Blackhurst Care Home

Blackhurst Care Home is a care home providing personal care to five people with sensory impairment, mental health conditions, learning disabilities and/or autism at the time of the inspection. The service can support up to 6 people in one adapted building. It is locate in the village community of Longnor, outside of Shrewsbury.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Effective risk management plans were in place. Risk assessments were updated and clear guidelines in place to guide staff as to how to support people.

The numbers and skills of staff matched the needs of people using the service. Staff recruitment and induction training processes promoted safety. Staff knew how to consider people's individual needs, wishes and goals. People were supported by staff who followed systems and processes to prescribe, administer, record and store medicines safely.

Right Care

People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to. Staff knew people well and interacted positively with them.

Staff helped people to have freedom of choice and control over what they did. People were supported to participate in their chosen social and leisure interests on a regular basis.

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.

Right culture

Governance processes were effective in ensuring records management was consistent to keep people safe, protect people's rights and provide good quality care and support. Important incidents were being reported to the Care Quality Commission.

The provider sought feedback from people and those important to them and used the feedback to develop the service.

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 25 October 2018).

Why we inspected

We received concerns in relation to the welfare of people. As a result, we undertook a focused inspection to review the key questions safe and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has remained good, based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blackhurst Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• People were supported by staff who were fully trained in infection prevention and control and who wore Personal Protective Equipment (PPE) in line with current guidance.

• People were supported to take responsibility for deep cleaning of their own rooms to promote their independence. Staff provided close oversight to ensure cleaning regimes were undertaken in line with current infection prevention and control guidance.

• People who had tested positive for Covid-19 were required to self isolate in their rooms in line with current guidance. Where possible, people were supported in rooms that were self contained and could be accessed independently from the rest of the home.

• People’s individual health and support needs were considered when they were required to self isolate. One person had a specific health need so the provider liaised with the local health team to agree a personalised isolation plan that specifically met their needs whilst also minimising risk of transmission of Covid-19.

• People’s hospital passports had been reviewed to ensure their health needs were up to date and relevant to the pandemic. People’s wishes and feelings regarding Do Not Attempt Resuscitation (DNAR) orders had been discussed and were clearly documented in their hospital passports.

• Staff were required to complete a daily Covid-19 risk declaration which considered whether they were at any disproportionate risk of Covid-19. This ensured that risks to staff were up to date and that action could be taken immediately to mitigate any enhanced risk to staff.

A registered manager was in post and present throughout this inspection. 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.

Blackhurst Care Home 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 the last inspection, published in June 2016, the service was rated good. At this inspection we found the service remained good.

People continued to remain safe as staff knew how to recognise and respond to concerns of ill-treatment and abuse. The provider followed infection prevention and control guidance. The equipment that people used was maintained and kept in safe working order. Any incidents, accidents or dangerous occurrences were recorded and if necessary investigated, to minimise the risk of reoccurrence. There were enough staff to support people to meet their needs. The provider followed safe recruitment procedures when employing new staff members.

People continued to receive care that was effective and personalised to their individual needs and preferences. They were assisted by a staff team who were well supported and had the skills and training to effectively assist them. People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. Staff were aware of current guidance which informed their practice and people's rights were protected by the staff who supported them.

People received support that continued to be caring and respectful. People were supported by a compassionate staff team. People's privacy and dignity was respected by those providing assistance.

People continued to be involved in developing their own care and support plans. When changes occurred in people's personal and medical circumstances, these plans were reviewed to reflect these changes. People's individual preferences were known by staff members who supported them as they wished. People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.

Blackhurst Care Home continued to be well-led by a registered manager and provider that people and staff found approachable and supportive and who they saw on a regular basis. People were involved in decisions about where they lived. Staff members believed their opinions and ideas were listened to by the provider. The provider had systems in place to monitor the quality of service they provided and where necessary made changes to drive improvements.

Further information is in the detailed findings below.

Blackhurst Care Home is a service that provides accommodation and support for up to six people with learning difficulties. There were six people using the service when we inspected.

There is a registered manager in post who is also the owner and registered provider. 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 from harm and abuse by staff who were knew how to recognise and respond appropriately to any concerns that they had. Staff knew how to support people safely. Risks associated with people’s care had been appropriately assessed including discussions with the person as to how to reduce risks. Staff did not start work until checks had been made to make sure they were suitable to support people and keep them safe.

People were supported to safely take their medicine by staff, and knew what their medication was for.

The majority of the staff had worked at the home for many years and the people living at the home have also lived there for many years. We observed mutually caring and respectful relationships between the staff and the people who lived there. People and those that mattered to them were involved in planning their own care. Staff were provided with up to date information and understood how to support people. People were supported by staff who were kind, caring and compassionate and who treated people with dignity and respect. Staff encouraged people to be as independent as they could.

People told us that they were supported to make their own choices and decisions about their care and support, with the focus being on enabling and celebrating their achievements. The registered manager encouraged people to raise any issues and people were confident that appropriate action would be taken.

There was a very positive culture where people were involved in their planning and support. They were encouraged to be the main decision maker in any actions which affected their lives.

There was clear and open leadership and communication by the registered manager so that staff knew what was expected of them.

The provider had checks in place to monitor the quality of the service and sought feedback from people, relatives and staff to drive improvements in the service.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People told us they were happy living at Blackhurst Care Home and they felt safe.

There were sufficient numbers of staff working at Blackhurst Care Home on the day of our inspection so that people received safe and personalised care.

Risks to the environment and people had been identified and managed in a way that ensured people's safety. The environment was clean and tidy but there were some areas where attention was required to maintain hygiene and cleanliness.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no application had needed to be submitted procedures were in place and staff had received training in these safeguards.

Is the service effective?

People's needs had been assessed before care was provided and their plan of care was individual to them. People we spoke with told us their needs were being met and that staff understood them. Staff showed a good understanding of how to respond to people's support needs.

Staff we spoke with understood how to support people living at Blackhurst Care Home and showed that they knew them well. All staff had received appropriate training to help them meet people's needs.

We saw evidence that staff and the registered manager worked closely with other health professionals to ensure there was a joined up approach to meeting people's care.

Is the service caring?

One person told us, 'It's very nice here'. Another person said the staff were, 'More like family'.

One member of staff told us, 'I love working here. I feel I have contributed to people having a different day each day'.

We saw staff treated people with respect, patience and as an individual. We saw people had choice offered to them and were involved in food shopping, making decisions about what activities they would like to do and what they would like to eat.

Is the service responsive?

Activities were provided for people which were individual and relevant to them. People we spoke with talked about the different activities they took part in and enjoyed. These included day services, walking, shopping, swimming and holidays. People were excited about a holiday they were going on the week after our inspection.

Incidents, accidents and complaints were acted on quickly by the registered manager. This helped to ensure that people received a good quality service at all times.

Is the service well led?

People were asked their opinions on the service. They told us they were listened to and saw the registered manager, 'All the time'.

The provider monitored the quality of care provided through observation and supervision of staff. All staff we spoke with had a good knowledge of the needs of people who used the service and their care and support needs. This helped to ensure that people received a good quality service at all times.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that they had attended so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally.

The provider had developed a system whereby they can fully monitor how well the home is meeting the needs of the people who live there.

People told us that they enjoyed the meals that were served to them and that they enjoyed helping the staff to prepare them.

People told us that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

People received health care support. Community services were accessed to support people when necessary.

Staff talked of their awareness of how to keep people safe from harm. They told us about the training that the service had arranged so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally.

People we spoke with said their comments were listened to.