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Raby Hall Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 July 2019

About the service: Raby Hall is a residential care home for people who have autism. The service was split between the main building of Raby Hall and an annex called The Courtyard; there was also a part of the building that was currently not being used. These two parts of the service had a different registered manager. At the time of our inspection the service provided accommodation and support for 18 people in a variety of settings, including individual self-contained flats, three people within a flat and shared group accommodation.

People’s experience of using this service: At our previous inspection in July 2016 the service was rated as good. At this inspection we saw that the service needed to make improvements and has been rated Requires Improvement. This is because, the systems in place to address and reduce risks to people were not always working effectively; exposing people to risk of harm. Processes were not always followed to ensure that decisions made on a person’s behalf were appropriate and in their best interests. Some people’s support plans and other reports were not consistently written in an everyday and respectful manner; at times they did not demonstrate treating the person concerned with dignity and respect. Leadership of the service had been inconsistent in ensuring all aspects of the service provided for people was appropriate and of high quality.

We found the registered managers of the service to be candid and responsive during our inspection; with some of the areas requiring improvement being addressed within the inspection timeframe.

In June 2017, CQC published Registering the Right Support. This along with associated good practice guidance sets out the values and standards of support expected for services supporting people with a learning disability and or autism. The service has not been developed and designed in line with this best practice guidance. Raby Hall was at the centre of a large campus of five registered services for up to 59 people with autism along with day services for more people. Current best practise guidance promotes housing models that increase opportunities for people’s independence, choice and control so they are able to achieve the best possible outcomes.

Some of this was mitigated by the renovation of the accommodation within Raby Hall, 10 people stayed in the main building in self-contained ‘flats’ for between one to three people; with another seven people living in the courtyard area of the building with a separate entrance. This helped create a less institutional feel within people’s home.

People told us that they were happy with the support they received. There was a friendly atmosphere at the home and people looked relaxed and comfortable. Staff were thoughtful and spoke with people in a kind and dignified manner.

People and their relatives told us they felt safe living at Raby Hall. Staff received training on and were knowledgeable in how to safeguard people from the risk of harm and abuse. New staff were safely recruited in line with best practise. People received their medication safely, the home was clean and the main building was safe.

We saw that people’s needs and wishes were assessed and recorded as part of an initial assessment. Staff at the service had tailored how people were introduced to the home in ways that met their needs and preferences as much as possible.

Each person had an individualised care plan that asked people the question, “What’s important to me.” These plans outlined people’s preferences, likes and dislikes. From observing people’s support, it was clear that staff knew people and their support needs and preferences well. People’s relatives told us that they were consulted on people’s care plans.

Each person had a health care plan called, “All about my health” which detailed people’s healthcare needs. We also saw that staff kept good records of people’s daily health, with any concerns they had receiving prompt attention. We saw examp

Inspection areas

Safe

Requires improvement

Updated 9 July 2019

The service was not always safe.

Effective

Requires improvement

Updated 9 July 2019

The service was not always effective.

Caring

Good

Updated 9 July 2019

The service was caring.

Responsive

Good

Updated 9 July 2019

The service was responsive.

Well-led

Requires improvement

Updated 9 July 2019

The service was not always well-led.