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Inspection carried out on 25 November 2019

During a routine inspection

Huish House provides accommodation with personal care for 12 people. The home specialises in providing a service to adults who have a learning disability, autism, sensory impairment or physical disability.

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

People were not able to tell us about their experiences of life at the home, so we therefore used our observations of care and our discussions with staff and relatives to help form our judgements.

The service was going through a period of change. The last registered manager had left after managing the home for 12 years. Some people may have been affected by this change and were being supported. The deputy manager had now become the manager and had applied to register with us. They were keen to develop and improve the service and ensure the ethos was inclusive, open and honest.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People were safe. The provider had policies and procedures in place designed to protect people from the risk of suffering harm and abuse. Risk assessments were in place which identified possible risks to people and how to reduce them.

People's needs had been assessed before they moved into the home, to ensure their needs could be met. People’s changing needs were responded to. Suitable staffing numbers to meet people’s changing needs were a concern for relatives and staff. This issue was being acted upon by the manager.

People were supported by staff who were well trained to meet their individual needs. The service worked closely with people's families, advocates and other professionals to improve the care and support they provided.

Staff asked people for their consent before supporting them. People were supported by a staff team who respected their choices and decisions. Staff promoted people’s privacy, dignity and independence.

People, and those close to them, were involved in planning and reviewing their care which meant the care provided was specific to each individual. People's communication methods were identified within their care plans and understood by staff. People's, relative’s and advocate’s views were central to how the service was run.

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 were part of their community. They chose a wide range of college courses, activities, trips and other social events.

The service was well managed with the provider’s support; a new management team was being developed. The current management team were open and honest. There were effective systems to monitor the quality and safety of the service. There was a strong commitment to improving the service.

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 April 2017)

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

Inspection carried out on 9 March 2017

During a routine inspection

This inspection took place on 9 March 2017 and was unannounced. It was carried out by one adult social care inspector.

At our last inspection of the service in September 2014 we did not identify any breaches in our regulations. However we found some aspects of the mealtime experience were rushed. At this inspection we found the provider had taken action to address this.

Huish House is situated in a quiet rural area and is close to the town of Langport. The home provides accommodation with personal care for up to 12 people. The home specialises in providing a service to adults who have a learning disability, sensory impairment or physical disability. The environment is spacious and all bedrooms are for single occupancy. There are large gardens and parking. The home is staffed 24 hours a day.

At the time of our inspection there were 12 people living at the home. People were not able to tell us about their experiences of life at the home so we therefore used our observations of care and our discussions with staff and relatives to help form our judgements.

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.

The registered manager was available throughout our visit. They had a clear vision for the home and the people who lived there. They told us they were committed to ensuring people received the best possible care and enjoyed a happy life. Through our observations and discussions with staff it was very clear the ethos was that it was very much the home of the people who lived there.

There was a very happy and relaxed atmosphere in the home and people looked relaxed and content with the staff who supported them. Staff understood people’s needs and preferences and engaged with each person in a way that was most appropriate to them.

There were enough staff deployed to help keep people safe. People were supported to live the life they chose with reduced risks to themselves or others. There was an emphasis on supporting people to develop and maintain independent living skills in a safe way.

There were policies and procedures which helped to reduce the risks of harm or abuse to the people who lived at the home. These were understood and followed by staff. These included recognising and reporting abuse, the management of people’s finances, staff recruitment and the management of people’s medicines.

People were supported by a caring staff team who knew them well. Staff spoke with great affection when they told us about the people they supported. One member of staff said “I love it here. Everyone here is amazing. You get so attached to them. We are like part of their family really.” Another member of staff said “I have never worked in such a brilliant home with such wonderful people.”

People were always asked for their consent before staff assisted them with any tasks and staff knew the procedures to follow to make sure people’s legal and human rights were protected.

People and the people close to them were involved in developing and reviewing the care they received. Each person had a care plan which detailed their needs, abilities and preferences. These had been regularly reviewed to ensure they reflected people’s needs and aspirations.

People accessed various activities in the home and local community. People were supported to maintain contact with the important people in their lives.

There were systems in place to monitor and improve the quality of service people received.

Inspection carried out on 05/08/2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. Our last inspection was in February 2014 when we found the service to be meeting all the standards we looked at. Huish House provides care and support for up to twelve people who have a learning disability, sensory impairment or physical disability.

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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

Relatives told us they felt their relatives were safe and their welfare was protected. The service protected people’s rights and ensured wherever possible people were involved in making decisions.

We found staff were up to date with current guidance to support people to make decisions.  Any restrictions placed on them were done in their best interest using appropriate safeguards.

Staff received comprehensive training so they could provide professional and effective care.  Staff were supported to fulfil their role and responsibilities through regular one to one supervision and appraisals.

People were offered varied, balanced and nutritious meals and specialist support was available to ensure people’s nutritional needs were met. We saw people being offered support and assistance to have their meals however there was a sense of people being rushed to complete their meal rather than an unhurried and relaxed atmosphere.

Relatives told us they were very satisfied with the healthcare people received. People’s health needs were identified through comprehensive assessment and reviews to ensure they accurately reflected people’s needs.

People told us they liked staff. We observed staff interacting with people in a sensitive, patient and understanding professional manner. Staff had an understanding of how people communicated their feelings and needs and were able to respond to those needs in a caring, non-judgemental and supportive manner. People were enabled to have control, be treated with respect and have their dignity upheld.

Relatives told us how staff established close and caring relationships with people. One relative told us their relative had become very close to a member of staff and this reflected the caring relationships staff established with people. We noted how the service had retained staff over a long period which contributed to the consistency and continuity of the relationships people had with staff.

A social care professional told us “I found the home to be a friendly warm environment that gave an overall good impression. Speaking to parents they all reiterated that they were always made to feel welcome and the homes manager was easily contactable with a good dialogue between themselves and the service user’s home.”

There were comprehensive assessments of people’s health and welfare needs. These had been regularly reviewed and updated to accurately reflect the person’s needs. People and/or their representatives took part in the reviewing of care arrangements.

The service had responded to an individual’s changing physical needs making adaptations to the person’s environment. Their representative welcomed how the service had been able to continue providing care and support to this individual.

There were flexible staffing arrangements ensuring there were the necessary numbers of staff to support people. A range of activities were organised with people having the opportunity to use community facilities and take part in activities of their choosing. This ensured the service provided meaningful activities suited to people’s interests, abilities and preferences.

People are enabled to maintain their relationships with friends and family. One relative told us they visited frequently and were “always made to very welcome” another said “they are incredibly welcoming”. They told us how they always felt able to voice any concerns.

There was a culture of empowering and enabling people in making choices and decisions about their care and how they led their lives. Staff benefit from a management style which is accessible and responsive.

People and others who have contact with the service are able to voice their views about the quality of the care provided. The provider was open to making improvements and responding to identified shortfalls where these are found.