Background to this inspection
Updated
5 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 carried out by one inspector.
Service and service type
101, Cheam Road is a care home. People in care homes receive accommodation and nursing or personal care as 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.
This inspection was unannounced.
What we did before the inspection
The inspection planning took into account what we already know about this service and the provider including previous inspection reports, notifications which are important events the service is required to tell us about and any feedback about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with four people who used the service. We also spoke with the registered manager and two staff. We observed medicines being administered and the support people received in communal areas, including the preparation and consumption of meals. We reviewed three people’s care records and medicine administration records (MAR). We looked at four staff recruitment files, together with the provider's training schedules. We also examined other documents relating to the management of the service, procedures, quality assurance audits, team and residents meeting minutes and satisfaction surveys.
After the inspection:
We spoke with four relatives and two health and social care professionals.
Updated
5 March 2020
About the service:
101, Cheam Road is registered to provide care and accommodation for up to seven people with a learning disability and autism. The aim is to help people to live with more independently in the community.
At the time of this inspection there were five people accommodated in one adapted building. Each had their own room, ensuite accommodation and shared communal space. The house was near the town centre and people were able to access community services easily.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service 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 using the service 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 told us they continued to feel safe with the service they received. Relatives confirmed this with us.
Staff received training to do with safeguarding adults and the provider followed clear safeguarding procedures that helped to protect people from harm.
People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe and work with them positively to help them be as independent as possible.
The provider ensured there were safe recruitment practices to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable. There were sufficient staff to meet people's needs.
Safe medicines management processes were in place and people received their medicines safely.
Whistleblowing procedures were in place and displayed on notice boards for all to see. Staff told us they were confident any concerns they reported would be dealt with appropriately.
Effective infection control procedures were in place and staff received training with food hygiene.
Comprehensive needs assessments were carried out and there was sufficient detail and personalisation in the care plan to ensure the person's needs were met in a personalised way.
The registered manager ensured staff completed training to ensure they were able to meet people’s needs effectively. Support was provided appropriately for staff with regards to their professional roles.
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.
Records showed people were supported to have their health needs met, with access to health professionals as required.
The registered manager and staff spoke about the people they supported with care and kindness.
The service was responsive to people’s needs. Staff worked together with people and their relatives to provide care and support to people to meet their individual needs. Staff were passionate about encouraging people to stretch their boundaries and to make safe but positive steps to advance their wellbeing and their life opportunities.
Staff understood people well and were able to provide consistent, supportive care which reduced people's anxieties and helped them engage in opportunities both they and their relatives told us they only once dreamt about achieving. Staff demonstrated good interpersonal skills in their communication with people. Staff were cheerful and showed tolerance and patience. They supported people to make their own decisions and gave people the tools they needed to overcome the difficulties they faced.
Assessments and care plans included details of people’s preferences and wishes for care and support. They told us they were fully involved in the assessment and care planning process. Paperwork and care plans were well kept and reflected the person-centred care we observed.
Management and oversight of the service was robust, and the staff worked in partnership with health and social services to provide the best possible outcomes for people.
The provider had systems in place to ensure concerns and complaints were responded to in an appropriate way. Staff knew how to raise concerns or recognise what might constitute a safeguarding concern and actions they should take.
There were well developed quality assurance mechanisms which took into account people's feedback and how the staff were meeting people's needs in line with their wishes and expectations.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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.
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 10 June 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 re-inspection programme. If we receive any concerning information we may inspect sooner.