L'Arche Bognor Regis Jericho

About the service

L'Arche Bognor Regis Jericho is a care home providing accommodation and personal care for up to six adults with learning disabilities and/or a variety of associated health and support needs. At the time of inspection, the service was supporting six people. People live in one large house.

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

Right Support

The service didn’t always provide people care and support in a safe, clean or well-maintained environment. Governance systems were not always effective and had not always identified or managed concerns. For example, kitchen hygiene standards were not formally monitored or checked and this shortfall increased the potential risk of harm to people. The community leader provided assurances of their improvement plans. There were shortfalls with managing risks in the environment and we have made recommendations about the management of the premises to support people to stay safe.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. We observed people participating in a variety of individual and group activities of their choosing. People and relatives told us staff supported people to take part in activities and pursue their interests in their local area. A visiting professional told us about how staff engaged with people to participate in activities and how the pandemic had impacted on opportunities. They told us, “Hopefully the houses will start mixing again, it’s good for everyone. It's a wonderful organisation and I admire the [staff] greatly”.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs with genuine regard for the person. A relative said, “The house is a wonderful place, the staff are wonderful people and they think the world of [the person]”. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. A relative told us how staff had supported their loved one with an interest in music, “Staff had thought it would be a good idea for [person] to work on their music”. The persons skills and enthusiasm continued to develop and resulted in them being able to sing happy birthday to a loved one.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People and relatives told us they felt safe.

Right culture

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. L’Arche Jericho operated a community shared lives model where ‘Core members’ (People) were respected and supported to live a quality life of their choosing.

Staff knew and understood people well and placed people’s wishes, needs and rights at the heart of everything they did. We saw people offered opportunities and choices within a collaborative culture based on respect and inclusivity.

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 2 February 2018)

Why we inspected

We undertook this focused inspection to assess that the service is applying the principles of Right support right care right culture. We have found evidence that the provider needs to make improvements. Please see the safe and well led section of this full report.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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. L'Arche Bognor Regis Jericho provides support and accommodation for a maximum of six adults with a variety of learning disabilities. These include Down’s syndrome and autism . At the time of this inspection there were six people living at the service, all of whom were able to communicate verbally and independently. People’s levels of support varied; with some people requiring support with personal care whilst others needed emotional support and were independent in other aspects of their lives.

L'Arche Bognor Regis Jericho 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 Bognor Regis Jericho are known as ‘core members’ and staff as ‘assistants’. Most assistants live in the service alongside the core members.

At the last inspection on 27 April 2015, the service was rated Good. At this inspection we found the service remained Good.

People and relatives told us they felt the service was safe. People remained protected from the risk of abuse because staff understood how to identify and report it. One person said “I feel safe and if I didn’t I would speak to someone”.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

People felt there was enough staff to meet their needs and felt staff were skilled to meet the needs of people and provide effective care. A relative told us “The staff always do very well at meeting the needs of everyone at L'Arche”.

Staff were given training updates, supervision and development opportunities. Staff spoke positively about training and supervisions they received from management and commented on how they found they could ask questions freely. One member of staff told us “We have a good knowledgeable manager who is very caring and committed”.

People’s nutritional needs were met and people reported that they had a good choice of food and drink. Weekly menus were discussed at a house meeting each Sunday. One person told us they liked to help in the kitchen and with evening meals and said “I help do dinner and helped with breakfast this morning”.

People’s individual needs continued to be assessed and detailed care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

Quality assurance audits completed by the registered manager and provider were embedded to ensure a good level of quality was maintained. We saw audit activity for areas such as infection control, care planning and training.

People and relatives all told us that they were happy with the service provided and the way it was managed. One person pointed at the registered manager and told us “I can go to her if I need to ask anything, she helps me”. A relative said “The manager is very efficient” .

Further information is in the detailed findings below

We saw that staff treated this person with gentleness and consideration whilst promoting their choice. This approach by staff in general was confirmed by our review of people's records.

We saw that staff interacted well with people when they were supporting them and were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence. We saw that activities were provided to suit individual needs.

We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These had been developed for each individual and documented their wishes and preferences in relation to how their care was provided and were presented in a form that assisted people to understand what they said. A relative's assistance was sought with this where the person was unable to fully contribute themselves.

Equality and diversity had been considered in the service by looking at each individual's needs. Any equipment or adaptations needed were provided.

Jericho was part of the L'Arche community in Bognor Regis. L'Arche also provided day services for people to attend. We were informed that these included working in the gardens growing vegetables and plants, arts and crafts, music and drama

During our visit we spoke with three members of staff including the house leader who was responsible for the day to day management of the home. We visited the Sycamore Day Centre and later in the day observed people when they returned from the day activities. Due to communication difficulties we were not able to speak to some of the people; however two of the people did briefly introduce themselves. People in the home looked happy and we saw staff treating people in a sensitive, respectful and professional manner.

We looked around the building which was clean and free from unpleasant odours. The bedrooms were personalised with photographs, books, computers and pictures.