We carried out a review of the data available to us about Living Ambitions Limited - 32 Ringstead Road 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 Living Ambitions Limited - 32 Ringstead Road, you can give feedback on this service.
Living Ambitions Limited - 32 Ringstead Road is a residential care home providing personal care to up to 6 people with a learning disability in one adapted building. At the time of our inspection there were 4 people using the service.
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.
People’s experience of using this service and what we found
Based on our review of the Safe and Well-led key questions the service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture.
Right Support
Staff kept people safe by assessing and reducing known risks. 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.
Right Care
Staff made timely referrals to health and social care professionals to ensure people’s needs were assessed and met. People and staff knew each other well and over many years. The service had enough staff to meet people's needs in a person-centred way and keep them safe.
Right Culture
The provider checked the quality of support people received and developed plans to ensure continuous improvements. People and those important to them, were involved in planning their care and the service gathered feedback from people and their relatives and took action in response.
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 8 September 2018). You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Living Ambitions Limited - 32 Ringstead on our website at www.cqc.org.uk.
Why we inspected
We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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, which will help inform when we next inspect.
Living Ambitions Limited- 32 Ringstead Road 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.
Living Ambitions Limited- 32 Ringstead Road accommodates five people in one adapted building. Accommodation is provided on three floors. The service specialises in the care and support of people with a learning disability, autism and behaviours which may challenge the services they require. There was one person using the service at the time of our inspection.
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.
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.
Since our last inspection, the service had undergone major refurbishment to create more living space for people using the service. People had the use of an additional lounge and orangery in the garden which was furnished with sensory equipment. Bedrooms each had ensuite facilities and the service had been redecorated throughout.
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.
Care plans were well organised, kept up to date and contained personalised information about the individual person's needs and wishes. The person’s care plan gave direction and guidance for staff to follow to help ensure they received their care and support in the way they wanted. Risks in relation to their care and support were assessed and planned for to minimise the risk of harm. These records were reviewed regularly and whenever people's needs changed.
People were supported to maintain good health, have access to healthcare services and receive on-going healthcare support. The staff had developed positive working relationships with health and social care professionals.
Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse. The provider followed an appropriate recruitment process to employ suitable staff. Staffing was managed flexibly so that people received their care and support when they needed it.
People received their medicines as prescribed and medicines were stored and managed safely.
The provider’s training programme was designed to meet the needs of people using the service. Staff had the knowledge and skills they required to support people. Training included supporting people who presented behaviours that could result in harming themselves or other people. This helped staff to manage situations in a consistent and positive way, and protect people's dignity and rights.
People took part in activities they liked or had an interest in and maintained relationships with people that mattered to them. People decided how they spent their time and staff supported their choices and independence.
People, their families and staff were encouraged to share their views and contribute to developing the service. Any concerns or complaints were acted on and the provider used feedback to improve the service.
Staff were positive about their experience of working at 32 Ringstead Road. They knew their roles and responsibilities and felt supported by the registered manager and each other.
There was effective leadership and direction from the registered manager who in turn had full support and guidance from the provider. Regular support visits, audits and quality assurance checks took place and the provider had good oversight of the service. Where improvements were needed or lessons learnt, appropriate action was taken.
There were systems in place to ensure that people received their care and support in line with best practice. The provider worked in partnership with other agencies to support the development of joined-up care.
After the unannounced inspection we undertook in July 2015, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach in respect of staff training and support. We carried out this focused inspection on 19 January 2016, to follow up the action the provider had stated in their action plan they had taken to meet legal requirements.
This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Living Ambition Limited - 32 Ringstead Road’ on our website at www.cqc.org.uk’.
32 Ringstead Road is a home that can provide accommodation for up to six adults with personal care and support needs. The home specialises in supporting older people living with a learning disability, autistic spectrum disorder or Down’s syndrome. There were six people using the service at the time of our inspection.
The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
During our focused inspection, we found that the provider had followed their action plan, which they had said would be completed by December 2015. We saw legal requirements had been met because the provider had improved its arrangements for training and supporting staff who worked at the home. This meant staff were appropriately trained and supported to effectively carry out the duties and tasks they were employed to perform.
This inspection took place on 17 July 2015 and was unannounced. At the last inspection on 9 September 2013 we found the service was meeting the regulations we looked at.
