5 Horse Leaze

We found the following examples of good practice.

The provider had policies and procedures in place to ensure staff followed effective infection control guidance. Staff and visitors had access to PPE and there was sufficient PPE supply in stock. Staff exempt from wearing PPE, had a risk assessment in place to help minimise the risk of spreading infection.

Visiting arrangements were in accordance with the most recent government guidance. Professional visitors were required to take a lateral flow test and evidence of COVID-19 vaccination status. Lateral flow testing is a fast track test which allows the provider to receive a COVID-19 test result within 30 minutes. Social distancing was observed as far as it was practicable to do so.

Staff had completed training in infection control, COVID-19 and putting on and taking off PPE. Staff and people using the service were tested regularly for COVID-19 and action taken if a test was positive. The home was very clean throughout and additional cleaning measures were in place. This helped to keep people safe and minimise the risk of spreading infection.

Regular infection prevention and control (IPC) audits were carried out to ensure staff followed good IPC practice. Where areas for improvement had been identified an action plan was put in place. This helped the service to closely monitor and improve IPC practice within the service.

5 Horse Leaze is a short break service based in an accessible bungalow. The service provides respite support and accommodation and personal care for up to six people with a learning disability. At the time of the inspection there were three people using the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The provider worked in line with best practice and in partnership with health and social care professionals to provide outstanding outcomes for people using the service and to help them to have a better quality of life. The provider supported people to live healthier lives and had adapted the design of the building to meet people’s needs.

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 exceptionally well led. The service went the extra mile to provide the best possible care for people living at the service and staff were proud of the support they were able to provide. The service was operated in a way that promoted outstanding care through effective quality monitoring.

People’s needs were holistically assessed and personalised care plans were created before people started living at the service. The service provided exceptionally effective and consistent care. Staff treated people as unique individuals with their own likes and dislike. People’s diversity and independence was promoted and staff challenged discriminatory practice.

People felt safe living at the service and staff understood their responsibilities to keep people safe from potential abuse. People were supported to have their medicines as prescribed and to maintain a healthy diet. Staff developed caring relationships with people living at the service and supported people using a range of communication methods to make choices about their day to day care needs.

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.

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 (published 26 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager at the service at the time of our inspection. 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.

The service was safe and people who used the service were protected from harm. Staff were knowledgeable about safeguarding and what to do if they had any concerns and how to report them. People who used the service told us they felt safe.

Risk assessments were personalised and robust and updated if there were any changes to people’s needs.

People with behavioural needs were supported using positive behaviour support techniques.

Staffing levels were sufficient to meet the needs of the people who used the service and care workers demonstrated they had the relevant knowledge to support people with their care. The registered manager told us there was always enough staff to cover any absences.

Recruitment practices were safe and records confirmed this. The service obtained references and carried out checks to ensure that staff could work with vulnerable people.

Newly recruited care staff received an induction and shadowed other members of staff on various shifts. Training for care staff was provided on a regular basis and updated regularly. All staff had a 100 per cent completion rate for their training. Staff spoke positively about the training they were provided and told us about a culture of staff helping one another at the service.

Care workers demonstrated a good understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

The service was supporting people who were subject to DoLS and had submitted notifications to the Care Quality Commission.

People were supported with maintaining a balanced diet in line with specific needs. People told us they enjoyed the food.

People were supported to have access to healthcare services and receive on-going support. The service made referrals to healthcare professionals when necessary.

Care workers demonstrated a caring and supportive approach towards people who used the service and we observed positive interactions and rapport between them. People who used the service and their relatives told us that staff were caring.

The service promoted the independence of the people who used the service and people felt respected and treated with dignity. People who used the service were supported to maintain their religious and cultural needs.

Despite the nature of the service being ‘short stay’ for the purposes of respite, people were supported to learn and enhance their skills during their time at 5 Horse Leaze, with the view of facilitating people to use their new and developed skills upon returning to the community. Care plans were person centred and focused on people’s individual needs. People were encouraged to set goals for things they wanted to do and people’s achievements were recorded to motivate them.

People who used the service were involved in the recruitment of new staff and sat on the interview panel and given the opportunity to ask questions.

Resident’s meetings were held on a quarterly basis for all people who had used the service. People’s views were recorded and changes were implemented accordingly.

The service had a key-working system to promote consistency in care. Staff demonstrated that they knew each person who used the service well.

Care plans were reviewed and any changes were documented accordingly. Staff told us that care plans were informative and contained vital information about people who used the service.

Concerns and complaints were encouraged and listened to and records confirmed this. People who used the service told us they knew how to make a complaint.

The registered manager had a good relationship with care workers and the people who used the service. Care workers, people and their relatives spoke positively about the registered manager and their management style.

The registered manager had involvement in community networks and utilised the knowledge gained from conferences and forums to facilitate a high quality of care at the service.

The service had quality assurance methods in place and carried out regular audits and spot checks. The service monitored the feedback from people who used the service by way of an annual questionnaire and implemented action plans to resolve any issues highlighted in the survey.

One person we spoke with told us the care they received was "good". We found there was documentary evidence in people's files they were risk assessed before they received care from the service. Risk assessments in people's files included manual handling and transition needs. We saw that where risks had been identified there were actions in place to ensure the person's safety and welfare.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. Staff we spoke with told us they worked with other external services to ensure people received the care they needed.

Appropriate checks were undertaken before staff began work. We reviewed four staff records. We found documentary evidence staff provided two references of previous employment and proof of address. There was evidence that medical and criminal record checks were undertaken by the provider.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Some of the people we spoke with said that they had choices in relation to clothing and meals and said that they had information about the placement before they came to live there. Other people who were present on the day of the inspection had limited verbal communication skills. Professional parties we spoke with said that there had been good communication between themselves and the provider. They also said that the staff on site had been able to demonstrate skills in dealing with challenging behaviour in their experience. When we spoke with relatives of people who use services and the feedback they gave was of a positive nature.