Ellenborough Court

We found the following examples of good practice.

We did not enter any of the flats. This was because we kept our movements in the home to a minimum. The registered manager told us the support staff assisted people to maintain the cleanliness and tidiness of their flat. The frequency that cleaning tasks were carried out had been increased. All touch points were regularly sanitised, and cleaning checklists had been introduced. The registered manager monitored cleanliness, work practice and staff compliance with wearing personal protective equipment (PPE).

Staff and visitors entering the home were required to wear a face mask and wash their hands. Hand sanitising gel was placed in the hallway. All visitors had to pre-book their visit, had to wear a facemask and complete a health questionnaire. Any visitor who was subject to COVID-19 testing was not allowed to enter the home until a negative result from a lateral flow test was known.

The service had completed a visitor’s risk assessment and also a ‘meet and greet’ checklist. This was used if potential new staff visited the home as part of the recruitment process, seen as essential to ensure they recruited the right staff.

Support staff were able to maintain social distance from their workmates because they worked individually with one person at a time. The staff were aware of the need to ensure social distancing was maintained in the hallways and stairwells.

People were supported to maintain contact with family and friends. They were assisted with writing letters, making telephone calls and video calls. Activities away from the home had been restricted since the beginning of the pandemic but people were assisted to go out into the community as required.

There were no vacancies at Ellenborough Court at the time of this inspection, but the service had a strict procedure to follow for new admissions. During the pandemic, one person had needed to attend the emergency department at the hospital. Upon return to the home, they were taken straight in to their flat and ‘isolated’ and tested very regularly. These measures ensured if the person had contracted COVID-19, they would not have spread it to others in the home.

The support team had all completed on-line infection prevention and control training. In addition, training had been arranged on donning and doffing PPE and good hand hygiene. The registered manager monitored the support staff continually to ensure compliance with the correct use of PPE and social distancing. The staff team were regularly tested for COVID-19: once a week with the full laboratory test (known as a PCR test) and twice a week with a lateral flow test. It had recently been introduced that staff were completing an LFT test prior to starting a shift, so if there was a positive result, they would not have entered the home. Those people who lived in Ellenborough Court were tested every four weeks and more often if necessary (symptoms or unwell).

GPs and other health or social care professional visits only took place if they were essential. The registered manager used telephone calls, video calls and emails to liaise, report any concerns and gather advice. Four people, and the staff team had already received their first COVID-19 vaccination.

The service had reviewed all their infection prevention and control policies and procedures and undertaken risk assessments to ensure safe practice was followed at all times. The registered manager had regular contact with the service provider, Public Health England, CQC and ensured changes in Government COVID-19 guidance were followed.

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

At the last inspection, the service was rated Good. At this inspection we found the service remained Good overall. Why the service is rated Good:

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.

The service consistently conducted sufficient checks to ensure prospective staff were safe to work with vulnerable people. The service had effective recruitment procedures in place and conducted background checks of all prospective staff. References were obtained and criminal background checks were recorded ensuring staff were suitable for their roles.

People remained safe living in the service. There were sufficient staff to meet people's needs and staff had time to spend with people.

Risk assessments were carried out and promoted positive risk taking which enabled people to live their lives as they chose.

People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice.

People were supported to access health professionals when needed and staff worked closely with health and social care professionals to ensure their health and well-being was monitored.

People's nutritional needs were met.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity.

People were involved in decisions about their care needs and the support they required to meet those needs. People had access to information about their care and staff supported people in their preferred method of communication.

Staff also provided people with emotional support. The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly and their views were sought and acted upon.

The service was well led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people and staff and promoted a caring ethos.

The service had strong links with the local community.

The registered manager monitored the quality of the service and strived for continuous improvement. There was a very clear vision to deliver high quality care and support and promote a positive culture that was person-centred, open and inclusive. This achieved positive outcomes for people and contributed to their quality of life.

The registered manager was effectively supported by the providers’ senior management team.

Ellenborough Court provides accommodation and personal care for up to five people who had a learning disability, autism and or mental health needs. It does not provide nursing care.

At the time of this inspection there were five people living at the home. Ellenborough Court has five individual flats that have their own bathrooms, toilets, kitchens, lounges and bedrooms. There is also a staff room, staff sleeping in room, staff toilet, office and storage room. There is a front garden which has an outdoor seating area.

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. The registered manager was not present during the inspection.

People, staff and relatives felt the home was safe and incidents and accidents were audited with actions taken when required. People received their medicines safely and when required by staff who had received training. People had detailed risk assessments and guidelines in place for staff to follow.

People were supported by staff who had appropriate checks in place prior to commencing their employment. People were supported by adequate staffing levels and staff supported people in a kind and caring manner. Staff demonstrated they knew people well and felt supported and able to raise any concerns with the registered manager and the deputy manager.

People received a service that was based on their personal needs and wishes. Changes to people’s needs were identified with referrals to appropriate health professionals when required. People felt able to make requests about their care and express their wishes. People who were unable to consent to care and treatment had completed assessments and best interest decisions paperwork in place that involved significant others.

People were able to receive visitors whenever they wished. Relatives were able to visit as often as they liked; people often visited their parents at weekends. People were supported by staff who received regular supervision and training to ensure they were competent and skilled to meet their individual care needs. The service and staff put people central to the care and support they provided. This was reflected in staff values and practice.

People, relatives, staff and health professional’s views on the service were sought so that improvements could be made. People and their relatives felt happy to raise a complaint with the provider or the deputy manager. There was a quality assurance system that monitored the service and identified areas for improvement.

We observed support being provided in a way that promoted choice and dignity. Staff told us they enjoyed working at the service because they could see the positive impact on people's lives. We observed there were sufficient staff to support people in their chosen lifestyle.

Staff told us 'we work with people toward their independence'. We heard from the manager that the ethos of the service is based on 'Pro-social modelling' which respects the views of people and acts as a positive re-enforcement of behaviour.

We saw that people's support was reviewed regularly with them. We read about how people had developed their skills and reached planned goals toward being independent.

We found that people's needs had been comprehensively assessed so that care needs could be effectively met. There was a person centred approach in the provision of the service. We found that there was an environment where individuals were enabled to undertake daily living tasks. We saw that people were enabled to make choices about their lives and enabled to undertake tasks where risks were assessed and steps taken to alleviate identiifed risks. There was a focus on providing meaningful activities and involving people with the local community.

We found that the service provided an environment where people were protected from the risk of abuse. Staff illustrated an understanding of the nature of abuse and the protection of vulnerable adults. The service had responded professionally when concerns about possible abuse had been raised.