Archived: Fenwick Close

People’s experience of using this service: The outcomes for people using the service reflected the principles and values of Registering the Right Support through promoting choice, involving people in their local community and promoting their independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s received personalised care. A relative and an advocate said people were well cared for. People and staff had positive relationships; we observed many meaningful interactions between people and staff.

A relative and staff felt the home was safe. Staff knew about safeguarding and the whistle blowing procedures; they knew how to raise concerns if required. Staffing levels were sufficient to allow staff to support people to meet their individual needs. New staff were recruited safely.

Incidents and accidents were monitored effectively; the findings were analysed to checks for trends and patterns.

The provider completed checks to maintain a clean and safe environment. People received their medicines safely.

Staff were supported well and had access to the training they needed for their role. 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. Staff had a very good understanding of people’s needs; this enabled them to effectively support people to make choices and decisions. People were supported to have enough to eat and drink and to access healthcare services.

People’s needs were assessed to identify how they wanted to be supported; religious, social and lifestyle needs were considered. The information gathered was used to develop personalised care plans. People were supported to choose and participate in activities; they were also supported to work towards achieving their aspirations.

The registered manager was effective in managing the home. The provider had been restructuring its registered services, leading to regular changes in staff. The provider continued to operate a structured and effective approach to quality assurance. People, relatives and staff had opportunities to give feedback.

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

Rating at last inspection: Good (the last report was published on 12 July 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule for services rated good.

Fenwick Close provides care and support for up to three people who have a learning disability. The home is one of three homes situated in its own small close that is set in its own landscaped grounds. There is one manager responsible for the management of all three homes in Fenwick Close. They have an office base on the close. The close is for the sole use of people living there, their families and staff. The home does not provide nursing care. At the time of the inspection there were three people living at the service.

The manager had been in post since February 2015. At the time of the inspection they were not registered with the Care Quality Commission. The last registered manager cancelled their registration on 18 April 2016.

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.

Relatives we spoke with said they thought their family members were safe. One relative said, “There’s always staff around.” Staff confirmed they were well trained and there were enough staff to meet people’s needs.

Safe recruitment procedures were in place and people had been trained in recruitment so they were invited to attend panel interviews.

Medicines were administered, recorded and stored in a safe manner.

There had been no safeguarding concerns raised. A procedure for recording, reporting and investigating any concerns was in place and staff understood what they should do if they had any concerns.

Risk management plans were in place. Two were dated 2008 and 2012. They had been reviewed and the manager said the information was still relevant but could be updated. Other risk management plans were person centred, specific and detailed.

Personal emergency evacuation plans were in place and staff understood how to evacuate people in an emergency. One staff member said, “We do simulated evacuations with [people], it’s about two minutes to evacuate, everyone copes well. People know the drill.”

Accidents and incidents were recorded, investigated and analysed for lessons learnt. There was a procedure for recording and investigating complaints but none had been received. Relatives told us they had no reason to complain.

The Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) was understood by staff. They were aware people had authorised DoLS in place and they knew how to support people with making decisions in their best interest.

People had the involvement of external professionals such as speech and language therapy, the community learning disability team, district nurses, dentists and opticians.

We observed warm and caring relationships between staff and people. One person said to a staff member, “You’re lovely you are, I like you.” Relatives said they were happy with the care provided. One relative said, “They are happy and looked after and that’s the main things, that’s what’s important.”

Care records were detailed and person centred. One relative said, “I was involved in care plans and I go to the review meetings, it’s all explained to me.”

Detailed communication passports were in place to support effective communication and understanding between people and their staff. Hospital passports were in place to support hospital staff to know vital information about people should they ever be admitted to hospital.

Each person had an activities timetable, which meant they had a routine. It also meant there was social engagement and community involvement.

A range of quality assurance systems were in place to audit the quality of the service and to identify any improvements. Peer reviews were also completed where managers from another service completed the audit.

Staff and relatives were happy with the management of the service. One relative said, “The manager is fantastic.” They added, “There are no improvements that could be made, I’m happy with everything.”

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

The service was safe. There were suitable risk assessments in place that were reviewed when needed. People were recruited to the home in accordance with safe practices and staffing levels reflected the needs of people living there.

CQC monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

The service was effective. The service assessed people's needs and the risks associated with their care. Care plans showed how staff would meet people's needs and records showed that staff implemented what was on the care plans. People told us that 'the staff were marvellous and had done wonders for their relative'. We observed staff acting in accordance with the care plans and having a positive impact on the people living there.

A visiting community nurse told us 'staff had undertaken client specific training and she was confident they would put her guidance into practice'

Is the service caring?

The service was caring. Our observations showed staff being attentive to the needs of people speaking to them in a friendly way and asking what they wanted.

The manager explained that she 'felt they were not only providing services for people living but also supporting their relatives if they needed it'. A relative told us 'the staff are marvellous, so caring and welcoming', 'it's a lovely place'

Is the service responsive?

The home was responsive. We saw records that showed that staff re assessed people's needs regularly. Care plans were detailed and showed changes over time as people's needs changed. One relative said 'they (the staff) have done wonderful things with our (relative) and ask us all the time about such things as visits to the GP or outings'

Is the service well-led

The service was well led. The manager was experienced at working with people with profound learning disabilities. She had systems in place to monitor what happened in the home and was observed to be an active presence within the home. A relative said 'the manager is approachable and listens and the nice atmosphere is down to the manager and staff'

People were seen to be relaxed and comfortable with staff. Staff were observed asking if they would like a drink or if they needed anything.

We were supported on this inspection by two experts by experience. An expert by experience is a person who has personal experience of using, or caring for someone who uses this type of care service. We asked the experts by experience to spend time with the people living in the service to find out their views about what it was like to live there.

They told us that one of the people in the house seemed to do quite a lot of activities and they had some choice in what they do. The expert by experience told us that there was good chat going on and laughter, which was a sign that people were getting on well. They told us that the people were chatting about where they were going that day. One person was about to go out to play bowls and the other to the park and out for lunch.

They reported that the staff informed them that hey support the people to try new activities. For example they take people to taster sessions so they can first this gives people the chance to see if they would like to try a new activity.

The experts by experience told us that they found the home comfortable and the rooms contained personal items. However, there were no low-level benches, sinks or cookers in the house so that people who used a wheelchair could access them. One of the experts by experience who used a wheelchair found that the garden was not easily accessible.

During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed.