Background to this inspection
Updated
12 March 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by one inspector.
Service and service type
Gloucestershire House is a 'care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We also reviewed information we had received about the service since the last inspection.
During the inspection
We spoke with three people who used the service. We spoke with one relative and received feedback via email from two relatives and a social care professional about their experience of the care provided. We spoke with nine members of staff including, the registered manager, the deputy manager, two activity staff, two physiotherapists and three care staff. We reviewed a range of records. This included three people's care records and the service’s medication records. We looked at four staff files in relation to recruitment and a variety of records relating to the management of the service, including quality assurance systems.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
12 March 2020
About the service:
Gloucestershire House is a care home that provides nursing and residential care and support for up to 30 people. Care and support was provided to people living with learning and physical disabilities. Support is provided within one adapted building.
The service was developed and designed prior to Registering the Right Support and other best practice guidance being published. The provider was knowledgeable about the guidance and that it is in place to ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. They were aware that its principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
The service was bigger than most domestic style properties. It was registered for the support of up to 30 people. At the time of our inspection, 30 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated, as the service was community-based and enabled independence, inclusion and choice for the people living there. The service consisted of five separate lodges within the building, each of which housed six people and had its own name and set of care staff. Staff did not wear anything that suggested they were care staff when coming and going with people.
People's experience of using this service and what we found:
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.
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 ensured that people were involved in decisions about their safety and empowered to take positive risks.
Feedback from people and relatives was overwhelmingly positive. There was consistent praise for the exceptional physical and emotional support provided by the staff at Gloucestershire House. Comments from relatives reflected the quality of the ongoing support for people to access meaningful activities in the home and community which promoted people’s independence and mental wellbeing.
People received highly effective and responsive support with their health and social care requirements and the safe administration of their medications. There was a strong, clear multi-disciplinary approach to meeting people’s care and support needs.
Staff demonstrated a culture of inclusivity and positivity that was evident throughout the service. Leaders constantly looked for ways to improve the service and ensure people received the outstanding support and care they deserved. Staff supported people to make decisions for themselves and engaged with people and their relatives about their wishes and preferences.
The service was a hub of activity with friendly staff providing care and support in a way people liked and enjoyed. Positive interactions took place between people, staff and each-other throughout our visit.
People had their privacy and dignity respected by staff, and there was a clear emphasis on independence.
The service's visions and values put people at the heart of the service. People were encouraged to comment on the quality of their support and their feedback was used to develop and enhance the service provided.
Gloucestershire House worked in partnership with health and social care professionals to ensure people’s care was well organised and met their expectations. People's care was regularly reviewed and was flexible. Staff responded to changes in people’s health and support needs to ensure people remained well supported and were happy.
Staff were skilled, motivated and knowledgeable. They had received appropriate training and support and were encouraged to develop their individual skills and interests.
The management team, staff and the provider understood the importance of the service within the local community and how family values and connections were vital to how people lived their lives. Community links were strong. People regularly accessed community based leisure activities and work based placements and were encouraged to engage with members of the public to raise the profile of the home and of those with disabilities.
Since our last inspection, under the leadership of the registered manager Gloucestershire House had continued to improve and had implemented some highly innovative support strategies. People clearly benefitted from a visibly person-centred culture that consistently delivered positive outcomes, reinforced by the provider's principles, values and expectations of staff.
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 (report published 5 July 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 reinspection programme. If we receive any concerning information we may inspect sooner.