Tiverton Drive

Tiverton Drive provides accommodation, personal care and support for up to four people who have mental health and learning difficulties. The service specialises in providing 'aftercare services'; the care and support of people who may have been detained under the Mental Health Act 1983 and then discharged from certain sections of the Act. The provider worked closely with other professional organisations and agencies in providing the agreed care and support to people. There were four people living at the home on the day of our inspection visit but only two people received personal care. Each person had their own bedroom and there was a shared lounge, bathroom and a dining room area that people used.

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

People were supported by a well-established staff team that knew them well and how to keep them safe.

Staff were trained in safeguarding and demonstrated a good understanding of recognising signs of abuse. Staff knew how to report any concerns and told us they would be acted on appropriately by the management team.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the key questions Safe and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence. People were supported to live their lives how they wanted to and were supported to continue doing things that interested them.

Right care: People were supported by staff that were kind and caring. Staff were passionate about their roles and the people they were supporting. They knew people well and knew there likes, dislikes, needs and preferences. This allowed staff to provide personalised care that met people’s needs.

Right culture: There was a positive culture in the service that promoted independence. The staff team spoke positively about each other and the support they received from the management team.

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’s care and support was personalised and tailored to meet their needs. Staff showed a good understanding of people; their likes/dislikes, routines and their preferred methods of communication.

Staff supported people to access the community, be involved in activities and interests that they wanted to pursue and staff encouraged and prompted people to be as independent as possible.

People were supported to take their medicines and for those people who could, they were encouraged to self-administer their own medicines. People received their medicines by trained and competent staff. Staff understood what action to take should an error occur with medicines. Daily medicine counts ensured errors were kept to a minimum.

Staff were provided with training and regular refresher training which enabled them to carry out their roles effectively. Staff told us they felt they were supported.

The staff team ensured people’s health needs were met and sought appropriate healthcare when required. This included working closely with mental health support teams.

A variety of audits and monitoring systems were in place to maintain oversight of the service and to further drive through improvements which supported good care outcomes for people.

Risks to people had been assessed and identified. Staff had information which helped them to understand people’s individual risks and how best to support them to reduce these.

The registered manager welcomed the inspection and during our visit, implemented improved ways of recording certain information and risks.

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 28 November 2018).

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

The overall rating for the service has remained good based on the findings of this inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Tiverton Drive on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Selborne Care Limited is a large provider of care services which had been acquired by another provider, CareTech since the last inspection in 2016. Selborne Care Limited continues to be the legal entity for 5 Tiverton Drive.

5 Tiverton Drive provides accommodation, personal care and support for up to four people who have mental health and learning difficulties. The service specialises in providing 'aftercare services'; the care and support of people who have been detained under the Mental Health Act 1983 and then discharged from certain sections of the Act. The home works closely with other professional organisations in providing the agreed care and support to people. There were three people living at the home on the day of our inspection visit. Each person had their own bedroom and there was a shared lounge, bathroom and a dining room area that people used. The home also had an annexe that included a small lounge area, kitchen and bedroom. This was unoccupied, but a person was planning to move into the annexe after our inspection visit.

People in care homes receive accommodation and nursing and/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.

At our last comprehensive inspection in February 2016, we rated the service as Good overall. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

There had not been a registered manager at the home since 10 October 2017. However, a manager was responsible for the day to day running of the service. 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 time of our inspection visit, there was a manager in post who was in the process of applying to be registered with us.

The manager and staff continued to assess risks to people’s health and welfare and care plans provided accurate information for staff to minimise the identified risks. There were the same staff and people had lived at the home as our last inspection. They were familiar around each other’s company which helped people be relaxed with staff. We were confident staff knew people well and they continued to support and encourage people’s independence.

Staff understood their responsibilities to keep people safe and protected from harm, but allowed them to do the things they wanted to do, to live a fulfilled life as possible. Policies and guidance were accessible to staff to remind them how to raise concerns in the event they saw poor or abusive practice.

