Saint John of God Hospitaller Services - 22 Sandown Road

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 ensured people who lived at the home 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 living at the home received planned and co-ordinated person-centred support that was appropriate and inclusive for them. Although the home is larger than current best practice guidance, there were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People experienced care which was exceptionally person-centred, placing great emphasis upon ensuring people lived the best lives they could. Feedback received from relatives and a variety of visiting professionals described how the service had literally transformed people’s lives. They told us the change in people was amazing. One relative told us how as a result of the outstanding effort and level of care their loved one received from staff, they now were able to enjoy a relationship with their loved one, which was something they had not had previously.

Relatives and professionals told us people were safe living at the home. Risk assessments were in place to help staff keep people safe. Regular safety checks of the building were completed. Only suitable staff were employed. The manager used incidents as a learning opportunity to improve things.

People’s needs were assessed before they came to live at the home. Staff had appropriate skills to care for people. Staff received regular training. Relatives were very complimentary about how staff cared for their loved one, one relative told us, “Since [person’s name] has moved to Sandown Road, their quality of life has massively improved. They are doing things that would never have been possible in previous environments, and I believe that Sandown Road is enabling them to reach their potential. It has been wonderful to see.” People enjoyed a healthy and varied diet. People attended regular healthcare appointments. People’s bedrooms were decorated and furnished to their liking.

People received care from staff who were very caring and committed to their role. Staff were aware of the importance of maintaining both people’s dignity and independence. People were encouraged to be involved in their care to ensure their preference and choice were the focus of care delivered.

Regular reviews of people’s care were completed, to ensure good progress was made against planned outcomes. A complaints policy was in place, but no complaints had been received. People had access to documents in various formats to support their understanding and communication. End of life wishes were included in people’s care plans (where these could be established).

The service was without a registered manager. However, the provider had arranged for a peripatetic manager to oversee the service until the new manager came into post early 2020. They managed the service very well. The manager ensured information was shared with the appropriate authorities. When things had happened, action was taken to address any issues. A service improvement plan was in place and was updated monthly. The manager worked closely with various healthcare professionals. Staff, relatives and visiting professionals were very complimentary about the new manager. Comments included, “There has been a recent change in management, and I feel that the new manager has worked swiftly to identify areas of improvement.”

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was good (published 14 April 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.

At the last inspection in December 2014, the service was rated 'Good'. At this inspection we found the service remained 'Good'.

The home had a registered manager. 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.

Saint John of God Hospitaller Services - 22 Sandown Road is a single storey, bungalow style service providing residential care for nine adults who have learning disabilities and may also have physical disabilities. The service is situated in a housing estate and is close to local amenities. At the time of the inspection there were nine people who used the service.

Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring. Medicines were managed safely with an effective system in place. Staff competencies, around administering medication, were regularly checked. Appropriate checks of the building and maintenance systems had taken place to ensure health and safety was maintained.

There were sufficient staff on duty to meet the needs of people who used the service. Staff were available to provide one to one support and with visits out in the community. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A comprehensive training plan was in place and all staff had completed up to date training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to choose meals of their choice and staff supported people to maintain their health and attend routine health care appointments.

Care plans detailed people’s needs and preferences and were person-centred. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People who used the service had access to a wide range of activities and leisure opportunities. The service had a clear process for handling complaints.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance processes were in place and regularly carried out by the registered manager and registered provider, to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met. Feedback was sought from people who used the service through regular meetings’. This information was analysed and action plans produced when needed.

We spoke with the deputy manager and four staff and engaged with the eight people using the service. During this inspection we spent time in communal areas within the home so that we could observe the interaction between staff and people who used the service. We saw throughout the inspection that staff treated people with dignity and respect. We observed staff knocking on people's bedroom doors prior to going in and heard them engaging positively with people.

We found that people had detailed well written 'Individual Life Plans', which provided person centred information about each person living at Sandown Road.

We found that people were provided with support and care by an experienced staff team and that staffing levels and skill mix were sufficient to meet individual needs. Staff said, 'Sufficient staff, there are always two staff when we take people out.' 'Staffing levels have been increased when this has been needed."

We found there were good systems in place for ensuring there was sufficient equipment, which had been regularly serviced.

We found that there were good systems in place for the ongoing monitoring of the service.

We found that staff continually included people in their conversations and ensured people views were sought. We observed staff sensitively worked with people to reduce any their anxieties. Staff effectively assisted people who disliked meeting strangers feel a little more comfortable meeting us. Staff discussed people with a sense of genuine warmth and told us the home was run much like a large family. We found that staff had a good understanding of how to best meet each person's care needs.

We found that staff valued and cared about all of the people who used the service and could readily tell us what each individual liked and how to enable them to lead ordinary lives. We spoke in depth with two staff about people's ability to make decisions. We found that the staff used positive risk taking practices and understood the requirements of the Mental Capacity Act 2005. Staff actively involved family members in designing their relatives care and when appropriate sough the input of advocates.