21 January 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection team consisted of one inspector.
Service and service type
Saint John of God Hospitaller Services – 22 Sandown Road, is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
There was no registered manager at the service. However, there was a peripatetic manager who was managing the service until the new manager came into post. A registered manager is someone who, along with the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information available to us since the last inspection. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from commissioners and professionals who work with the service, including the local authority safeguarding adults’ team. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We also contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During the inspection
We spoke with the manager, the operations manager, three support workers, one senior support worker and one domestic. We were unable to speak with people living at the home as people were unable to communicate with us. However, throughout the inspection, we observed positive practices and outcomes, which demonstrated how well staff knew the people they cared for.
We reviewed a range of records. This included two people’s care records and medication records. We looked at one staff personnel file and records related to the management of the service.
After the inspection
We continued to receive information from the manager to confirm the inspection findings. We spoke to two relatives. We also received written feedback from two professionals and spoke to one professional on the phone.
21 January 2020
Saint John of God Hospitaller Services - 22 Sandown Road, is a care home providing accommodation and personal care for up to nine people living with a physical, learning disability or autism. At the time of inspection, nine people were living at the home.
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.
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.