plans in easy read format. People's likes and dislikes were central to these plans and staff provided support in the ways people chose.

The premises and equipment were appropriate and suitably maintained. The provider had now implemented an effective quality assurance process.

Records at the home were now up to date and contained relevant information needed to ensure people's care needs were met.

We saw that people were relaxed in the home and were supported to be as independent as possible. Everybody living at the home had an individual program me of activities and three people were supported to work part time.

Staff were thoughtful about people's individual needs and had ensured they catered for these as much as possible. For one person who had frequent falls they had come up with an innovative solution to protect them from injury whilst maintaining their dignity.

Staff received up to date training and were well supported through both formal and informal supervision.

Care records, however, were only partially completed and risk assessments were not accessible to all staff. The home had lost all records in a fire two years ago but had still not developed new care plans. The provider's regular quality assurance visits by the area manager had identified this issue but no action plan had been developed to address this issue. Due to problems with the home's computer system monthly audits by the manager had not saved correctly and the home could not evidence these had taken place.