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Inspection carried out on 8 October 2019

During a routine inspection

About the service

Croft Cottage is run by the Epilepsy Society. It is a residential care home providing accommodation and personal care to seven people. At the time of the inspection seven people were living there.

Croft Cottage accommodates seven people in one adapted building. Each person has an en-suite shower and share the communal facilities such as the kitchen, lounge/diner, laundry room and have access to a bathroom. They have an enclosed accessible rear garden.

Services for people with learning disabilities and or autism are supported

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.

People’s experience of using this service and what we found

People felt safe and were happy with their care. We observed they had positive relationships with staff which promoted their well-being. Relatives were happy with their family members care. They felt confident they received safe care. Relatives described the staff as exemplary, caring, kind with one relative commenting that “staff treated their family member as family”.

People were provided with information on how to raise concerns. A relative raised a number of issues with us about their experience of their family member’s care which they indicated they had raised with the provider. This was not recorded as a formal complaint. We have made a recommendation for the provider to work in line with best practice and policy in relation to the handling of concerns and complaint. We have referred the concerns raised by the relative to the provider to treat as a formal complaint.

Risks to people were identified and managed, which included infection control risks. Systems were in place to safeguard them. Staff were suitably recruited, and people were supported by a consistent staff team who had a good knowledge of their needs to promote people’s safety. Whilst the agreed staffing levels were maintained the change in people’s needs was having an impact on the availability of staff to support people. The service had responded to the changes in people’s needs and a request for a review of individuals was underway with the funding authority.

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 was clean, homely and maintained. People’s health and nutritional needs were identified and met. Staff were suitably inducted, trained and supported to enable them to support people effectively.

People’s privacy, dignity, choices and independence was promoted. They were supported by a staff team who were kind, caring, encouraging and supportive.

Person centred care plans were in place which identified people’s needs including their communication needs. End of life wishes were being explored. Staff were aware of people’s needs and responsive to them. People had access to a programme of activities.

The service was audited and monitored to promote safe practices. Peer audits had commenced. Systems were in place to enable people, staff and relatives to give feedback on the service. Records were suitably maintained. People and staff were happy with the way the service was managed. They told us the management team were accessible, approachable, flexible and responsive. Systems were in place to promote good communication and staff felt they worked well together as a team. Some relativ

Inspection carried out on 7 March 2017

During a routine inspection

Croft Cottage is a residential care home for seven people with epilepsy, learning and or physical disabilities. The accommodation is spread over two floors with lift access to the first floor.

At the last inspection in December 2014, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good:

People and their relatives were happy with the care provided. They described it as “Home from home, family environment, consistent individualised care”.

Systems were in place to keep people safe. Risks to people were identified, managed and kept under review. People received their medicines safely. Staff were suitably recruited and sufficient staff were provided to meet people’s needs.

Staff were inducted, trained, supervised and adequately supported in their roles. People had access to health professionals to meet their needs. Their nutritional needs were met and appropriate referrals and support was provided for people who required it.

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 service supported this practice.

Staff were kind, caring and had positive fun relationships with people. They treated people with dignity, respect and promoted their privacy.

People had care plans in place which outlined the care and support they required. They had regular reviews of their care to ensure any changes in their needs were addressed. Person centred and varied activities were made available to people. People were enabled to be involved in their care. Assistance and prompts were provided to enable people with limited verbal communication to have their needs understood and met. People and their relatives had the information they needed to make a complaint.

The home had an experienced manager and established staff team. They worked well together to provide person centred care to people. Systems were in place to audit the service and the provider monitored the service to ensure it was suitably managed.

Inspection carried out on 3 and 4 December 2014

During a routine inspection

This inspection took place on the 3 and 4 December 2014 and was unannounced. We previously inspected the service on the 10 May 2013. At that time the service was meeting the regulations inspected.

Croft Cottage is a care home which provides accommodation and personal care for up to seven people with epilepsy, learning and/or physical disabilities.

At the time of our inspection there were seven people living in the home. 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.

We saw staff engaged positively with people and respected their privacy and dignity whilst supporting them. Staff had a good understanding of people’s needs and the support required and promoted their involvement in their care and daily life of the home. One relative commented “The care is fantastic and in their experience it is the cream of the crop”. Another relative commented “The care given is first class and staff are friendly, lovely and so kind”.

The provider had systems in place to satisfy themselves that the service was being effectively managed and monitored. Staff, people who used the service and relatives were happy with the way the home was run. They told us the registered manager was approachable, available and the staff all worked well as a team. Staff were all clear of their roles and responsibilities and worked well together to provide safe, effective, caring and responsive care to people.

A relative commented “It is lovely as all the staff and manager seem to get on well together”. A consultant involved with the home commented “There is outstanding epilepsy expertise, but also unique knowledge of clients gained over many years and due to very little fluctuation in key workers and senior care staff, which is testament to the excellent care they provide, but also the management in place”.

People and their relatives told us they felt safe. Staff were trained in safeguarding adults and protocols were provided on the action to take if such incidences occurred.

Risks to people, staff and visitors were identified, addressed and managed which promoted safe care and a safe working environment. The home was clean, well maintained and systems were in place to prevent the risks of cross infection. Accident and incidents were appropriately managed which ensured people’s safety.

There were enough staff to support people and meet their needs. The home used thorough recruitment procedures which included a check for criminal convictions and written references. Staff were supported to meet people’s needs through induction, training and supervision.

Medicines were stored and administered to people safely. Staff undertook training so that they knew how to handle medicines safely and in line with guidance.

Care plans recorded the support people needed. These were detailed and kept under review which ensured staff provided consistent care for people. People had a weekly programme of activities and had access to leisure activities. Systems were in place to address complaints and concerns raised and people were aware of these.

People were able to make decisions on their care and staff supported people to attend healthcare

appointments and maintain their health and well-being. The home had a stable staff team who knew the people they supported well which meant they were quick to notice and respond to changes in people’s health.

Staff and people who used the service ate together and this created a homely family environment for people. People were offered choices and were encouraged to eat their meals independently with support given when required.

Inspection carried out on 10 May 2013

During an inspection to make sure that the improvements required had been made

There were seven people living at the home when we visited. We spoke with three people who lived at the home. They said that they were very happy with the care and support they received. One person told us "I am very happy here...all the staff take good care of me." Another person told us "I am comfortable here...I like it that I am independent and I enjoy helping with things like cooking and washing up." And third person told us "The staff are very good and work hard to keep us happy and safe."

People told us staff always sought their consent before assisting them. One person told us "They always ask me first before they help." Another person told us "They always take my permission...they never do anything against my wishes."

During a tour of the home, we noted all areas of the home were clean and tidy and the environment was pleasant for both staff and people living in the home. One person told us "The home is always clean", another person told us "My room is always very clean...I help staff clean my room by Hoovering and putting my things in nice order." A third person told us "Staff clean the home everyday which keeps it nice and tidy."

We found there were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

Reports under our old system of regulation (including those from before CQC was created)