Background to this inspection
Updated
30 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 21 May 2018 and was unannounced. This was a comprehensive inspection carried out by two inspectors.
Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR prior to our inspection.
During the inspection we spoke with or met six people who lived at the home, spoke with three members of staff, including the manager and provider’s area manager. If people were unable to tell us directly about their experience, we observed the care they received and the interactions they had with staff. We looked at four people’s care records, including their assessments, care plans and risk assessments. We checked training records and how medicines were managed. We also looked at health and safety checks, quality monitoring checks and the results of the provider’s latest satisfaction surveys.
After the inspection we spoke to or received feedback from four relatives and we received feedback from one social care professional by email.
Updated
30 June 2018
Bells Piece is a care home providing accommodation, personal care and support for up to 13 adults who have a learning disability, physical disability or mental health conditions. At the time of our unannounced inspection on 21 May 2018, there were 13 people living in the home. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was no registered manager in place. 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. A new manager had started at the service in March 2018 and had submitted their application to register with the Commission. The new manager (hereon in known as the manager) assisted us with our inspection.
At the last inspection on 4 December 2015, the service was rated Good. At this inspection we found the service remained Good in Safe, Effective, Caring and Well-Led. The service had progressed to ‘Outstanding’ in Responsive.
People ‘s care and support was planned proactively in partnership with them. Staff used individual ways of involving people and people took a key role in the local community and had opportunity to access education and work. People were supported in a way that promoted an enhanced sense of well-being. They had facilities and support available to them to help them live as fulfilling a life as possible
People had opportunities to take part in activities that reflected their interests and preferences. This included activities on site, such as gardening and growing their own foods, going to the on-site art studio and contributing towards the running of the shop. People told us how much they enjoyed living at Bells Piece, spending time with their friends and being given opportunities to learn and to work.
People were supported by sufficient numbers of appropriately skilled staff to meet their needs and keep them safe. Staff understood their responsibilities in safeguarding people from abuse and knew how to report any concerns they had.
Risks to people’s safety were identified and action taken to keep people as safe as possible. Accidents and incidents were reviewed and measures implemented to reduce the risk of them happening again. People’s care would not be interrupted in the event of an emergency and people were made aware of fire procedures.
People lived in a home which was clean and hygienic and both people who self-medicated and those who did not received their medicines safely and as prescribed.
People’s needs had been assessed before they moved into the home to ensure staff could provide the support they required. Staff had the training and support they needed to carry out their roles effectively. All staff attended an induction when they started work and had access to ongoing training.
People’s rights under the Mental Capacity Act 2005 were respected. Staff understood the importance of gaining people’s consent to their care and how people communicated their decisions. Applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe.
People could make choices about the food they ate and were supported to maintain a healthy diet. People were supported to maintain good health and to obtain treatment when they needed it. Each person had a health action plan which detailed their health needs and the support they needed. Staff worked with external organisations and professionals to help provide the most effective care to people.
The home provided bright and spacious accommodation with access to large grounds and outside space. People had been encouraged to choose the décor and were able to personalise their bedrooms.
Staff were kind, caring and compassionate. People had positive relationships with the staff who supported them and there was a homely, caring atmosphere in the home. Staff treated people with respect and maintained their dignity. People were supported to make choices about their care and to maintain relationships with their friends and families.
There were appropriate procedures for managing complaints. Were complaints had been received by the service these had been responded to appropriately.
People, relatives and staff benefited from good leadership provided by the manager. Relatives said management was open and transparent and it was clear from our discussions that they had a drive to continuously improve the service people received. Staff said there was a strong team ethos and staff said they received good support from their colleagues. Staff had established effective links with health and social care professionals to ensure people received the care they needed.
People who lived at the home, their relatives and other stakeholders had opportunities to give their views. The provider’s quality monitoring systems were effective in ensuring people received good quality care and support. Important areas of the service were audited regularly and action plans were developed when areas for improvement were identified.
Further information is in the detailed findings below.