We carried out a review of the data available to us about Gloucester House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gloucester House, you can give feedback on this service.
Gloucester House is a residential care home providing accommodation and personal care to 8 people with a learning disability and / or autism in one adapted building. At the time of the inspection 8 people were living at the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality , dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The service was able to demonstrate how they were meeting underpinning principles of right support, right care, right culture.
Right support: Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful life. People were supported in a safe and clean environment that met their sensory and physical needs. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. The service had enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted.
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.
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. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture: People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff provided people with personalised, proactive and co-ordinated support in line with their communication and support plans.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 21 November 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. 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.
This report only covers our findings in relation to the safe and well-led Key Questions. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gloucester House 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.
Gloucester House is a residential care home providing accommodation and personal care to eight people with a learning disability and / or autism in one adapted building. At the time of the inspection eight people were living at the service.
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.
People’s experience of using this service and what we found
Improvement was required in some areas of the management of medicines to ensure the protocol in place reflected their fluctuating needs.
The management and staff were aware of the need to report abuse or potential abuse to the local authority.
Quality assurance systems were in place to monitor the quality and safety of the service provided. However, these had not identified a timing issue with a person's medicines.
Risk involving people’s care were assessed. Staff were aware of these and of the care and support people needed to manage and mitigate these risks. Checks were in place regarding the environment to ensure it was safe for people to live in.
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 had access to healthcare specialist and other professionals to maintain their wellbeing. People had a choice of food and staff were aware of people’s likes and dislikes as well as any medical requirements regarding their dietary needs.
Staff were trained in areas relevant to meet people’s needs. The registered manager had attended specialist training re de-escalation techniques.
People were positive about the staff members who cared for them and were seen to enjoy each other’s company. People were able to engage in fun and interesting things to do. These included activities and events at the home as well as in the wider community.
Staff and management were responsive to people’s changing care needs and acted upon these to ensure their wellbeing. Care plans were in place and regularly reviewed. People were confident any concerns would be listened to and acted upon.
People were consulted and able to take part in satisfaction surveys. People and staff spoke positively about the management of the home and of their passion to provided good quality care.
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 23 March 2016).
Why we inspected
This was a planned inspection based on the previous report.
We have found evidence that the provider needs to make improvement. Please see the safe section of this full report.
We had the opportunity to talk with three people who lived at the home on the day of the inspection. We have therefore not used quotes within this report and the examples we have given are brief because we respect people’s right to confidentiality.
A registered manager was in post at the time of our inspection. 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 and senior staff team supported care staff to provide safe and compassionate care. Risks to people’s safety were recognised and staff took action so people were able to do things they enjoyed in a safe way. There were enough staff available to support people in the ways they wanted. Staff knew what actions to take, if they had any concerns for people’s safety or well-being and were able to obtain advice from the manager, provider or external organisations if required. People were supported to take their medicines so they would remain well.
Staff had the skills required to support people so they would enjoy a good quality of life. People’s right to make decisions and their freedom was protected and staff worked with other organisations to make this happen. Staff supported people to enjoy a range of food and drinks so they would remain well. Some people enjoyed preparing their own meals. Access to health services was arranged so people would benefit from specialist advice to remain physically and mentally well.
People enjoyed being with the staff who cared for them and were given encouragement and reassurance by staff when people when they wanted this. We saw people got on well with the registered manager and caring relationships had been built with the staff. Staff knew how to support people so they were able to make choices about what daily care they wanted. People’s need for independence was taken into account by staff.
People benefited from living in a home where staff understood their individual preferences, diversities and unique needs. The whole staff team were committed to making sure people received the right care for them as individuals. Staff recognised when people’s needs changed and took action so people continued to enjoy life and receive care in the best way for them. People wishes were embedded into the way their care was planned and reviewed and people felt listened to. People and relatives knew how to raise any complaints they had and were confident staff would take action if this happened.
There was clear and open communication between the registered manager and staff, so staff knew what was expected of them. Checks were undertaken on the quality of the care by the registered manager and provider and actions were taken where developments had been highlighted. The registered manager and provider made sure there was a focus on continuous development of the home.
People who lived at the home were supported to make choices around the care they received. A relative told us: 'They (staff) always try so hard to make sure the people who live there have choice'.
We saw that staff helped and supported people. We saw that people received care that met their individual needs.
We found that medicines had been appropriately stored and administered.
Staff told us they had access to further training and felt supported by their peers and the registered manager. One staff member said they had: 'Good support and training'. Another said: 'You never feel that you are not supported fully by everyone'. This meant that staff had the support and knowledge to meet the care and welfare needs of the people living there.
We saw that staff gave people choices and supported people to make their own decisions within the home environment. We saw that people were relaxed and at ease with staff. Staff showed an individual knowledge of people, their abilities and their personal backgrounds. Staff told us they supported people 'to do things for themselves' and gave help when this was needed. We found that people were treated with respect and their dignity and choices had been considered by staff.
People told us that staff 'were nice here' and 'they help me when I need it and 'all the staff are very caring and they work hard'. They told us that there were things to do and one person we spoke with knew about the record of their care and told us they had been involved in completing it.