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Inspection carried out on 23 February 2021

During an inspection looking at part of the service

Croft House is a residential care home providing personal care and accommodation for up to six people living with a learning disability and or autism. At the time of inspection there were five people living at the service. Bedrooms were over two floors and there were communal spaces for dining and relaxation and a large outdoor space.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture under the key enquiries we reviewed in the Safe section. People received individual person centred support that promoted and maximised their choice, control and independence in how they lived their lives. Staff had developed positive relationships with people and they clearly knew what was important to them such as their routines and preferences. Staff had a caring and respectful approach and they promoted people's dignity and human rights.

The infection prevention and control practice of managing the current COVID-19 pandemic was found to be well managed. The provider had developed a COVID-19 contingency plan and a service business continuity plan, both were regularly reviewed and updated to reflect changes to government guidance. Staff had received training in infection prevention and control, including the requirements of wearing personal protective equipment (PPE). Staff had access to a good supply of PPE.

Regular COVID -19 testing for people and staff was completed in line with government guidance and people and staff were participating in the COVID -19 vaccination programme. New systems and processes had been implemented for visitors to reduce the risk of infection transmission. Increased cleaning of high touch areas such as door handles and light switches was being completed. The service was found to be clean. During November 2020 an outbreak of COVID-19 at the service was managed by zoning the environment and cohorting staff. This practice reduce the risk of transmission and the infection was contained. People were supported to maintain contact with their relatives.

The deployment of staff was found to be sufficient in meeting people's individual needs and safety. Bank and agency staff including the management team covered any staff shortfalls and new staff were in the process of being recruited. Staff experience, skills and competency was considered when developing the staff rota. Staff demonstrated a good level of awareness and understanding of people's individual needs and risks. Staff were positive about the support and guidance provided by the registered manager.

In the main, risk management was found to be comprehensive and guidance for staff was up to date and detailed. One person's risk plan associated with physical intervention and risks associated with community drives in the services vehicle could have been more detailed, this was discussed with the registered manager who took immediate action. At the time of the inspection contractors were working on site, whilst the provider had a generic risk assessment this was not specific to the service. This was discussed with the registered manager and regional operations manager who agreed to amend the document.

People were protected from abuse and avoidable harm. Where safeguarding incidents, concerns or allegations had been raised these had been responded to as per the local multi-agency and provider's safeguarding policy and procedures. Action taken by the registered manager and senior managers confirmed all allegations, conce

Inspection carried out on 20 February 2018

During a routine inspection

Croft House 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. Croft House is registered to accommodate six people with learning disabilities; at the time of our inspection there were five people living in the home.

At the last inspection in November 2016 this service was rated as requires improvement. At this inspection, we found that improvements had been made and sustained and the service was rated good overall.

The service had a registered manager. 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.

People received care from staff that knew them and were kind, compassionate and respectful. There were usually sufficient staff to provide the care and support people required.

People’s needs were assessed prior to moving to the home, care plans based on their individual needs and preferences were in place and were kept under review. Risks to people had been identified and measures put in place to mitigate any risk. However, one person had an identified risk and there was not a plan in place to give staff guidance how to reduce the risk.

Medicines were managed in line with the prescriber’s instructions. The processes in place usually ensured the administration and handling of medicines was suitable for the people who used the service. The registered manager was in the process of reviewing medicines with the GP to make sure there were clear instructions on when to give all medicines.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to keep people safe from any risk or harm and knew how to respond if they had any concerns.

Systems were in place to ensure the premises was kept clean and hygienic so people were protected by the prevention and control of infection. There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff were supported through regular supervisions and undertook training, which helped them to understand the needs of the people they were supporting. People and where appropriate their relatives were involved in decisions about the way in which their care and support was provided.

People’s diverse needs were met by the adaptation, design and decoration of premises.

Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day-to-day routines. However, these had not always been completed for a specific decision. Care plans included information about how the person had been supported to make their own decision.

People’s health care and nutritional needs were met and relevant health care professionals were appropriately involved in people’s care.

People were supported to take part in activities which they wanted to do, and encouraged to participate in events within the local community. Care plans were focused on the person and their wishes and preferences

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

There were comprehensive systems in place to monitor the quality and standard of the home. Regular audits were undertaken and any shortfalls addressed. Concerns we had identified about the registered manager having time to work on improvements at our previ

Inspection carried out on 18 November 2016

During a routine inspection

This inspection took place on 18 November 2016 and was unannounced. At our last inspection of the service on 13 November 2015 the service had been rated as requires improvement.

Croft House is a residential service for six adults with autistic spectrum disorders and challenging behaviours. The property is an extended detached house comprising of six en-suite bedrooms and sleep-over room. It is set in the village of Thurcaston close to amenities and bus routes. There is ample car parking and a large mature garden with wooden cabin, conservatory and patio area. At the time of our inspection there were five people using the service.

There was a registered manager at the service. 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.

People felt safe at the service. People and their relatives were happy with the care they received. People were supported to have their medicines in their preferred way and people received their medicines as prescribed.

People were supported by a staff team that was kind and caring towards their needs. There were not always enough staff that were suitably qualified and skilled to meet people's needs and support people appropriately. The registered manager had was going through a period of recruitment to ensure that they had staff with the right skills and knowledge to meet people's needs.

Staff felt supported within their roles but they had not always received regular supervision and support to complete their induction training.

People were supported to be involved in decisions about their care and support. People were supported to have a varied and balanced diet.

People's care plans contained information of people's likes, dislikes and the things that interested them. This ensured staff had the knowledge they needed to assist people do the things they enjoyed doing. Risk assessments were also in place to effectively identify and manage potential risks.

People and relatives knew how to make a complaint. Complaints were recorded and investigated.

Systems were in place to monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. However there was still some work to be completed to ensure that these were used as an effective feedback source.

Inspection carried out on 13 November 2015

During a routine inspection

The inspection took place on 13 November 2015 and was unannounced. This was the first inspection of the service since it changed to a new provider in June 2014.

Croft House is a registered care home providing care and support for up to six adults with learning disabilities. There were six people using the service at the time of our inspection.

There was a registered manager at the service. 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. At the time of our inspection the registered manager was working their notice period before leaving the service.

People felt safe at the service and staff knew how to report any concerns. Where a concern had been reported the service had taken appropriate action to keep people safe. The service carried out appropriate pre-employment checks before people started work. Staff complete the Care Certificate as part of their induction and received relevant training to enable them to carry out their roles.

Staff knew people that used the service well and showed concern for their well-being. We saw that people had detailed behavioural guidelines in place for staff to follow. This ensured that people received consistent approaches towards their care and behaviours from staff members.

The service was working within the principles of the Mental Capacity Act 2005. Where there was a reasonable doubt that a person had capacity to give consent to a decision a mental capacity assessment had been carried out. Where appropriate a best interest decision had been made and a referral sent to the local authority if the decision deprived people of their liberty in any way.

Staffing levels enabled the service to be responsive to people’s needs. People were supported to in their interests and carry out activities of their choice. People were able to choose which activities that they carried out.

Staff felt supported by the registered manager but there had been a recent period where the registered manager had been off from the service where staff felt that they had not received appropriate support.

There was a quality assurance process in place and audits of the service had been carried out. These had failed to identify the concerns with medicines that we found and the risks that this posed to people using the service.