Archived: Perrymans

We found the following examples of good practice.

The provider had made arrangements in line with government guidance for staff and visitors to the home to have their temperature checked on arrival. There was a supply of PPE provided for visitors to use if required. Staff were observed to be wearing appropriate PPE during the course of our inspection.

Where people had tested positive for Covid-19, the provider had been able to follow best practice and ensure that people self-isolated in their room. Due to issues of mental capacity, Deprivation of Liberty safeguards authorisation were sought from the local authority to help ensure the safety of other people and staff at the service.

There was an enhanced cleaning regime at the service, in line with the providers policy and best practice guidance from Public Health England, with surfaces and door handles frequently being cleaned using disinfectant. The provider ensured that people using the service were able to maintain links with family members and friends. People were supported to have visits from their relatives and friends in designated areas where social distancing was observed.

The provider had made arrangements so that all people using the service and all staff had been tested for Covid-19. The provider informed us that going forward they planned to have regular testing for people and staff.

Further information is in the detailed findings below.

Perrymans is a residential care home providing accommodation and support with personal care to six people with learning disabilities or on the autistic spectrum at the time of the inspection. The service can support up to six people. The service is a purpose-built care home all on one floor.

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

Procedures were in place to help protect people from the risk of abuse and staff understood their responsibility with regard to safeguarding people. Risk assessments were in place which provided guidance about how to support people in a safe way. There were enough staff working at the service to meet people’s needs and robust staff recruitment practices were in place. The service sought to learn lessons when accidents and incidents occurred. Steps had been taken to protect people from the risk of infection. Medicines were managed safely.

People’s needs were assessed before they commenced using the service to ensure those needs could be met. Staff received training and supervision to support them in carrying out their role effectively. The design and layout of the building was suitable for the people using it. People had a choice of what they ate and drank. The service worked with other agencies and professionals to support people’s health care needs. 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 told us staff were kind and caring and treated them respectfully. Staff had a good understanding of how to promote people’s privacy, dignity and independence. The provider sought to meet people’s needs in relation to equality and diversity.

Care plans were in place which set out how to meet people’s needs. People and their relatives were involved in developing these plans. People had access to a range of social and leisure activities. Complaints procedures were in place. Steps had been taken to make communication with people accessible to them. End of life care plans had been developed for people.

Quality assurance and monitoring systems were in place to help drive improvements at the service. Some of these included seeking the views of people who used the service and others. The service had links with other agencies to help develop best practice.

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 16 August 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.

Perrymans is a six bed service providing support with personal care and accommodation to people with learning disabilities. At the time of the inspection six people were using the service.

The service had a registered manager in place. 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.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were managed in a safe way

Staff received on-going training to support them in their role. People were able to make choices for themselves and the service operated within the spirit of the Mental Capacity Act 2005. People told us they enjoyed the food. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place.

Staff spoke positively about the senior staff at the service. Systems were in place to seek the views of people on the running of the service.

We have made one recommendation that service user meetings cover more issues then just menu planning.

The May 2013 inspection found that some people's needs had not been appropriately assessed by the service. They did not have up to date support plans. This meant they were at risk of receiving unsafe and inappropriate assistance. On this visit records confirmed that the provider had clarified people's current needs. We saw evidence that people received appropriate assistance. Support was planned and delivered in a way that ensured people's welfare and safety.

The last inspection found the service had not acted in accordance with the Mental Capacity Act 2005. People's mental capacity to make decisions about their health treatment had not been appropriately assessed. Relatives and professionals had not been involved in making 'best interests' decisions about their medical treatment. On this visit we found that people's records included assessments of their mental capacity to make decisions. When it was appropriate, a 'best interests' decision about treatment was made on a person's behalf. The service had met legal requirements in relation to people who do not have the mental capacity to make a decision.

In May 2013 we found that the provider did not have an effective process to improve the quality of the service. An audit had identified that people's support plans were not up to date. The provider had set a date for them to be updated. However, this had not occurred. On this visit we found that the quality of the service was monitored regularly. When improvements were required timely action had been taken. The provider's arrangements to assess and improve the service were effective.

The previous inspection found that the provider had not always responded appropriately to people's complaints. On this visit we saw that a person had received a full written response to their complaint. They had received it within the timescale specified in the organisation's complaints procedure. People's complaints were fully investigated and resolved where possible to their satisfaction.