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Archived: Horncastle Care Centre


Inspection carried out on 12 June 2014

During a routine inspection

Horncastle Care Centre provides care and accommodation for up to 20 adults with learning and physical disabilities in two purpose built bungalows. Maple Lodge provides a home for up to 10 adults with acquired brain injury and neurological conditions. Willow Lodge provides a home for up to 10 young adults with learning and physical disabilities. At the time of our visit there were 17 people living at Horncastle Care Centre.

Two inspectors carried out this inspection.

We considered our findings to answer the questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based upon our observations during the inspection, speaking with six people who used the service, seven of the staff who supported them, from the care records of five people and the employers’ records for four staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Is the service safe?

People we spoke with told us they felt safe. One person told us, “I have no concerns at all.”

We saw that potential risks to people were appropriately assessed and planned for. The service routinely screened for risks associated with mobility, nutrition and additional risks specific to the individual. There were instructions for staff on how to reduce risks to people in these care areas.

People were protected against the risks of abuse as the provider ensured staff received appropriate training. Staff we spoke with knew the different types of abuse that might occur and the signs that might indicate abuse. Staff were aware of their responsibility to report abuse and told us that they confident to do so. We saw that where concerns were identified that these had been reported to the local safeguarding team and CQC in line with Sussex multi-agency policy and procedures for safeguarding adults at risk.

We saw leaflets were available within the service that contained contact details for external agencies such as the CQC where people could raise concerns.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs. We observed that staff had time to support people and responded to requests for assistance quickly. At lunch we observed that people were supported individually and at a pace that suited them.

Staff told us they felt supported by the provider to deliver care and treatment safely and to an appropriate standard. Staff received relevant training and had opportunities to achieve further qualifications.

We found that the provider regularly carried out audits in a number of areas and had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. When a care home identifies that a person who lacks capacity is being, or risks being, deprived of their liberty, they must apply to the local authority (the supervisory body) for an authorisation of deprivation of liberty. We saw that the provider made applications as required by the Mental Capacity Act 2005

Is the service effective?

People confirmed that they were happy with the care and support provided. One person told us, "They try and help all the time. They’re well trained.” Another person told us, “They provide stuff for you to do, if you want to do it.”

We saw that people's health and care needs were assessed and that people and their relatives were consulted in planning their care. Daily records showed that care was delivered in line with people's care plans. Staff we spoke with demonstrated that they knew people's care and support needs well and the ways in which people preferred their care to be delivered.

Is the service caring?

One person told us, “I’m fine, everyone is very helpful. The staff are brilliant.” Another person used their communication book to tell us, “I like this place, they are very good.”

We observed that the atmosphere was relaxed and that interactions between people and staff were positive. We saw that staff ensured they were at eye level when supporting people who used wheelchairs and checked with people before they provided support.

Is the service responsive?

We found that people were encouraged and supported to express what was important to them. One person told us, “I can express my feelings.”

In records we looked at and from speaking to people we found that people were supported to maintain relations with friends and relatives.

We found that regular meetings took place for people who used the service and that they were asked for feedback. We saw that regular satisfactions surveys were undertaken.

The provider undertook regular health and safety audits in order to identify assess and manage risks relating to the health and safety of people who used the service. We saw that the provider took action to ensure that people were supported within a safe service.

Following our previous inspection in February 2013 a number of compliance actions were set. In response, the provider sent us a report that detailed steps that would be taken to achieve compliance. At this inspection we found that steps had been taken by the provider and all the compliance actions were met.

Is the service well led?

All staff we spoke with told us that they felt supported by the manager. One staff member told us, “I feel very supported. I can raise things.”

We found that people who used the service, their representatives and staff were asked for their views about the care and treatment and they were acted upon. One person we spoke with told us, “They take note of what you say.”

We found that systems were in place to regularly assess and monitor the quality of the service that people received had been implemented and were effective.

Inspection carried out on 3 February 2014

During a routine inspection

People using the service told us the staff treated them with respect and supported them in a way that respected their privacy and dignity. They told us they were supported to make choices and maintain their independence. One person told us, "I can do what I want when I want. I come and go as I please."

People were not always protected from harm due to changes in their care needs and manual handling needs not being undertaken as detailed in their care plan.

We were told there were not always sufficient numbers of staff available to meet the needs of people using the service. Staff were not supported to deliver appropriate care and support.

Inspection carried out on 13 February 2013

During a routine inspection

We spoke with two people who used the service and one relative. People told us they were "Very happy" living at Horncastle Care Centre. One relative said that, in the past, the service was not as good as it was now and that it was "Starting to improve in every way." People told us their consent was obtained and they had many choices in their daily life. A relative said "We work together" to make decisions about people's care. People's care plans were reviewed regularly which ensured that they were accurate and fit for purpose.

People said their environment was clean and tidy. They told us that their rooms were cleaned daily and we observed a cleaner in the home during our visit. A relative said the environment was maintained to "A good standard." We observed that staff maintained good infection control practices.

We found that there were sufficient staff to meet the needs of people who lived at the home. People's needs were responded to in a timely manner and staffing levels maintained people's safety.

We found that the service had robust systems in place for obtaining and responding to complaints and concerns. People and their relatives understood how to raise a complaint and had confidence in the manager to respond appropriately. People said that staff listened to them and took action where needed.

Inspection carried out on 5 March 2012

During a routine inspection

People said they liked living at Horncastle Care Centre. They said they had visited the home before admission and been involved in discussions about the help they needed and their preferred day to day routines. People said there were different activities to do and that they could join in with activities if they wanted to. They said they were happy with the support they received and the staff looked after them well. People said they liked the food, there was a choice of menu and that they chose where to eat. People said they knew who to speak to should they have any concerns, but said they had no complaints.

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