SeeAbility - Fiennes House Residential Home

SeeAbility - Fiennes House Residential Home is a care home providing personal care and accommodation for up to 12 people. The service provides specialist support for people with learning disabilities, autism and sight loss. There were 12 people living at the home when we visited.

People’s experience of using this service and what we found

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 service is larger than current best practice recommendations. However, the size of the service having any negative impact on people was lessened by the layout of house into separate areas, with two kitchen/dining/lounge areas, en-suite facilities and the choice of communal areas people could use. Also, by personalised nature of the service.

People’s experience of using this service and what we found

Right Support:

The service supported people to have the maximum possible choice and control over their own lives. Staff were observed communicating with people in ways that met their needs and supporting people to make choices.

People benefitted from the interactive and stimulating environment. Bedrooms were personalised and the service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.

Staff supported people to take part in activities and pursue their interests in their local area. One person told us about their hobby and how staff supported them into the community to pursue this.

Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines safely and infection control procedures and measures were in place to protect people from infection control risks.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Throughout the inspection we observed kind, relaxed, compassionate and caring interactions between people and staff.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People could communicate with staff because staff supported them consistently and understood their individual communication needs. This included using assistive technology, body language, sounds and objects of reference.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Throughout the inspection we observed that staff were respectful of people and took time to offer support and reassurance when needed.

People received good quality care and support because trained staff could meet their needs and wishes.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff knew and understood people well and placed people’s wishes, needs and rights at the heart of everything they did. One staff member told us, “It is about them, they are in the centre of their care, if they decide they don't want to do something it is their choice, they have a right to make their own choices.”

People and those important to them were involved in planning their care.

Staff ensured risks of a closed culture were minimised so people received support based on transparency, respect and inclusivity. The staff, registered manager and deputy manager were open and transparent throughout our inspection. The registered manager and deputy manager acted efficiently on queries and feedback throughout the 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 good (published 23 March 2020)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Fiennes House is a care home providing personal care and accommodation for up to 12 people. The service provides specialist support for people with learning disabilities, autism and sight loss. 11 people lived there when we visited.

People's experience of using this service and what we found

People and staff had built strong relationships, cared about each other and enjoyed spending time together. There was a happy atmosphere with lots of good humour. Staff were proud of people and celebrated their achievements.

People's care was organised around their individual needs. Staff promoted people to be as independent as possible and upheld their right to privacy. Relatives and professionals praised staff and described them as caring and compassionate.

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 service is larger than current best practice recommendations. However, the size of the service having any negative impact on people was lessened by the layout of house into separate areas, with two kitchen/dining/lounge areas, en suite facilities and the choice of communal areas people could use. Also, by personalised nature of the service.

People were supported to express their views, in ways relevant to their communication needs. Staff were skilled at communicating and involving people in decision making.

People received effective care and consistent support from experienced staff with the right skills to meet their needs. Staff monitored people's health and wellbeing and worked with other professionals to make sure people received the treatment they required.

People were protected from abuse by staff who were aware of the different types of abuse, and ways to protect people. People received their medicines safely and on time.

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.

People received personalised care to meet their needs. They participated in a range of activities and were supported to pursue their hobbies and interests. People enjoyed a variety of social activities which included in house activities, trips out, social events, holidays and family visits.

The service was well-led by the registered manager and their deputy. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. The provider had systems in place to monitor the quality of care provided and made improvements in response to their findings.

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 (Report published 23 August 2017.) At this inspection the rating has remained the same.

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 reinspection programme. If we receive any concerning information we may inspect sooner.

We were only able to have limited interactions with people because of their language difficulties. We relied mainly on our observations of care and our conversations with people’s relatives and staff to understand their experiences.

At the last inspection in December 2014 the service was rated Good.

At this inspection in August 2017 we found the service remained Good.

Why the service is rated Good:

People remained safe at the service. Relatives felt people at the service were safe. There were sufficient staff on duty to meet people’s needs and meaningfully engage with them. Recruitment procedures were safe. Detailed risk assessments were completed to help manage identified risks. People received their medicines safely and as prescribed. Regular checking of the service environment and testing of the equipment used within it had been conducted.

People continued to receive effective care. Staff received training to ensure they had the required skills and knowledge to effectively support people. People’s healthcare needs were monitored by staff and advice was sought when needed. The service demonstrated a firm understanding in applying the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People received adequate supported to eat and drink.

The service continued to provide a caring service to people. Relatives commented positively on the staff and the care provided by the service. People appeared at ease with staff and we observed positive interactions when staff communicated with people. Staff understood people well, including showing a detailed knowledge of people’s non-verbal communications to express their needs or mood.

The service remained responsive. Care and support was personalised to each person. Care records were detailed and highlighted people’s communication methods and ability. People’s relatives felt the service was responsive to people’s needs and most felt informed about the care and support provided to their relative. There was a complaints procedure in operation and the service had acted in accordance with this procedure when needed.

The service continued to be well led. There was a registered manager in post and people’s relatives spoke positively about how the home was managed. Staff told us the management within the service were open and approachable and commented positively on the current staff team. The registered manager was actively involved in giving care and support to people. There were systems that monitored the health, safety and welfare of people at the service and the service had links with the local community.

Further information is in the detailed findings below.

We reviewed how the service administers medicines because of reports of incidents of errors where medicines were omitted or given at the wrong time. We reviewed the processes of how medicines were administered, recorded and stored and found that appropriate systems had been implemented to ensure they did not reoccur.

When we spoke with relatives we were told, 'X enjoys living at Fiennes House, and since X has been there he has 'spread his wings' and become more independent and enabled to make decisions.' They added 'Top marks!' Another relative said, 'They have done so much for X, makes decisions for himself and appears to have grown up.' Relatives told us about their experiences with staff. They had observed, 'Staff had a good understanding about people.' And 'Staff are really, really lovely.'

We saw that staff treated people with respect, and their approach was friendly and inclusive. We saw staff offered choices to people and encouraged people to make decisions about daily activities. We received positive feedback overall from parents and health care professionals. One parent said, 'Staff are very caring'. Health professionals told us they did not have any concerns about the service. One told us, 'They take our instructions on board'. Another said, 'The service has a person centred approach'. Both professionals felt that the home managed complex needs well.

We found that the home was meeting the outcomes we inspected. The provider acted in accordance with legal requirements where people did not have the capacity to consent. People were cared for in a clean, hygienic environment. People were protected by the effective recruitment and selection processes in place. There was an effective complaints system available which meant that complaints people made were responded to appropriately.