There continued to be enough staff to meet people’s health needs and there continued to be flexibility in staffing levels, to make sure people received a safe, effective and responsive service. People had their prescribed medicines available to them and staff supported those people who needed help with them, whilst others self-medicated.

Staff received training in the safe handling, administering and recording of people's medicines. New staff received an induction and long-term staff continued to receive refresher training to ensure their skills and knowledge remained updated.

Staff said people's care plans provided them with the information they needed to support people safely and effectively. Communication through records and staff handovers continued to inform staff of important issues regarding people’s health and welfare.

The manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Health care professionals were involved in people's care and support and multi-disciplinary team reviews took place when needed. Staff supported people to access specialist healthcare appointments to maintain their wellbeing.

People were involved in what they had to eat and drink. Menu planning ensured people’s choices and preferred foods were considered so people maintained a balanced and healthy diet. People were involved in planning how they wished to spend their time and some people used an individual weekly activity plan because they benefitted from routine and structure. People were involved in pursuing a variety of individual and group activities that continued to give them pleasure and promote social skills.

Staff knew what worked well for people in their care. Staff knew about people's individual personalities and if people were of low mood, what worked well and how to support them to keep their overall health and wellbeing positive. Staff helped people plan goals and objectives and helped people build and maintain social engagement.

Staff continued to promote people's independence and people said staff were considerate, patient and kind towards them.

People were regularly involved in planning and reviewing their care and support. Care was planned to meet individual needs and was focussed on meeting people’s emotional and physical needs.

People's feedback on the service was sought by the provider and people were very complimentary of the service and staff team who supported them.

People felt confident and comfortable to share any concerns they had and were confident they would be listened to and actions taken.

Consideration and thought has gone into the decoration and layout of the service with people’s involvement. The overall effect created was a homely and relaxed environment with due consideration given to the needs of people with learning disabilities and mental health issues.

Staff told us they felt supported by the management team and by each other. The provider had quality monitoring processes which included audits and checks on health and safety, fire safety, training, medicines management, infection control and care planning. Some audits required better monitoring however the new provider was improving and strengthening the audit systems in the service so they were aligned to the standards they expected.

The provider fulfilled their legal responsibilities by displaying their rating and telling us of notifiable incidents that happened within their service.

Further information is in the detailed findings below.

Selborne Care Limited is a large provider of care services. 5 Tiverton Drive provides accommodation, personal care and support for up to four people. The home specialises in providing ‘aftercare services’; the care and support of people who have been detained under the Mental Health Act 1983 and then discharged from certain sections of the Act. The home works closely with other professional organisations in providing the agreed care and support to people. There were four people living at the home on the day of our inspection visit.

There was 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.

Staff understood their responsibilities to keep people safe and protect them from harm. Policies and guidance were accessible to staff to remind them how to raise concerns following the provider’s safeguarding and whistleblowing policies. Risks to people had been assessed. Staff were trained to manage risks that could present a risk of harm or injury to people or others.

People had their prescribed medicines available to them and staff supported people to take them. Staff received training in the safe handling, administering and recording of people’s medicines.

People had been involved in planning their care. Staff read people’s care plans and received an induction and training so that they were able to effectively meet people’s needs. Further training took place to update and refresh staff skills and knowledge. Staff said people’s care plans provided them with the information they needed to support people safely and effectively.

The registered manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Health care professionals were involved in people’s care and support and multi-disciplinary team reviews took place when needed. Staff supported people to access healthcare appointments to maintain their wellbeing.

People were involved in menu planning and had choices about food and drink. People said the food was good. People were involved in planning how they wished to spend their time and had individual weekly activity plans. We saw people involved in various activities of their choice. Staff knew about people’s individual likes and dislikes and how to provide support so that people did not become anxious. Staff promoted people’s independence whenever possible, and were kind and respectful toward people.

People were involved in planning and reviewing their care and support. Care was planned to meet individual needs and was person centred. People’s feedback on the service was sought by the provider. People told us they felt they could raise concerns or complaints if they needed to.

The provider had quality monitoring processes which included audits and checks on medicines management, infection control, care records and staff practices. Where improvement was needed, action was taken.