Archived: Care Management Group - 78 Stubbington Lane

78 Stubbington Lane is a small residential care home providing personal care to six people, living with a learning disability, at the time of the inspection. The care home accommodates six people in one adapted building.

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

There were enough staff to meet people’s needs. People were supported by staff who were kind, compassionate and caring and who understood their likes, dislikes and preferences. Staff were trained to a good standard and could request additional training. Peoples care, and support plans were person centred and detailed.

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.

People were protected against the employment of unsuitable staff, staff were recruited safely. Where one person had a gap in their recruitment record, this was rectified immediately by the registered manager.

The provider had a robust complaints policy in place that was accessible to people, their relatives and staff. The provider and the registered manager had effective governance systems in place to identify concerns in the service and drive improvement.

The service applied the principles and values consistently 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 24 May 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.

There was a registered manager in post. 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.

In addition to the registered manager, a deputy manager was employed at the service, along with team leaders and support workers.

People were safe. Staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Medicines were well managed and people received their medicines as prescribed. Emergency systems had been put in place to keep people, visitors and staff safe.

The service was effective. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see their GP and other healthcare professionals when required. People’s healthcare needs were met and staff worked with health and social care professionals to access relevant services. The service was compliant with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that was easy to understand. People were supported to maintain relationships with family and friends. People were supported to eat and drink enough. Staff often went above and beyond in providing more than care, and became positively involved and supportive of people’s whole life aspirations and interests as well as needs.

Health and social care professionals gave positive feedback about the personalised approach of staff towards people and how well people were cared for. Comments included, “I have visited this home quite a few times for reviews and I have never had any concerns. The staff are very caring. In particular I have been impressed with the compassion and perseverance I have seen when they have been supporting some people with complex care needs.”

The service was very responsive to people’s needs. People received person centred care and support. They were offered a range of individual activities both at the service and in the local community, based upon their hobbies and interests. People, relatives and staff were encouraged to make their views known and the service responded by making changes. Transitions for people moving to the service were well planned. Staff had worked to ensure people had fair and equal access to healthcare services. A person's relative described the service as "fantastic", and went on to say, "I can't praise it enough. Since [name] has been at 78 Stubbington [name’s] life has changed completely. The difference is great, less anxiety and they can cope with life better than before."

People benefitted from a service that was well led. The registered manager and senior staff were well respected and demonstrated good leadership and management. They had an open, honest and transparent management style. When talking about the work they did the registered manager commented that he was always looking at "How we can do things better?" and "How can we get people to reach their heights of potential?"

The provider had systems in place to check on the quality of service people received and any shortfalls identified were acted upon. The vision and values of the service were effectively communicated. The management team had a clear plan for further developing and improving the service people received.

We considered all the evidence we had gathered under the outcomes we inspected. To answer five key questions:-

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

This is a summary of what we found:-

Is the service caring?

People were supported by kind and attentive staff. We saw staff knew the five people as individuals. People's preferences, interests, aspirations and diverse needs were recorded and met. Care and support was provided in accordance with people's wishes. People were keen to tell us about their recent achievements and experiences.

Is the service responsive?

People told us that the manager and staff listened to them. They reported they were

involved in making decisions regarding their care and the running of the home. People were offered activities each day but people told us these were optional and they could join in if they wanted. People’s independence was promoted. On arrival to the home one person was watching the television, another was cutting the grass. One person was still in bed, whilst another was loading their laundry into the washing machine.

Is the service safe?

People told us they felt safe. There were systems in place to make sure that the manager and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. The service was safe, clean and hygienic. Some people were responsible for keeping their room and the home clean with the support of the staff.

People were supported by staff who had the appropriate skills and experience to ensure people's safety and welfare. Staff had a good awareness of the needs of people who lived at the home. CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. The manager told us about a previous application which had been authorised but had now elapsed. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's health and care needs were assessed with them and care plans were produced from this process. People told us their needs were met and they had regular reviews to ensure they were satisfied with the care and support they were received. Staff received appropriate training and support to ensure they could meet and understand the needs of people.

Is the service well led?

People and staff spoken with all told us the manager was approachable and would listen to any concerns or ideas they had to improve the service. We were able to establish the home had an effective system for managing and assessing the overall quality of service provided. Staff received appropriate support through supervision sessions and were clear about their roles and responsibilities and management were supportive of their roles

The home had a medication procedure which staff were aware of and followed. Information was available on the medication people took and on their medical diagnoses to ensure staff were aware of how these could affect people. People were encouraged to be independent with the administering of their medication. Good protocols were held on medication prescribed take as necessary (PRN).

People had been involved in the development of their support plans and in the monthly review of their care and support. People told us they were happy living at 78 Stubbington Lane. They told us they had choices in how they lived their lives and took part in a wide range of activities both within the home and in the community.

People told us they thought the home was well decorated and met their needs. People had decorated and furnished their bedrooms to their taste. Most areas of the home were clean but there were a few areas which needed improving.

There were enough qualified, skilled and experienced staff to meet people's needs.

The home had a complaints procedure which was available to people. The provider responded to all complaints made.