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We are carrying out a review of quality at Cricklade House. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 6 December 2018

During a routine inspection

Cricklade House is a care home. 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. Cricklade House provides accommodation with personal care for up to four people with learning disabilities and autism. At the time of our inspection four people were living in the home.

The care service has been developed and designed in line with 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 inspection took place on 6 December 2018 and was unannounced. This meant the provider did not know we would be visiting.

At our last inspection, in May 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.

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.

At this inspection we found the service remained Good.

Why the service is rated Good.

Sufficient numbers of staff were deployed at the time of our visit. Staff performance was monitored. Staff received supervision, training and support in a variety of ways to ensure they could meet people’s needs.

Medicines were safely managed and checks were in place to identify and take actions when shortfalls were identified.

Staff had received safeguarding and whistle-blowing training and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions. The principles of the Mental Capacity Act (MCA) 2005 had been followed.

Risk assessments and risk management plans were in place. Personal care was delivered in line with assessed needs and accurate monitoring records were maintained.

People’s dietary requirements and preferences were recorded and people were provided with choices at mealtimes.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

Care was personalised, responsive and ensured individual needs were met.

A range of leisure and therapeutic activities were offered that provided people with stimulation, entertainment and engagement.

Systems were in place for monitoring quality and safety. Where shortfalls or areas for improvements were identified these were acted upon.

Relatives and a health professional spoke positively about the quality of care and support people received.

Inspection carried out on 3 May 2016

During a routine inspection

We undertook an unannounced inspection of Cricklade House on 3 May 2016. When the home was last inspected in January 2014 no breaches of the legal requirements were identified.

Cricklade House provides personal care and accommodation for up to four people. At the time of our inspection there were four people living at the home.

A registered manager was in post at the time of our 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.

The home ensured people were safe by having positive risk assessments in place which promoted independence but identified and minimised risk. Staffing levels were safe and enabled people to be supported in a range of activities. Medicines were managed and administered safely.

New staff completed a full induction programme aligned with the Care Certificate. This process focused on knowledge and learning specific to the needs of the people living at the home. On going training was in place for staff, together with a supervision and appraisal process.

The registered manager was aware of their responsibilities in regards to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the capacity to consent to care or treatment or need protecting from harm. The registered manager kept clear records of the steps taken in the DoLS process. Staff were aware how the Mental Capacity Act 2005 was relevant to their role and applied the guiding principles through choice and enablement.

The home was responsive to people’s needs as staff worked in a person centred way. Care records were detailed and gave clear guidance on how to effectively support people. Staff were knowledgeable about how people preferred to be supported. We observed positive relationships between people and staff.

Systems were in place to monitor the quality of the home. People, staff and relatives were asked to give feedback about the home. Comments received from relatives about the home were positive and consistently good. Staff felt valued in their roles and received support through regular supervision.

Inspection carried out on 6 January 2014

During a routine inspection

It was difficult for us to engage with the people living in the home due to their diagnosis of autism. However we observed interactions between staff and people living in the home.

The quality of record keeping was excellent and provided evidence of systems in place to seek the consent of people using the service regarding their care and treatment. Recordings and observations showed that people were able to demonstrate their consent in a variety of ways and in the manner that they chose to communicate.

Care plans were comprehensive and person centred. They showed that people enjoyed many activities of their choosing. People were supported to learn new skills and maintain existing ones through realistic goals and appropriate support from staff.

The systems in place for the storage, administration and recording of medicines were robust and processes were audited. People were encouraged to take as much responsibility for taking their own medicines as possible.

The service had an effective recruitment process that reduced the likelihood of inappropriate people being appointed. The induction programme was comprehensive and followed-up with discussions with the manager to ensure that the learning was embedded in the daily practice of staff.

There were processes in place for assessing and monitoring the quality of service provided. These included auditing of systems and records but also included being sensitive to the feedback from people using the service on a daily basis.

Staff said that the managers were always there and that the home felt like a family. One person said that the �service users are lovely� and that �there was real job satisfaction in this.�

Inspection carried out on 16 December 2012

During a routine inspection

It was difficult for us to engage with the people living in the home due to their diagnosis of autism. However, we observed staff who they were familiar with, engage in conversations and activities.

Staff told us how people were involved in making decisions about their everyday lives. People living at the home had limited verbal communication. Methods people used to communicate were described in their care plans. Staff were knowledgeable about the communication methods people used.

We saw that people�s needs were assessed and that care plans were put in place. This ensured that people�s needs were met. People were involved in reviews of their care and where appropriate relatives were invited.

Staff met with the people living at the home individually on a monthly basis. They discussed if the person had any suggestions, comments or complaints.

Staff told us that they received regular training and felt supported in their roles. They said the management of the home were very approachable. If staff had an issue they felt confident to raise it with them.

In the event of abuse being witnessed or suspected the homes safeguarding policy contained guidelines for staff to follow. Staff were able to explain to us what they would do if they witnessed or suspected that abuse was occurring in the home.

The home had procedures in place to ensure that where people were assessed to lack capacity to make more complex decisions, these were made in people�s best interest.

Inspection carried out on 20 March 2012

During a routine inspection

When we arrived the people were out at their day centre and the provider organised for them to return to the house after lunch. On their return people were observed moving freely between their bedrooms and the communal areas. The individuals were given a choice whether they would like to stay in the home for the afternoon or return to their planned activities after about 45 minutes. All the individuals made a choice to return to the day centre.

Due to the nature of the people�s condition it was difficult to engage with the people living in the home due to their diagnosis of autism. However, we observed staff who they were familiar with, engage in conversations and activities.

We observed staff interacting with individuals in a positive and inclusive manner and at a pace suitable to the individual. Staff were knowledgeable about the support needs of the individuals and how their diagnosis of autism effected their every day living.

Staff told us how they supported the people living in the home to make decisions on a daily basis in respect of how they wanted to spend their time, giving choices in respect of what to eat and drink and what to wear. Care plans included how people communicated and how the staff support people with making day to day decisions.

Some of the individuals use non verbal communication and staff told us that they supported people to make decisions through the use of pictures and photographs. This included how people can express their emotions, food choices and activities. The manager told us they were continually reviewing these and increasing the pictures that were available to the individuals.

People living in Cricklade attended a day service five days per week. This was provided by the organisation within another residential service managed the same provider. Activities organised were varied and included swimming, going to the gym, shopping trips, lunch trips, coffee mornings at the local church, bowling, arts and crafts and cooking to name a few. The manager told us that the activities were planned with the people taking into consideration their preferences and known interests.

People�s personal and health care needs were being met. People were registered with a GP and attended regular appointments with a dentist and optician.

People contribute to the cost of transport. However, this was not clearly documented, ensuring it was open and transparent and that they had agreed to the expenditure.

Reports under our old system of regulation (including those from before CQC was created)