32 Ringstead Road is a home that can provide accommodation for up to six adults with personal care and support needs. The home specialises in supporting older people living with a learning disability, autistic spectrum disorder or down’s syndrome. Two of the people using the service were also living with dementia. There were five people using the service at the time of our inspection.
The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
Although people using the service and their relatives told us they were happy with the quality of the care and support provided by the home, we found people’s needs may not always been fully met because staff were not trained in some key aspects of their role and nor were they always appropriately supported by their managers.
People were safe living at the home. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. There were appropriate plans in place to ensure identified risks to people were minimised. Staff had access to appropriate guidance and knew how to minimise identified risks in order to keep people safe from injury or harm in the home and the wider community. Managers ensured regular maintenance and service checks were carried out at the home to ensure the environment was safe.
Staff looked after people in a way which was kind, caring and respectful. Our observations and discussions with people using the service and their relatives supported this. Staff spoke with people in a warm and respectful way and ensured information they wanted to communicate to people was done in a way that people could understand. Staff knew how to ensure that people received care and support in a dignified and respectful way. When people were nearing the end of their life they received compassionate and supportive care.
People were encouraged to maintain social relationships with people who were important to them, which included their relatives. There were no restrictions on visiting times and we saw staff made peoples’ guests feel welcome. Staff encouraged people to participate in meaningful social, educational and vocational activities that interested them. Staff also supported people to maintain their independence so far as possible, as well as learn new independent living skills, where appropriate.
Care plans had been developed for each person using the service, which reflected their specific needs and preferences for how they were cared for and supported. These plans gave clear guidance and instructions to staff about how they should care and support people and ensure their needs were met. Consent to care was sought by staff prior to any support being provided. People were involved in making decisions about the level of care and support they needed and how they wanted this to be provided. Where people's needs changed, the service responded by reviewing the care and support people received, which included their care plan.
People and their relatives felt comfortable raising any issues they might have about the home with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately.
People were supported to keep healthy and well. Staff ensured people were able to access community based health and social care services quickly when they needed them. Staff also worked closely with other health and social professionals to ensure people received the care and support they needed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration. People received their medicines as prescribed and staff knew how to manage medicines safely.
There were enough suitable staff to care for and support people. Managers continuously reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service.
Managers understood when a Deprivation of Liberty Safeguards (DoLS) authorisation application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.
Managers demonstrated good leadership. It was clear managers understood their role and responsibilities, and staff told us they were supportive and fair. Managers encouraged an open and transparent culture. They proactively sought the views of people, relatives, visitors, staff and other healthcare professionals about how the care and support people received could be improved.
The provider and managers carried out regular checks of key aspects of the service to monitor and assess the safety and quality of the service that people experienced. Managers took appropriate action to make changes and improvements when this was needed. Managers used learning from incidents and inspections to identify how the service could be improved. They worked proactively with other health and social care professionals to share and learn best practice so that the quality of care and support people experienced was continuously improved.
We identified one breach of the Health and Social Care (Regulated Activities) Regulations 2014 during our inspection. You can see what action we told the provider to take at the back of the full version of the report.
We spoke with one person who told us 'I'm happy here' and they showed us a thumbs up. The person also said that 'I do like the staff' and confirmed that they got the help they needed. We observed that people were free and able to make choices regarding how they spent their time. We saw that staff treated people as individuals and communicated with them in a calm and sensitive manner.
We spoke with three members of the staff team who made positive comments about working in the home. The comments included 'It's a good place to work, I can't complain', 'It's a nice place to work especially because of the management', 'The service users are looked after well' and that it's a 'Very nice place and the manager is good.' These three staff members had worked at the home for over five years.
We found that people were enabled to make day to day decisions about their care and support and their well-being was closely monitored through daily discussions and regular key-working sessions. We found that people were provided with a choice of suitable and nutritious food and drink.
The two people who use the service both told us that they felt safe living at 32, Ringstead Road. People we spoke with also told us the staff were always kind and caring, and they felt able to talk with them about any concerns they might have. One person said 'I am happy living here' and 'I like the staff'. Another person told us 'I like it here'.
During our inspection we used the Short Observational Framework Initiative (SOFI) and saw staff treated the people who use the service with respect and dignity. We observed saw staff encouraged and supported people to become as independent as they could and to learn new skills.