Archived: Clacton Family Trust

Clacton Family Trust provides accommodation and care for people with a learning disability and physical disabilities within a care home and supported living flats. The care home consists of five bungalows on one

site. At the time of our inspection there were 37 people using this part of the service. Clacton Family Trust so provides personal care to people living in supported living units. People who use this part of the service have their own tenancies and receive most of their support from staff employed by Clacton Family Trust. At the time of our inspection, there were 33 people living in supported living units. These were predominantly located in a purpose-built property within the local area.

The care home has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This should ensure that people who live in the care home 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 living in the care home did not always 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

People's medicines were not always managed safely

The service did not learn and make changes where improvements were identified by professionals to ensure people were safe.

The provider did not always maintain the environment to ensure it was safe for people living in the service. We recommend the provider a maintenance schedule is implemented to address environmental improvements.

The service was not consistently well led. The provider and management lacked effective oversight of the service in order to take prompt action when things started to go wrong

Systems were in place to monitor the quality of the service; however, these were not effective and failed to highlight concerns raised during the inspection.

The service did not learn and make changes where improvements were identified by professionals to ensure people were safe

End of life care plans were not always in place for people. We recommend the provider develops end of life care planning for people.

People’s dignity was not always maintained did staff interacted with people in a caring and compassionate way.

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.

Mental capacity assessments were not always person centred and decision specific. We have recommended mental capacity assessments are reviewed.

People had access to adequate and meaningful activities for people

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 4 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Clacton Family Trust provides accommodation and care for people with a learning disability and physical disabilities within a care home and supported living flats. The care home consists of five bungalows on one site. At the time of our inspection there were 37 people using this part of the service. Clacton Family Trust also provides personal care to people living in supported living units. People who use this part of the service have their own tenancies and receive the majority of their support from staff employed by Clacton Family Trust. At the time of our inspection there were 21 people living in supported living units. These were predominantly located in a purpose built property and the remainder in other properties within the local area. There were a further two people receiving support in their own homes.

A registered manager was in post at the service. 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.

When we last visited the service in 2015, we found people did not receive consistently good care across the service. People and staff in the care home had a less positive experience than in the supported living service. At this inspection we found the service had made significant improvements and people were now received good quality care and support across the service.

There was a new registered manager in post. Improved systems had been introduced to monitor the quality of the service and address poor practice. The manager demonstrated strong leadership and was committed to continuing the process of improvement through introducing innovation and best practice.

There was an open culture at the service and staff morale had improved. People who used the service, their families and staff were encouraged to speak about their experience of care to the manager. Concerns and complaints were responded to and dealt with promptly and effectively.

People were protected from harm. Staff knew what to do if they were concerned people were not safe. Risk was well managed across the service. Where people were assessed to be at risk there were practical and effective measures in place to keep them safe. When implementing these measures, staff were encouraged to minimise any restrictions on people.

The registered manager ensured there were always sufficient numbers of staff on duty to keep people safe. Staff were recruited safely and managed efficiently to enable people’s needs to be met. Medicines were safely administered by appropriately trained staff.

Staff were skilled at meeting people’s needs. They had received effective training and the manager was proactive in ensuring staff had the necessary expertise, knowledge and attitude. Care plans were in place which provided staff with the necessary guidance to meet people’s needs and preferences.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. The management and staff understood their responsibility in this area and promoted people’s right to make choices about their care. Where people’s freedom was restricted the manager had made appropriate referrals for authorisation to the local authority.

People were supported to have a healthy diet. They were encouraged to be involved in choosing and preparing their meals and drinks. People were supported to maintain good physical and mental wellbeing. Staff worked well with health and social care professionals to meet people’s needs. Where people had complex needs, they had been referred for specialist support and guidance.

People were supported to have an active life and were encouraged to take part in hobbies and interests of their choice. Staff supported people to maximise their independence and develop new skills, particularly within the supported living service.

Staff knew people well and treated them kindly. People were encouraged to communicate their views. Where they had complex communication needs, staff were skilled at offering choice and enabling them to make decisions about the care they received.

Relatives who completed surveys as part of the home's quality monitoring process were positive about the care. They said: 'My [relative's] care is exemplary.' and 'X's social needs and physical and health needs are well catered for.'

Staff knew people well and they were able to tell us about their specific needs. We saw that there were respectful and caring interactions between members of staff and people living in the home. Staff listened to people and provided care and support in ways that met their needs and took into account their individual preferences.

The service co-operated with other agencies, such as community health services and the NHS, to ensure people received continuity of care and support when they needed to access other services.

There were systems in place to recruit staff safely and provide them with the training they needed. This ensured that they had the skills and knowledge to provide safe and effective care.

Clacton Family Trust was well run by a competent management team and there were effective processes to monitor the quality of the service. They listened and took people's views into account to make improvements.

Relatives who completed surveys as part of the home's quality monitoring process made positive comments about the home. One relative said 'At present absolutely everything is very positive for which we...are very grateful'.

We saw that people smiled and were relaxed and comfortable with staff and others living in the home. We saw good-humoured and friendly exchanges between staff and people living in the home.

During our inspection we saw that people received good care and that staff treated them with respect.

Staff demonstrated a good understanding of people's needs, likes, dislikes and preferences. They were also able to tell us about people's individual ways of communicating.