Stone Cottage

The care home accommodates 4 people in one building. People have their own bedrooms and bathrooms and there is a communal lounge and dining room. There is a communal garden and parking for people’s cars. The model of care is based on the Rudolf Steiner principles of providing a spiritually oriented community, supporting people with learning disabilities to continually develop, regardless of disability.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

Risks were assessed and measures in place to mitigate risk were documented for staff guidance, where further information was required this was added promptly to further mitigate risk. Medicines were managed safely. Staff understood the signs of abuse and how to report it to protect people. Accidents and incidents were recorded and monitored for trends and patterns.

Staff were recruited safely and there were enough staff to meet people’s holistic needs.

People were protected from the risk of infection, staff had access to personal protective equipment (PPE) and were following the latest government guidance.

People were leading their care and making their own decisions and choices in their day to day care delivery as much as possible, independence was well supported. People were supported by a regular team of staff that knew them well and they were relaxed and comfortable in their company.

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.

Right Care:

Staff received regular training and supervision, they had the skills, knowledge and support to carry out their role effectively.

Initial assessments took place to ensure that the service could meet people’s needs. People and their relatives were involved in care planning and care plans provided staff with information and guidance on how to support people as per their preferences, safely and in a person centred way. Information was provided in formats that met people’s needs such as, pictorial and easy read. People's records were updated following changes in support needs.

There was evidence of partnership working and seeking guidance from other health care professionals to meet people’s needs. The provider and the management and care team had a good understanding of the challenges faced by people with learning disabilities in accessing healthcare services and had measures in place to support people. People were supported to be as independent as possible with eating and drinking, peoples individualised dietary requirements were met.

People’s religion and culture was respected, people chose to take part in celebrating religious festivals and were supported to attend religious services as and when they wished.

Right Culture:

Systems and processes were effective in maintaining oversight of the safety and quality of the service. The provider sought regular feedback and there was an open and transparent culture. People their relatives and staff had the opportunity to share ideas and felt listened to. The provider ensured regular updates about changes in the service via newsletters.

People were empowered to play active parts in the operation of the home and enjoy the local community. People were well supported to develop and maintain relationships and friendships. Activities were person centred and focused on peoples interests and preferences.

The provider invested time and resources into staff development and wellbeing to ensure a good quality service and good outcomes 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 outstanding (published 26 January 2018).

Why we inspected

The inspection was prompted in part due to concerns received about restrictions on people using the service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stone Cottage on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection the service was rated ‘Good’. At this inspection, the registered manager and the chief executive officer / provider, demonstrated they had continued to develop the service and the overall rating of the service is ‘Outstanding’.

There was a registered manager. 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 demonstrated an excellent commitment to providing outstanding care that put people at the heart of the service. The registered manager and the provider led by example and inspired the staff to deliver person centred care that consistently achieved outstanding outcomes for all people using the service.

The staff were highly motivated and inspired to offer care that was kind and compassionate. They continuously went the 'extra mile' to ensure people lived as fulfilled and enriched lives as possible. People's individuality was upheld, which enabled them to grow in confidence and develop as much independence as possible. The staff were proud of the support they provided and the positive outcomes people had achieved. Information was provided to people in an accessible format to enable them to make informed choices and decisions about their care and support.

People and their relatives were very involved in decisions regarding their care and support needs. The care plans were highly personalised to reflect people's individual requirements. Staff had an excellent understanding of people’s values and beliefs on how they wanted to receive their care and support to be delivered. The support people received was flexible and responsive to their individual needs and preferences. This gave people an exceptional sense of wellbeing and excellent quality of life. The individual and social activities provided at the service consistently met people’s needs and preferences.

The service played a key role in the local community and was actively involved in building further links. People were encouraged and supported to regularly engage with events outside of the service. People using the service and families were actively encouraged to give their views and raise any concerns or complaints. People’s feedback was valued and responses to matters raised were dealt with in an open, transparent and honest way.

Staff continuously demonstrated they upheld and promoted the values and ethos of the service, through providing person centred care that respected the unique qualities of each person. The provider ensured the service kept up to date with current best practices through membership of relevant organisations and working with various professionals and agencies. The registered manager continuously looked at ways to improve the service and enhance people's lives. The feedback from people, relatives and professionals was consistently positive.

Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA). The registered manager was aware of how to make referrals to the local authority under the Deprivation of Liberty Safeguards (DoLS). In order to keep people safe the least restrictive practice was always used to ensure people’s human rights were fully promoted.

People continuously received support by the numbers of staff according to their individual assessed needs. People's health was closely monitored and staff worked with other healthcare professionals involved in their care. People received their prescribed medicines safely; the medicines management system was clear and consistently followed by staff. Healthy eating using some home gown organic produce was integral to promoting people’s good health and overall well-being.

We found that people's needs were assessed and care and support plans had been put in place to ensure their needs were met. We saw where people were unable to communicate verbally they had communication passports in place to enable people to understand how they communicated their needs. We found that people were supported to carry out a range of activities and work placements that met their needs.

We saw that appropriate arrangements were in place to protect people from the risks associated with the management of medication and checks were carried out on equipment to ensure that it was safe. We found that the provider listened to and acted on comments and concerns that were raised.

We found that people living at the service had detailed care and support plans that met their needs. We saw that people were involved in a variety of activities such as horse riding, indoor sports and music. We found that risk assessments were carried out to ensure peoples safety and welfare. We looked at staff records and found that appropriate recruitment checks had been carried out before staff started work at the service. We saw that the provider asked and listened to the views of the people who used the service, their relatives and other people involved in providing care at the service.