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Inspection carried out on 5 December 2018

During a routine inspection

This inspection took place on 05 December 2018 and was announced.

At the last inspection in September 2017 we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the safe handling of medicines, cleanliness and the premises and good governance. We also made recommendations in relation to the environment.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe and well led to at least good. At this inspection we found that the provider had improved the cleanliness and safety of the environment. People’s medicines were managed in a safe way and overall governance of the service had improved. They were no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

L’Arche Preston Moor Fold is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide accommodation for up to six people over the age of 18 who have a learning disability or autism/autistic spectrum disorder. There were five people living in the home at the time of our inspection. People who used the service liked to be known as core members and staff liked to be known as assistants.

The 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 had a registered manager 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 was run.

The service had systems in place to protect people from abuse, neglect and discrimination. People who lived at the service and their representatives told us they were happy with the care and support provided and made positive comments about the staff.

People’s individual risks were assessed and their safety was managed and monitored. L’Arche Moor Fold were confident in positive risk taking and this enabled people to maintain their independence.

Staff were safely recruited and we found sufficient numbers of staff to support people who lived at the service.

We found a medicines management had improved, medicines were stored in a safe area and people were administered their medicines by staff who followed safe procedures.

The service was clean and well maintained. Maintenance work and redecoration had been prioritised since our last inspection.

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.

Staff told us that they were supported and listened to. We saw evidence of staff training courses and found that the provider made sure staff were suitably trained and experienced to support people who lived at the service.

People had access to quality food and encouraged to make choices around meal preparation. The service supported people to eat and drink enough to maintain a balanced diet.

People told us that staff were caring and compassionate. L’Arche as an organisation embraced a ‘community’ ethos and this was evident throughout the inspection findings.

We looked at people’s care records and found a very good standard of person-centred information. Care records showed how p

Inspection carried out on 19 September 2017

During a routine inspection

This inspection took place on 19 September 2017 and was unannounced.

L’Arche Preston Moor Fold is registered to provide accommodation for up to six people over the age of 18 who have a learning disability or autism/autistic spectrum disorder. There were five people living in the home at the time of our inspection. The registered manager told us people who used the service liked to be known as core members and staff liked to be known as assistants.

The service had 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 the last comprehensive inspection on 11 August 2015 the service was meeting the regulations requirements at that time and was rated good overall. At this inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the safe handling of medicines, cleanliness and the premises and good governance. And we made recommendations in relation to the environment.

Medication administration records were not always completed in full and gaps were seen. Guidance from health professionals relating to medicines had been hand written on small notes on the records. Fridge and room temperatures had not been recorded in line with recommended guidance.

We saw some concerns relating to the cleanliness and maintenance of the home. There was dust and discarded items in the store room for medicines and food. Some areas of the home required updating and we saw a broken cupboard in the store room.

There was evidence of some certificates for example electrical safety, gas safety and employers liability.

There was some evidence of audits taking place to monitor the quality of the service. However not all areas had regular audits to ensure the home was safe for core members to live in. Some of the audits had only recently been commenced.

We saw positive feedback about the registered manager and the house leader and the support they provided to core members and assistants.

Systems to safely recruit assistants were in place. Assistants told us and records confirmed they had undertaken an induction on commencement in their role. Duty rotas demonstrated there were enough assistants in place to support the core member’s needs. We saw these identified which core member assistants would be working with. Staff told us and records confirmed staff had undertaken training that supported the assistants to deliver care to core members.

Core members told us they felt safe in the home. Staff were aware of the steps to take to deal with any allegations of abuse.

There was a rolling menu of meals that provided evidence that core members chose their menus and were involved in the preparation and cooking of meals. We saw food was prepared freshly on site and looked and smelled appetising.

There was evidence of the involvement of health professionals in the care of core members. The home had completed a hospital passport that contained important information about core members if they were admitted to hospital.

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

We saw positive meaningful conversations taking place between core members and assistants. Core members told us they were happy with the care they received in the home and we saw them treated with dignity and respect.

Core members had detailed records that reflected their current and individual needs and how assistants could support them. There was evidence of activities taking place for core members both inside the home as well as in the community.

Systems were i

Inspection carried out on 11 August 2015

During a routine inspection

This was an unannounced inspection which took place on 11 August 2015.

The last inspection of L'Arche Preston Moor Fold took place on 05 June 2013. At that time we found that the provider was fully compliant with all the regulations assessed.

L'Arche originated in France in 1964 and is now an international movement that builds faith based communities with people with learning disabilities. The L'Arche home in Preston is close to the city centre, next to a large park and with good access to community amenities and transport links.The house is a large detached property, with bedrooms on the ground and first floors. The home accommodates up to 6 adults with learning disabilities.

