Ling Crescent

Ling Crescent is a residential care home providing personal care to up to 6 people. The service provides support to people who live with learning disabilities and autistic people in 1 adapted building. At the time of our inspection there were 4 people using the service.

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.

Based on our review of key questions safe, effective, caring, responsive, and well-led, the provider was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support: 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. However, mental capacity assessments and best interest meetings had not always been documented fully. The manager had identified this and was in the process of making improvements at the time of our inspection. We were assured the provider had a robust plan in place and found no negative impact on people.

Right Care: People were supported safely with their medicines. Staff were recruited safely and had the correct training. People's support plans were person centred and reflected their range of needs, and this promoted their wellbeing and enjoyment of life. People took part in activities and pursued interests that were tailored to them. People had privacy for themselves and their visitors in their bedrooms.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive, and empowered lives. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity.

The provider was reviewing people's care plans and risk assessments to ensure information was up to date.

The provider sought feedback on the service it provided, this information and outcomes were used to drive improvement.

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 29 November 2018).

Why we inspected

The inspection was prompted in part by notification of an incident in which a person using the service died following a fall from height. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of risk of falls. This inspection examined those risks.

Following this incident, the provider completed a full review of safety for all people living in the service.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ling Crescent on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

residential area and has been converted from two semi-detached houses which have been knocked through. The home also has a garden for use by the residents.

At our last inspection we rated the service outstanding. The service had been found to be outstanding in two domains, Responsive and Well-led. All other domains had been rated as Good.

At this inspection we found the evidence continued to support the rating of outstanding in the Responsive domain. The Safe, Caring, Responsive and Well-led domains were all found to be Good.

The home provided accommodation and care to four men and two women, all of whom were living with a learning disability and/or autism. Some people in the home also had a physical disability, although everyone could walk a short distance. People living the home had some challenges around communicating verbally. Staff were knowledgeable about each person’s preferred communication methods and could understand and be understood by them.

The provider had considered how to ensure that people at Ling Crescent were provided care in line with the recommendations made in Registering the Right Support and other best practice guidance. The home was in a residential area of a small town and provided easy access to shops and other commercial premises such as banks. Public transport routes were accessible on foot for people. People were supported to use local facilities and to feel part of the local community. For example, one person visited local shops and the bank on the first day of inspection. People were also encouraged to do activities that supported them to live fulfilled and active lives.

People were supported to have a healthy diet, eating food they enjoyed. However, records for a person who was underweight did not describe accurately what the person’s healthy or average weight was, or what staff should do if the person lost weight. We have made a recommendation about current guidance on Learning Disability and weight management.

Staff had been trained to administer medicines safely. The registered manager and staff had worked with health professionals to review people’s medicines and ensure they were not being over-medicated. They had done this by working with the professionals to find alternative strategies to support people when they displayed behaviours that could challenge others.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The registered manager and staff understood and followed the requirements of the Mental Capacity Act 2005. They were committed to supporting people to achieve as much independence as possible, while ensuring each person was safe.

The registered manager and staff were committed to providing care which supported people to live as independently as possible. People were encouraged to do activities they enjoyed both inside and outside the home. Some of the activities supported people to have an active lifestyle which included wall climbing, archery, boating, zip wires and bowling. People were also supported to go on holiday both in the UK and abroad. Staff understood how playing music and attending concerts was important to one person, while other people enjoyed going to the theatre. People were supported to use information technology to help them with aspects of their life, including communicating with families.

Feedback from families was very positive and included comments such as “He’s happy, we are very happy… staff very good” and “I find the home good, very good staff…It’s his home, staff are more like family.”

The home was in a quiet residential area where people could access public transport which helped them be independent. People were also able to walk to local shops and banks with staff and undertake chores around the house. The home was well maintained and clean throughout. People had personalised their bedrooms, choosing décor, flooring and furniture according to their preferences.

Staff had been recruited and received training to ensure they were knowledgeable about how to support people well. Staff understood their responsibilities to safeguard the vulnerable people in their care.

The registered manager ensured that the quality assurance policies and procedures of the provider organisation were followed. Where issues were identified, remedial action was taken. Senior managers also visited the home to provide support as well as complete audits and checks on the home and how it was run.

Further information is in the detailed findings below.