Archived: Care Management Group - 42 Twyford Gardens

42 Twyford Gardens 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. Care and support is provided for up to four people with a learning disability, autism and/or other complex needs. At the time of our inspection, there were three people living at the service. The service is a modern, detached bungalow within a quiet residential area in Worthing. The accommodation comprises a large, communal, open-plan sitting, dining and kitchen area with access to a rear garden. People have their own spacious bedrooms with en-suite facilities.

At the last inspection on 3 September 2015 the service was rated overall Good. At this inspection we found the service remained overall Good. At the last inspection we found robust staff supervision procedures had not been in place. We asked the provider to make improvements in supervision procedures and at this inspection this had been addressed. One member of staff told us, “I have had supervision, appraisal and a mid-year review.”

Systems had been maintained to keep people safe. One person told us how they felt safe with the care provided. They knew who they could talk with if they had any worries. They felt they could raise concerns and they would be listened to. People remained protected from the risk of abuse because staff understood how to identify and report it. Assessments of risks to people had continued to be developed. Staff told us they had been supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.

People's individual care and support needs continued to be identified before they received a service. Care and support provided was personalised and based on the identified needs of each person. Comprehensive and detailed care plans provided staff with information about how people wished to be cared for in a person-centred way. People met with their keyworkers monthly to discuss the care to be provided. One person told us how they felt listened to, supported to be independent and they were involved in decisions about their care. Staff had a good understanding of consent.

One person and a relative told us they were happy with the care provided. People continued to be supported by kind and caring staff who knew them well and treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. A relative told us, “The staff here are great.” Staff told us it was a good team. One member of staff told us, “It’s a good team. Friendly and our service users make it a good team. If they are happy, everyone else is happy. We all pitch in.”

The provider continued to have arrangements in place for the safe administration of medicines. People were supported to get their medicine safely when they needed it. People continued to be supported to maintain good health and eat a healthy diet.

Staff and visiting health and social care professionals told us the service continued to be well led. Staff told us the registered manager was always approachable and had an open door policy if they required some advice or needed to discuss something. The registered manager carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted about the care provided through reviews or by using quality assurance questionnaires.

We spoke with a visiting music therapist, who said 'Every effort is made for care to be individualised. The music therapy is really respected.'

We spoke with the acting manager and three senior support staff, including two seniors. One member of staff said 'It is really good here. The manager is always approachable.' Another told us 'The extra staff during the day means people can do more things, so we can really support people'. The third said 'we are really well supported'.

We reviewed care records for two people. Care and support were planned and delivered so as to ensure the welfare of people using the service and to meet their individual needs.

People were supported appropriately with their nutritional needs and were helped to make choices.

We found that people were protected from the risk associated with unsafe management of medication because there were effective systems in place.

People using the service benefited from a staff team who were well trained and supported to do their job.

People's views and experiences were taken into account in the way the service was delivered. It was our observation that they chose what they wanted to do and how they wished to have their care and support provided. We saw that people's routines were respected by staff, who also supported them in attaining their aims and objectives. For one person this had included flying in an aeroplane.

Staffing numbers were consistent, which meant that activities had been planned and carried out such as outings and college attendance. Staff had the skills and training to meet the needs of the people they support, for example they knew how to protect people from the risk of abuse.

The provider had made checks on the quality and safety of the service provided, including on fire safety, medication arrangements, and health and safety issues.