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Isaac Robinson Court - Care Home Good

Reports


Inspection carried out on 15 August 2019

During a routine inspection

About the service

Isaac Robinson Court is a residential care home providing personal care to up to a maximum or 40 with a learning disability and autism. There were 28 people living permanently at the service at the time of the inspection. The service had three bungalows for people who lived there on a permanent basis and two bungalows for people who had respite care. In addition, there were two flats for people who were more independent.

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 ensures that people who use the service 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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. 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 lived in a clean and safe environment. Staff knew how to keep people safe and how to raise concerns. Staff completed risk assessments to ensure risk was managed proportionately. There were enough staff to support people and they were recruited safely with all checks completed before they started work.

People had their needs assessed and care plans were produced to assist staff in supporting them in ways they preferred. For one person, their ongoing assessed needs had not been fully met; this had been addressed in a meeting with health and social care professionals. People’s general health and nutritional needs were met, and they received their medicines as prescribed.

Staff had access to training, supervision and support and told us the registered manager was always available when needed.

There were many examples of outstanding practice with regards to supporting people in a person-centred way. For example, with end of life care, in making connections with their local community, making friendships with other people and staff, attending functions and maintaining relationships with their families and friends. For one person, meeting their needs in a person-centred way could have been improved. Staff were kind and caring, respected people’s privacy and dignity, and at times went over and above, supporting people with activities and outings in their own time.

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. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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.

There were systems in place to monitor the quality of the service. This included audits, surveys and a complaints process.

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 29 March 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 se

Inspection carried out on 21 February 2017

During a routine inspection

Isaac Robinson Court provides personal care and support to up to 40 adults who have a learning disability. The service is located close to local facilities and bus routes into Hull city centre.

There are five purpose built single storey bungalows, three with eight single en suite bedrooms and two with six single bedrooms. There are two self-contained flats in the main building.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities.

Staff who had been recruited safely were provided in enough numbers to meet the needs of the people who used the service.

People were provided with wholesome and nutritionally balanced diet which was of their choosing.

Staff were provided with training in how to meet people’s needs and were supported to gain further qualifications.

People were supported to access health care professionals when needed. 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 support this practice.

Staff had a good understanding of people’s needs and were kind and caring. They understood the importance of respecting people’s dignity and upholding their right to privacy.

A wide range of activities were provided for people to participate in, these included involvement with the local and wider community.

Complaints were investigated and resolved wherever possible to the complainants’ satisfaction. People received care which was tailored to their individual needs.

People who used the service, and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run.

Regular audits were carried out to ensure the service was safe and well run.

Further information is in the detailed findings below.

Inspection carried out on 22 December 2015

During an inspection looking at part of the service

Isaac Robinson Court provides personal care and support to up to 40 adults who have a learning disability. The service is located close to local facilities and bus routes into Hull city centre. There are five purpose built, single storey bungalows. Three of these have eight single en suite bedrooms for people who live there on a permanent basis and two have six single bedrooms in each for people to have short respite breaks. There are two self-contained flats in the main building. On the day the follow up inspection took place, there were 25 people living in the service and several people using the respite service.

This inspection was unannounced and undertaken on 22 December 2015. We had previously inspected the service in November 2014; it was rated as Good overall but we issued a compliance action for staffing. The registered manager sent an action plan in response to this telling us what measures they were to take to address the issue. The inspection visit was to check the action had been sustained and staffing levels were sufficient to meet the needs of people who used the service. The findings of this inspection have not changed the service’s overall rating, however it did improve the rating of the specific question ‘Is the service Safe’ from ‘Requires Improvement’ to ‘Good’.

We specifically looked at staffing levels in the three bungalows in the residential side of the service. We found there were sufficient staff on duty on each shift. At the last inspection the main area of concern regards staffing levels affected one of the units, Arcon. This was due to an increase in two people’s health related needs which has since been resolved. Staff told us there were sufficient staff on duty to ensure they were not rushed when supporting people who used the service. We saw staff had time to sit and chat to people.

Inspection carried out on 19 and 20 November 2014

During a routine inspection

We undertook this unannounced inspection on the 19 and 20 November 2014.

Isaac Robinson Court provides personal care and support to up to 40 adults who have a learning disability. On the days the inspection took place there were 25 people living in the service and five people using the respite service. The service is located close to local facilities and bus routes into Hull city centre. There are five purpose built, single storey bungalows. Three of these have eight single en suite bedrooms for people who live there on a permanent basis and two have six single bedrooms in each for people to have short respite breaks. There are two self contained flats in the main building.