L'Arche Preston Moor Fold is part of an ecumenical Christian community which welcomes people of all faiths and those who have none. The community has a cycle of events throughout the year that provide a focus for spiritual development. These include an annual pilgrimage, monthly community gatherings, days of reflection and occasional retreats and gatherings. People who live and receive a service at L’Arche Preston Moor Fold are known as ‘core members’ and staff as ‘assistants’. Most assistants live in the home alongside core members.

The registered manager resigned in June 2015, however a new manager has been appointed and is in the process of registration. The manager was on leave during our inspection, the team leader was on duty on our arrival and assisted throughout. The team leader received feedback throughout and at the end of the 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.

People who used the service and their representatives expressed high levels of satisfaction with their care and felt confident that staff understood their needs. We found that staff worked positively with community professionals such as learning disability nurses, psychologists and speech and language therapists to ensure that people’s needs were met. Changes and recommendations by professionals were clearly communicated to people who lived at L'Arche in an easy to read format which helped them to understand the advice given.

We found that people were protected against avoidable harm and abuse.  Good systems were in place for reporting accidents and incidents and we found that the service was responsive to people's individual needs. 

Staff told us that they felt supported and had received training to enable them to understand about the needs of the people they care for.

L'Arche Preston Moor Fold met Mental Capacity Act 2005 legislation and associated requirements under the Deprivation of Liberty Safeguards (DoLS).

We found that people who lived at the service were supported to lead independent life styles and were encouraged to access the local community on a daily basis.  People who lived at L'Arche Preston Moor Fold were supported to engage in vocational, educational and occupational activities. Relatives informed us that their loved ones enjoyed it so much that many would rather remain at the service on occasions than return home for breaks.  Relatives felt reassured by this.

Staff were kind and caring.  We saw that people who lived at the service were allocated key workers and we observed trusting friendships between people who lived at Larch Preston Moor Fold and staff members.

We looked at care records and found high standards of person centred care planning.  Records showed that people who lived at the service were assessed against risk on an individual basis.  Care plans represented people's needs, preferences and life stories to enable staff to fully understand people's needs and wishes.

People who lived at the service and staff were invited to weekly meetings.  We found that people were encouraged to engage in the running of the service and involvement was clearly a key principle of care at the service.

We found that the service was extremely responsive to people's individual needs.  The high level of person centred care meant that people could lead independent lifestyles, maintain relationships and be fully involved in the local community. People and relatives we spoke with all confirmed to us how impressed they were with the level of encouragement for independent living provided and the support received.

The service had robust systems in place for monitoring the quality of care and support. We looked at auditing systems and found that the provider was responsive to needs of people who live at the service.

We found, due to the age of the building that some areas of the environment were tired looking and in need of refurbishment.  The team leader showed us maintenance plans which showed improvements to be made and these were on going.

Inspection carried out on 5 June 2013

During a routine inspection

Paid workers were referred to as assistants. The majority of assistants lived at the home and shared all aspects of day to day life with the people they supported.

Relatives and people who lived at the home told us they were always consulted about their care and support. Where people did not have the capacity to consent the provider acted in accordance with legal requirements. One relative said, “They always speak to us about important decisions such as medical care and holidays. They take our wishes into account and keep us informed of any changes”.

We found that comprehensive and person centred support plans were in place and that the people being supported were actively involved in developing them. One person told us that they regularly talked about their support plan with their key-workers and said they also had a review meeting once a year. People’s health needs were monitored and appropriate specialist support was sought when required.

Effective systems were in place for inducting, training and supporting staff. Staff members said they were equipped with the right skills to do their job. A relative said, “They are excellent….I’m impressed with the care being provided”.

We found safe systems for the effective management of medicines.

There was an effective system to regularly assess and monitor the quality of service that people receive and to ensure the provision of safe and appropriate care at all times.

Inspection carried out on 24 July 2012

During a routine inspection

Paid workers were referred to as assistants. The majority of assistants lived at the home and shared all aspects of day to day life, with the people they supported. On both our visits we observed a warm and relaxed atmosphere as residents and assistants chatted and worked together preparing the evening meal.

The assistants helped us to talk with people living at the home. All those currently resident required support and encouragement when talking to people they did not know. We had a joint discussion, with people telling us about their enjoyment of certain activities and their plans for the future. One person told us about a recent trip to America, their college courses and their hobbies. Another person was supported to talk about their job in a café and a forthcoming trip to London. One person told us the assistants were; “Brilliant.”

The relatives we spoke with were extremely happy with the care and support provided at the home.

We were told; “I am always, unfailingly kept up to date. Communication is excellent. The support is quite exceptional, the assistants so thoughtful. It is like an extended family. Decisions are taken together. Everything is done with care and love, with the individual at the centre.”

And from another relative; “We are fully involved and more than happy. Anything we want to contribute is always welcomed and taken on board. We have absolute confidence and have never had any misgivings.”

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