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Inspection Summary


Overall summary & rating

Outstanding

Updated 6 November 2018

Heronsmede is a 'care home'. It is a detached property, providing accommodation over two floors and has a secure rear garden. People in care homes receive accommodation and nursing or personal care as a 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 is registered to provide accommodation and support to eight people with a learning disability or autistic spectrum disorder. At the time of the inspection, there were eight people using the service.

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.

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.

The service was last inspected in January 2016. At that inspection, the service was rated good overall but requires improvement in the safe domain. At this inspection we found improvements had been made and sustained, therefore the safe domain is now rated good. We also found examples of outstanding care and support in both the effective and responsive domains which have been rated accordingly.

The provider kept staffing levels under review and people benefitted from being cared for by an established and experienced team of staff. There were sufficient numbers of skilled staff deployed appropriately to provide safe support for people. Robust recruitment practices helped to ensure suitable people were employed to work at the service.

People were protected from the risk of abuse by staff who were trained and had the knowledge and skills to identify safeguarding concerns and act on them. Risks to people's health and well-being were assessed and appropriate plans were in place to minimise risks. Regular checks were made regarding the safety of the premises and the provider had plans in place to manage foreseeable emergencies. Medicines were managed and administered safely.

People received extremely effective support from a staff team who were regularly supervised and had their personal performance evaluated at an annual appraisal. Staff were trained in the skills necessary to fulfil their role and had received extensive training in areas relating to the specific needs of people.

The strong person-centred approach focussed on individuals. The consistency of approach used by the staff team enabled people to make changes to affect positive outcomes in their lives. Staff worked with health and social care professionals to meet people’s complex health needs. They adopted a 'can do' attitude to supporting people to live life to the full in spite of those 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 support this practice.

People’s nutrition and hydration was monitored and staff supported them to have a varied diet.

The interactions between people and the staff were positive. Staff showed a genuine interest in the wellbeing of those they supported and demonstrated kindness and understanding toward people. Staff involved people in choices around their daily living and people's independence was encouraged.

People were relaxed and comfortable in the company of staff, they did not hesitate to seek support and assistance when required. People were spoken to and about in a respectful manner; their privacy and dignity were maintained.

Staff

Inspection areas

Safe

Good

Updated 6 November 2018

The service was safe

There were sufficient numbers of staff who were deployed appropriately to provide safe care. Recruitment processes were robust.

Staff had been trained in protecting people from abuse. They knew the actions to take to escalate concerns.

Risk assessments were in place which provided guidance to staff in order to manage and reduce the risks identified.

Medicines were managed and administered safely.

Effective

Outstanding

Updated 6 November 2018

The service was consistently effective.

Staff were very well-trained and supervised in their work. They were committed to maintaining and improving people�s health and well-being and worked closely with other healthcare professionals to ensure people received the support they needed to meet their complex health needs.

Staff worked hard to achieve positive outcomes for people despite the restrictions of their complex needs.

People using the service were effectively involved and supported with making decisions about their lives.

The adaptation and design of the premises and equipment helped staff achieve effective outcomes for people.

Caring

Good

Updated 6 November 2018

The service was caring

People were treated with kindness and respect. People were encouraged and supported to maintain their independence.

People�s privacy and dignity were maintained.

People were involved in their support as much as possible. Staff knew people�s individual needs and preferences very well.

Responsive

Outstanding

Updated 6 November 2018

The service was extremely responsive.

The service was consistently person-centred and put people at the centre of all they did.

People�s support plans and care records were extremely personalised, reflecting their individual, current needs.

The service was exceptionally responsive to people's needs, choices and preferences. They worked in partnership with people and their families to ensure people lived the best life they could.

The staff worked very hard to help people understand information and communicate their wishes. They were skilled in observing people and interpreting their needs.

Well-led

Good

Updated 6 November 2018

The service was well-led

There was an open and honest culture in the service.

Staff and relatives told us they had confidence in the registered manager�s leadership and found them to be approachable and supportive.

The quality of the service was monitored by the registered manager and provider.