The service has 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. The registered manager is currently on secondment to an area management post and the deputy manager has taken up the position of acting manager in the interim.

Some people who lived in the residential side of the service had needs that were increasing but the staffing levels had not kept pace with this. Therefore it was not always clear there was sufficient staff deployed in one specific unit of the service to meet these people's needs. This meant the registered provider was not meeting the requirements of the law and you can see what action we told the registered provider to take at the back of the full version of the report.

There were policies and procedures to guide staff in how to keep people safe and staff had completed safeguarding training. The environment was safe and staff completed risk assessments to help minimise risks for people. The equipment used was serviced and checked regularly by staff.

People had their health and social care needs met including visits from health professionals and appointments with doctors and consultants. People received their medicines safely and as prescribed by their GPs.

Most people were able to make their own decisions about aspects of their lives and were provided with information so they could choose what they wanted to do. When people were unable to make their own decisions, staff consulted with appropriate people and planned care in the person’s best interest.

People’s nutritional needs were met and they told us they liked the meals provided; there were lots of choices and alternatives to the main menu.

Staff were recruited safely and all checks were carried out before they started work in the service. They received induction and training suitable for their role. There was a support system for staff which included supervision meetings, appraisals and staff meetings.

People spoken with said staff were caring and they liked living at the service or spending time there for short breaks. There were lots of activities for people to participate in and opportunities for them to access the local community facilities.

Checks were made on the quality of the service by asking people their views and by carrying out audits. However, the audits had identified a shortfall in staffing levels but changes in deployment had not been adjusted to meet people's needs.

There had been restructuring of the company and senior management which had caused some anxiety for staff and a lowering of morale. Now the restructuring had been completed, a senior manager told us they felt this would improve stability and staff morale.

Inspection carried out on 2 December 2013

During a routine inspection

We found people were able to make decisions about aspects of their lives and staff supported them to access community facilities. Staff respected people�s privacy and treated them with respect. Comments from people who used the service included, �Oh yes you can go to bed when you want here and you can sit wherever you want� and �They knock on the door and I say it is ok (to come in).�

People told us they liked the meals provided and they had choices and alternatives. Comments included, �It�s great, you get what you want�, �The food is alright; I want to lose some weight and I�ve lost some� and �I like the food. I like to have sausages and I have them.�

We found the service helped to keep people safe by ensuring policies and procedures were followed and that staff received training in how to safeguard people from abuse.

We found medicines were managed well, which ensured people received their medicines as prescribed. However, the room were medicines were stored was small, cluttered and hot on some occasions, making it difficult for staff to work in there safely.

We found staff had access to training and supervision to enable them to feel confident in supporting the people who used the service.

We found records used in the service were accurate and up to date. They were held securely but were accessible when required. An incident regarding a care file was being addressed by the registered manager.

Inspection carried out on 29 January 2013

During a routine inspection

People who used the service told us they could make decisions about aspects of their life and support they received from staff. Comments included, �I tell them what I like. They check what I like and don�t like� and �I make my own decisions about all sorts of things. I do a lot for myself."

People told us staff looked after them and they said they had access to health and social care professionals when required. Comments included, �I have seen the doctor and got some cream for my rash�, �I have seen the nurse for a flu jab and another nurse. My key worker looks after this (hearing aid) and checks the battery �and �The staff are helping me to lose weight."

We found that staff had completed safeguarding training. People who used the service told us they felt safe in the home. They said they would tell the staff if they had any concerns. They also said these concerns would be addressed. One person said, �I feel safe with the staff and other people.�

We found the service to be safe, clean, warm and well maintained.

People who used the service told us the staff were friendly and helpful. Comments included, �The staff are really nice�, �You can have a laugh with them� and �You ring the bell and the staff come to help."

We found that questionnaires were used and meetings were held to obtain people's views about the service. Audits and checks were carried out to ensure it remained a safe place for people.

Inspection carried out on 12 January 2012

During a routine inspection

We spent time with people living at the home throughout our visit and we observed positive interactions between people and staff.

We spoke to one person living at the home directly and they told us that staff respected their privacy and dignity and encouraged them to be as independent as possible. They said that staff were kind and supportive and that they could speak to any of them if they had concerns. They said, �I always speak to people nicely and expect the same from other people�.

We also spoke to a visitor who told us that they visited the home every day. They were very complimentary about the care people received and said, �I have no concerns at all�.

The person living at the home and the relative told us that they would feel comfortable speaking to any of the staff if they had a concern.