Cartref House

Cartref House is 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.

Cartref House provides accommodation and or personal care for up to six people with a learning disability, physical and sensory needs, including autistic spectrum disorder. The accommodation is provided in a three-storey house with access to garden areas. At the time of our inspection six people were living at 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.

At our last inspection on 15 March 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

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.

People continued to receive safe care; risks associated with people's care and support were managed safely and relatives were confident their family members were safe and well cared for.

There were systems in place to keep people safe from abuse or harm.

People received their medicines when needed and there were suitable arrangements in place in relation to the safe administration, recording and storage of medicines.

There were sufficient numbers of staff to support people safely. There were suitable arrangements to prevent and control infection.

People continued to be effectively supported by staff who were trained and supported to meet their specific needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had sufficient amounts to eat and drink and were supported to access other health professionals to manage their day to day health needs.

People were supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support.

The accommodation was designed, adapted and decorated to meet people's needs and expectations.

People’s needs continued to be met by staff who were kind and respectful. People's privacy and dignity were promoted at all times.

Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.

The service was responsive to people’s communication needs in a person-centred way.

People's care plans contained information about their personal preferences and focussed on individual needs. People and those closest to them were involved in regular reviews to ensure the support provided continued to meet their needs.

Staff were supported through supervision and meetings which took place on a regular basis. Staff said they felt supported by the registered manager.

People's feedback was sought and used to improve the care provided.

There was an accessible complaints policy in place and people knew how to make a complaint.

The registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained.

The registered manager understood the requirements of their registration with CQC.

Further information is in the detailed findings below.

Cartref House is registered to provide care and support for up to six people who have a learning disability and or Autism. People were supported to learn life skills to increase their independence and confidence. At the time of our inspection, there were four people living at Cartref House. The people had different levels of independence, and required specific individual support.

There was a registered manager at the home. 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.

People were protected against the risk of abuse. We observed that people felt safe in the home. Staff recognised the signs of abuse or neglect and what to look out for. Both the registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.

The home had risk assessments in place to identify and reduce risks that may be involved when meeting people’s needs such as inability to verbally communicate, which could lead to behaviour that challenges and details of how the risks could be reduced. This enabled the staff to take immediate action to minimise or prevent harm to people.

Staff were recruited using procedures designed to protect people from unsuitable staff. Staff were trained to meet people’s needs and they discussed their performance during one to one meetings and annual appraisal so they were supported to carry out their roles.

There were sufficient numbers of staff to meet people’s needs. Staff were supported by their manager and felt able to raise any concerns they had or suggestions to improve the service to people.

Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff training plan showed that staff had all the essential training they needed to ensure they understood how to provide effective care, and support for people.

The systems for the management of medicines were followed by staff and we found that people received their medicines safely. People had good access to health and social care professionals when required.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards and the home complied with these requirements.

Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.

People’s care plans contained information about their personal preferences and focussed on individual needs. People and those closest to them were involved in regular reviews to ensure the support provided continued to meet their needs.

People were involved in assessment and care planning processes. Their support needs, likes and lifestyle preferences had been carefully considered and were reflected within the care and support plans available.

People were always motivated, encouraged and supported to be actively engaged in activities inside and outside of the home. People went out to their local community for activities and travel on holidays.

Staff were supported through supervision and meetings which took place on a regular basis. These were recorded any actions required were recorded and acted on. People’s feedback was sought and used to improve the care.

People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

The registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered manager understood the requirements of their registration with the Commission.

People living at Cartref House told us that they were happy there. One person said, 'The staff help and look after me well'; another person said, 'The staff are funny, they make me laugh. I am happy here'.

We heard staff ask for people's consent before we looked at people's personal files. Each person had a comprehensive plan of support which they had agreed with. The plans included people's preferences, needs assessment, goals for future independence and risk assessments.

People in the home had received their medication as prescribed.

Staff had received the training that they needed to care for people and to develop within their job role.

There were systems in place to monitor the on-going quality of the care and environment in the home.

People explained where they were going or what they were doing that day; one said 'we have a weekly plan so we know what we will be doing'. Another talked about the jobs they do around the house to keep it clean, one person had just finished cleaning the conservatory floor when we arrived.

People were heard making choices during the visit and staff were seen supporting people to be independent.

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Peple using the service were protected from the risk of abuse because the staff had received training and had a good understanding of their responsibility in reporting any suspected incidents.

Staff at the home had been recruited in a safe and robust way, with all necessary checks taking place before they started to work with people living in the home on their own.

We found the home had a complaints procedure and two people spoken to about this said they were happy to say when they were not happy about anything in the home.