Mainwaring Terrace

Updated 16 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 25 February 2022 and was announced. We gave the service 72 hours’ notice of the inspection.

Updated 16 March 2022

About the service

Mainwaring Terrace is a residential care home providing personal and nursing care to 10 people with learning disabilities or autistic spectrum disorder at the time of the inspection.

Although the service was registered as a large home, people lived in four individual properties on the same road. Three of the properties were next to each other with a fourth over the road. Up to three or four people lived together in each property. It was registered for the support of up to 14 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras 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.

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

People were safely supported. Improvements had been made to the management of medicines and premises safety. Risks to people were assessed and monitored. Staff were recruited safely and understood the principles of safeguarding vulnerable adults. Our observations were people were safe in the environment.

People were supported in line with the mental capacity act and were supported to make decisions in their best interests. The staff team worked with health and social care professionals to ensure people remained fit and well. People were given choices and support to eat a healthy and nutritious diet. The properties were suitable for people’s needs and people had their own bedrooms where they could furnish with personal belongings. Staff received training to support their job role.

Staff were caring and kind to the people living at Mainwaring Terrace. It was clear bonds had been formed and people told us the staff were good and listened to them. A relative spoke highly of the good work the staff team had done to ensure their relative remained well cared for and safe. People were given choices and encouraged to reach personal goals. Staff could describe how to support people and were aware of people’s routines.

Care plans were detailed and regularly reviewed. Care plans were developed with people, their relatives and staff and contained people’s likes, dislikes, preferences and aspirations. People were supported to attend many activities in and away from the home. People knew how to make a complaint and there was easy read information available to enable people to understand the process. Plans were being formulated to support people’s wishes should they be at the end of their life.

A new registered manager was in post and staff told us morale had been boosted and they felt well supported. The registered manager had oversight of the home and completed regular audits and walk around to monitor and improve the service. The management team worked in partnership with other professionals and multi-disciplinary working led to best outcomes for people.

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.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service did not use any restrictive interventions at the time of inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update. The last rating for this service was requires improvement (published 1 November 2018) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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 service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.