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Disabilities Trust - 128 Beech Hill Outstanding

Reports


Inspection carried out on 15 May 2017

During a routine inspection

Disabilities Trust 128 Beech Hill is a service registered to accommodate up to four people who require support with personal care. They specialise in providing support to younger adults with autism and a learning disability. On the day of the inspection there were four people using the service who required minimal support with personal care. The accommodation is provided in a semi-detached house located in a modern housing estate in Hay wards Heath near to local shops and bus routes. There is one bedroom on the ground floor with the other three located on the first floor which is accessed by a flight of stairs. There is a secure rear garden and off road parking to the front of the property.

This inspection took place on the 15th May 2017 and was announced. This was because the service is a small service and we needed to make sure people would be in when we arrived. It was also so that the provider had time to arrange for sufficient numbers of staff to be deployed on the day to facilitate the inspection without disrupting people's daily routines.

At the last inspection on 5 May 2015 the service was rated Good.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had an extremely positive culture that was exceptionally person-centred, open, inclusive and empowering. Staff went the extra mile to share information with people and provide explanations in a way that empowered them to make informed decisions and become more independent. One person told us “I make my own choices, I decide what I do”. There was a strong emphasis on team work and communication sharing. The registered manager and staff had a ‘can do’ attitude and were solution focussed. One relative told us “Staff are brilliant, they have good ideas, useful one’s, they have a lot of empathy and get things done. I’ve no concerns”.

The service was exceptionally well led. Staff were enthusiastic and happy in their work. They felt supported within their roles and held the management team in high regard, describing a management approach, where managers were always available to discuss suggestions and address problems or concerns. A social care professional told us “It’s very, very well organised. They are excellent and go beyond what they’re supposed to do”. A staff member told us “I love working here. I’ve learnt a lot and developed my career. (Line manager’s name) is very approachable the management is good”.

Staff had a common aim and purpose to achieve positive outcomes for people. They excelled at providing consistency which had a positive impact on people’s wellbeing, reduced their anxiety levels and provided stability. A relative told us “Consistency is the key and they do that well”. A staff member told us “We work well as a team, it works like clockwork. We provide consistent support; this is a very settled house”. Another staff member commented “I love it here, really good continuity of care and a rewarding job and great support”.

People mattered and the care was exceptionally personalised. Each person had a trusted member of staff, known as a keyworker, who took a lead role in each person's care and wellbeing. They continuously looked for ways to ensure people had positive experiences and led fulfilling lives. Staff knew about people's lives, their interests and talents and encouraged them to become more independent and try new things.

Information was shared and explanations given to people to help them form their own opinions and make their own choices and decisions. People were fully involved in every aspect of the day to day running of the service from cooking and cleaning to decorating and completing safety checks.

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Inspection carried out on 5 May 2015

During a routine inspection

The inspection took place on 5 May 2015 and was announced.

The service is registered to accommodate up to four people with a learning disability and additional complex needs such as autism. At the time of our inspection, there were four people living at the service. 128 Beech Hill is a modern, detached house on a residential housing estate on the outskirts of Lindfield. People have their own bedrooms which are personalised in line with their individual preferences. There are two bathrooms on the first floor and a downstairs WC. There is a large sitting room, dining area, kitchen and a rear garden, all of which are easily accessible to people using the service.

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 day-to-day management of the service was undertaken by the team leader.

People felt safe living at the service and staff knew how to keep people safe. They had been trained in safeguarding adults at risk and knew what action to take if they suspected abuse was taking place. Staff were trained in the use of physical intervention, to keep people safe who might exhibit challenging behaviour, although this was rarely used. Risks to people were identified and managed appropriately and people had personal emergency evacuation plans in place in the event of an emergency. Staffing levels were sufficient to support people and keep them safe. The service followed safe recruitment practices. Medicines were ordered, administered, stored and disposed of safely by staff who were trained in the administration of medicines.

Staff were appropriately trained in all essential areas and specific training was also arranged to meet people’s care needs. Training was refreshed as needed. Staff received regular face-to-face supervisions every quarter from the team leader and attended group supervision or team meetings. Handover meetings between shifts ensured staff had up-to-date information about people’s care needs. Staff followed the requirements of the Mental Capacity Act (MCA) 2005 and put this into practice. Where people’s freedom was restricted, the registered manager had applied for authorisation under the Deprivation of Liberty Safeguards (DoLS). People were supported to have sufficient to eat and drink and were involved in the preparation and cooking of their meals. They were able to choose their weekly menus and alternative choices were also available. People were supported to maintain good health and had access to a range of healthcare professionals, including those from the provider’s own multi-disciplinary team.

People were looked after and supported by kind, caring staff who knew them well. Care records provided detailed information for staff to follow about people’s preferences, likes and dislikes. People were supported to express their views and met monthly with their keyworker, who co-ordinated their care. People’s privacy and dignity were respected and promoted.

Care plans were person-centred and people had weekly planners that showed the activities and outings that were planned with them. These provided a daily structure to their lives. Care staff had comprehensive information about people including the support they required in communication, sensory needs and an autism profile. People were encouraged to stay in touch with people who mattered to them. The provider had a complaints policy in place but no complaints had been received in the last year. People knew how to raise a complaint and they were asked if they had any complaints at their monthly meetings.

People were involved in developing the service. They helped to plan menus and social activities. Staff knew what was expected of them and attended staff meetings which were held every seven weeks. Staff were asked for their views about the service and a questionnaire had recently been sent out. The provider had systems in place to audit the quality of the service and care provided. Monthly provider visits took place which enabled the service to identify areas which needed improvement and for action to be taken. Where accidents and incidents were recorded, the provider’s main office analysed any patterns or trends.

Inspection carried out on 14 October 2013

During a routine inspection

During our visit to Beech Hill we spoke with four people living at the home, the manager and four members of staff. We observed how staff reacted with people using the service and also how the people were getting on with their daily routine. We found that people were treated respectfully and supported appropriately.

Each person had a set of individual plans detailing their care, support, healthcare needs and any risks that staff needed to be aware of. The service had a robust medication protocol in place at the service and this ensured that the people using the service were having their medication at time they needed in a safe way. People using the service told us that they enjoyed preparing the evening meal and look forward to their take away meal on Sunday�s. We saw evidence of mandatory checks that had been carried out and maintenance schedule in place to ensure a safe environment for people using the service. There was a good level of hygiene around the home and we were told by staff that most of the people would clean their own room as part of their daily activity.

We looked at the training program in place and found that in addition to mandatory training, staff had to attend specialist training. They were training on Mental Capacity Act, Deprivation of Liberty Safeguards, autism, epilepsy and makaton. This ensured that people using the service were safe and their health and welfare needs were met by competent staff.

Inspection carried out on 31 January 2013

During a routine inspection

During our inspection we noted that there were two registered managers for the service, we have been informed by the current manager (R Davies) that the other person has been promoted within the service and will now be applying to de register as manager

There were four people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and four members of staff. People living at the home said they liked the home and felt safe.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and one person told us how they had chosen the colour of paint used to decorate their room. Rooms we looked at were personalised.

We saw people being addressed in a respectful manner. We looked at peoples individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded. We saw that monthly audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service.