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Inspection Summary


Overall summary & rating

Good

Updated 16 August 2018

This inspection took place on the 28 July 2018 and was unannounced

Myrtle Cottage 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. It is registered for up to six people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were four people living in the home.

The home was a two storey detached property which had an open plan lounge and dining area, a sensory room, a kitchen, one bedroom and a shared bathroom on the ground floor. On the first floor there were five further spacious bedrooms.

The care service had been developed and designed in line with the values that underpinned the Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. People with learning disabilities and autism using the service could live as ordinary a life as any citizen.

The service had not had a registered manager in post since August 2017. 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. A new manager had started at the home and had undertaken a telephone interview with our registration team five days prior to our visit.

People were not able to tell us about their experiences of life at the home so we therefore used our observations of care and our discussions with staff and other stakeholders to help form our judgements.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide the assessed care hours to people and recruitment checks had ensured staff were suitable to work with vulnerable adults. When people were at risk of seizures or behaviours which may challenge the service staff understood the actions needed to minimise avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

People had been involved in assessments of their care needs where possible and had their choices and wishes respected including access to healthcare when required. Their care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. People had their eating and drinking needs and preferences understood and met. Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service. 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 supported this practice.

Families and professionals described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. People were supported to express their views about their care using their preferred method of communication and were actively supported to have control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories and the people important to them. Equality Diversity and Human Rights (EDHR) were promoted and understood by staff. A complaints process was in place and people felt they would be listened to and actions taken if they raised concerns. People were not supported with end of life care.

The service had an open and positive culture that

Inspection areas

Safe

Good

Updated 16 August 2018

The service was safe. There were sufficient staff available to meet people�s assessed care and support needs.

People were supported by staff who had completed safeguarding adults training and were able to tell us how they would recognise and report abuse.

People were protected from harm because risk assessments and emergency plans were in place and up to date.

People were at a reduced risk of harm because medicines were managed safely, securely stored, correctly recorded and only administered by staff that were trained to give medicines.

People were protected by the prevention and management of infection control. Policies, equipment and schedules were in place.

Lessons were learnt and improvements made when things went wrong.

Effective

Good

Updated 16 August 2018

The service was effective. People�s needs and choices were assessed prior to admission which form the basis of care and support plans.

People�s choices were respected and staff understood the requirements of the Mental Capacity Act 2005.

Staff received training, supervision and appraisals to give them the skills and support required to carry out their roles and meet people�s assessed needs.

Staff supported people to maintain healthy balanced diets. Dietary needs were assessed where appropriate.

People were supported to access health care services and local learning disability teams.

Caring

Good

Updated 16 August 2018

The service was caring. People were supported by staff that spent time with and treated them with kindness and compassion.

People were supported by staff that used person centred approaches to deliver the care and support they provide.

Staff had a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives.

People were supported by staff that respected and promoted their independence, privacy and dignity.

Responsive

Good

Updated 16 August 2018

The service was responsive. Care file�s, guidelines and risk assessments were up to date and regularly reviewed.

People were supported by staff that recognised, responded to and understood their changing needs.

People were supported to access the community and take part in activities which were linked with their own interests and hobbies.

Information was provided to people in a variety of formats in line with the Accessible Information Standard.

A complaints procedure was in place which included an accessible easy read version. People and relatives were aware of the complaints procedure and felt able to raise concerns with staff.

Well-led

Good

Updated 16 August 2018

The service was well led.

The management promoted and encouraged an open working environment.

The management were flexible and delivered support hours as and when necessary.

Regular quality audits and service checks were carried out to make sure the service was safe and delivered high quality care and support to people.

The management team were aware of their responsibilities under the Health and Social Care Act 2008, Duty of Candour and demonstrated an open, honest approach.

Staff and relatives felt involved in developing the service.

The service worked in partnership with other agencies in ways which benefitted people using the service.