We carried out a review of the data available to us about Mrs Valerie Bullman - 18 Leafdown Close 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 Mrs Valerie Bullman - 18 Leafdown Close, you can give feedback on this service.
Mrs Valerie Bullman - 18 Leafdown Close is a care home service without nursing and accommodates one person with a learning disability in a domestic home environment. At the time of the inspection there was one person using the service.
People’s experience of using this service and what we found
The person living at Mrs Valerie Bullman - 18 Leafdown Close experienced positive care and support which promoted good outcomes for them. The person was supported by the provider who knew them well and their care was person-centred which had them at the heart of every decision made. The provider ensured the person led a full and varied life where they were supported to take part in activities they enjoyed, which included the provider taking them on days out and holidays.
The person lived in a domestic property which was homely. The home was kept clean and infection prevention control measures were in place to reduce the risks associated with COVID-19.
The person had a good caring relationship with the provider and was given the autonomy to live an independent life where they could make decisions and choices for themselves.
The person had their risks assessed, monitored and reviewed. The provider ensured they worked with other healthcare professionals which ensured the person received good and safe care. The person was administered their own medicines and we saw this was done safely.
The provider treated the person with dignity and respect and their preferences were understood. The person felt they were fully involved in their care and could speak up if they felt anything was wrong. The person was supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
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 19 February 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated good and outstanding to test the reliability of our new monitoring approach.
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.
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.
We found the following examples of good practice.
The home was kept clean. The provider understood the importance of maintaining a high standard of cleanliness.
The provider supported the person to undertake COVID-19 testing in accordance with government guidance. The provider was also regularly accessing COVID-19 testing.
The provider supported the person to access the community in a safe way.
The provider had educated the person about COVID-19 and the associated risks. As a result, the person had a good understanding of the virus and knew how to mitigate the risk to themselves and others.
Leafdown Close is a Residential 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.
Leafdown Close accommodates one person in a domestic home environment. At the time of the inspection there was one person using the service.
Registering the Right Support has values which include choice, promotion of independence and inclusion. This is to ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen. The home was meeting the principles of this policy.
The person living at the service was safeguarded from abuse and risks were assessed and planned for with the person. The provider gave the person support and there were arrangements in place to provide cover if needed. There were sufficient staff to support people. The person could administer their own medicines and we saw this was done safely. The person lived in a clean environment and the provider ensured they were protected from the risk of cross infection. The provider reviewed incidents and learned when things went wrong.
The person had their needs assessed and plans in place to meet them, this was reviewed on a regular basis and if things changed. The provider had received training and could access support from other organisations when needed. The provider ensured the person received consistent support in an environment that met their needs. The person could choose their meals and had their health needs met.
The person had choice and control of their lives and the provider was aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.
The person had a very caring relationship with the provider and was supported to live an independent life where they could make choices. The person’s communication needs were understood and the provider treated the person with respect and protected their dignity.
The person was at the centre of the service and the provider understood their needs and preferences. The person felt able to speak about anything they felt was wrong.
The provider submitted notifications as required and understood their responsibilities. The rating from the last inspection was on display. Quality checks were in place which were used to drive improvement.
The service had a registered manager in post. A registered manager is a person who has registered with us 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.
People told us they felt safe and the manager understood how to report and manage any concerns related to people’s safety and welfare. Risks were identified and people were involved with decisions. There were sufficient staff to meet people’s needs and ensure their safety. Medicines were managed safely in a way that promoted people’s independence.
Consent to care was sought in line with legislation and guidance and at the time of the inspection no DoLS applications were required.
People maintained a balanced diet and were encouraged to prepare meals. The kitchen was open for people to use when they wanted to. People also received support from health care professionals as and when required. The provider ensured people obtained advice from other health professionals to maintain and improve their health.
We saw that positive caring relationships had been developed and people were treated with dignity and respect. People were encouraged to express their views and make their own decisions. They were enabled to be independent and when they needed support this was done in a way that was acceptable to them.
People were involved with the development of care records and received support that was individual to them. These took into account their interests and preferences. We saw that people were listened to and their care records were individualised and reflected their needs. The manager ensured that community links were maintained.
The manager knew about their responsibilities and ensured they met these requirements.
We considered our inspection findings to answer the questions we always ask:
Is the service safe?
From our observations and from the information we saw in care plans, policies, procedures and records the provider's safety monitoring systems were robust. The provider showed that they had a clear understanding of their role in providing care and safeguarding the person they supported. They demonstrated that they knew the person very well and understood their support needs.
The provider understood about the risk management and detailed plans had been written for all the areas of care and support. The provider demonstrated that they understood how to show people respect, gain consent and maintain people's dignity at all times.
The provider told us that there were no deprivations of liberty safeguards in place. The provider demonstrated that they were aware of the Mental Capacity Act and Deprivation of Liberties and knew who to contact if circumstances changed. We saw that temporary carers in an emergency situation would have access to all the information they required to maintain safe levels of care and support.
Systems were in place to make sure that the provider learned from events such as accidents and incidents, complaints and concerns. This meant that the person was benefiting from a service that was taking on board lessons learnt.
Is the service effective?
The person's health and care needs had been assessed and care plans were in place. There was evidence the person was involved in care plans and reviews. The person's health care needs were regularly assessed and detailed in the care plans. Specialist health and social care professionals regularly gave support to the person's care. All care, activity and risk assessment plans were reviewed regularly and were up to date.
We saw that the person was supported to continue to develop their learning, independence and health care.
Is the service caring?
The provider told us the person had a full and active life. We saw details of these activities recorded in the care plan. The person had a wide range of interests and took part in a range of leisure and social activities.
The provider demonstrated to us that they were committed to providing the best level of care for the person who used the service. They were aware of potential risks, the person's rights and their responsibilities.
Is the service responsive?
We found that the care plan was person centred and contained detailed information about the person's needs and preferences.
There was regular support from health professionals when needed.
We were told by the provider how the person would be supported if a hospital admission was required. The person had a hospital passport with information about themselves and their care needs to take with them if they required a stay in hospital.
Is the service well-led?
The provider had supported this person for many years. They demonstrated to us that they knew the person very well. They undertook regularly reading of information to maintain and up to date level of knowledge. We saw evidence that the provider was experienced and skilled in the provision of care. The provider demonstrated to us that they worked hard to ensure the care provided to the person was the best it could be.
We saw that there were arrangements in place to gain the person's consent to the care and support they required. The person told us they were involved in choices about their care and support needs and their choices were respected.
There were appropriate arrangements in place to ensure that they received the care and support they needed and which promoted their health and wellbeing and kept them safe.
There were appropriate arrangements in place to ensure the person's health, safety and welfare was protected when more than one provider was involved in their care and treatment.
We found that the home was well maintained, warm, comfortable, homely and secure.
All support needs were provided by the provider, we were told: "We get on very well".
We found that there was an appropriate complaints system available to meet the person's needs.
The person was involved in choices about their care and support needs and their choices were respected. There were appropriate arrangements in place to ensure that people received the care and support they needed and which promoted their health and wellbeing and minimised the risk of harm to them.
The person told us they were involved in choices about their care and support needs and their choices were respected. There were appropriate arrangements in place to ensure that they received the care and support they needed and which promoted their health and wellbeing.
All support needs were provided by the provider, we were told, "We get on very well".