We carried out a review of the data available to us about Bewick House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bewick House, you can give feedback on this service.
About the service
Bewick House is a residential care home providing personal care to six people with learning disabilities and at the time of the inspection. The service can support up to six people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
We received extremely positive feedback from people, they told us they were very happy living at Bewick House. People were really happy with the person-centred support they received to enable them to enable them to have fulfilled lives, have improved well-being and increased independence. Visiting professionals spoke very highly of the staff team and the home.
The service had been fully developed and without doubt designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. People using the service received exceedingly well planned and co-ordinated person-centred support, appropriate and inclusive for them.
Peoples health, well-being were drastically improved as a direct impact from the level of personalised support they received from the staff team who continually supported people to develop, try new things, learn new skills to help achieve personal goals. People were empowered to have their say and to exercise their rights. Access to an advocacy service was available and taken up when needed. People were supported and empowered to take on additional self-advocacy projects.
Support was provided in a way which put the people and their preferences first. Excellent continual joined up working with healthcare professionals was in place and working together exceeded expectations and peoples personalised goals in wellbeing, education, independence and employment experience.
People were supported emotionally and confidentially to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and leadership in the service ensured this practice was the norm. People were supported to build and maintain important personal relationships that mattered to them; with peers, friends and relatives. People were empowered to support others to speak out and improve services.
Management and staff went the extra mile. Staff received superb additional support to retrain to the appropriate level of personalised training to meet people’s exceptional needs.
The home was adapted to meet people’s needs and raise their aspirations by providing a homely and also an educational environment. The home was very clean, modern and homely and maintained to a very high standard with personalised features throughout.
Audits and monitoring systems were used effectively to manage the service and to make improvements when required.
The registered manager and staff supported people to make valuable connections to help tackle social isolation and to support each other. People were able to access a superb range of activities in the home and outside which promoted, education, improved wellbeing and community independence.
There were excellent systems in place for communicating with people, their relatives and staff to ensure they were fully involved and included one to one key worker meetings, handovers, team meetings, phone calls and emails.
Medicines were managed well, safely administered and recorded accurately. Individualised risk assessments were in place. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.
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 (11 July 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 service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Bewick House is a residential support home based in Darlington. The home provides personal support for people with learning disabilities who also experience mental ill health. It is situated close to the local amenities and transport links. The service is registered to provide support to six people and on the day of our inspection there were six people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We last inspected the service in January 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ overall. The atmosphere of the home was vibrant, homely, warm and welcoming. People who used the service were relaxed in their home environment and visitors offered praise of the service and were always welcomed.
Without exception people were empowered on a daily basis to have choice and control over their lives from being supported by person centred approaches. Person centred is when the person is central to their support and their preferences are respected.
The home was extremely person centred, inclusive and was underpinned by a genuine desire to offer a quality personalised service.
Visiting professionals offered praise of the service and especially the person centred values and support offered to people.
People were empowered to forward plan goals and to achieve them to improve their quality of life.
We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness. We saw staff being respectful, considerate and communicating exceptionally well with people well.
Support plans were developed in partnership with people and not for people and these set out exactly how people liked to be supported and what goals they wanted to achieve.
People’s support plans were written in plain english and reflected the person centred values of the home. They included targets that people wanted to achieve and a ‘one page profile’ that made use of, personal history and described individual’s support needs. These were regularly reviewed; and people were always at the centre of the process.
People were encouraged to have their say and get involved in engagement opportunities with advocacy organisations on wider issues such as the ‘transforming care agenda’ that is tailoring services in the community for people who are currently in long stay hospital and treatment centres across the UK.
People were supported to play an active role within their local community by making regular use of local resources, clubs and amenities.
People were equal partners and fully involved in all aspects of the staff recruitment process.
People influenced how the home was run by voicing their opinions regularly and these were acted upon.
Support plans contained person centred risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm to enable them to do the things they wanted to live their lives fully.The support plans we viewed also showed us that people’s health was monitored and referrals were made to other health support professionals where necessary, for example: their GP, community nurse or optician.
People were enhancing their wellbeing on a daily basis by taking part in flexible person centred activities both at home and within the local community. Activities encouraged and maximised peoples independence and impacted positively on people’s lives.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. The home was truly reflective of what people liked and people were in control of this and chose daily what they would like to eat and were involved in shopping and preparing food.
An accessible complaints and compliments procedure was in place. Providing various ways for people to access information on what to do if someone wished to make a complaint and what they should expect to happen next.
The compliments that we looked at were praising the support staff, management and the service as a whole.
People had their rights respected and regular access to advocacy services.
People were supported to maintain their independence with dedicated one to one support.
People were supported to be active in their chosen religion both at home and in the community.
Without exception support staff told us they felt extremely supported to carry out their role and to develop further and that the registered manager led by example, was person centred focussed, supportive and always approachable.
Throughout the inspection we saw that people who used the service and staff were very comfortable, relaxed and had an extremely positive rapport with the registered manager and also with each other. Our observations during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs on a one to one basis in a person centred way.
When we looked at the staff training records, they showed us staff were supported and able to maintain and develop their skills through training, and development opportunities were accessible at this service. The staff we spoke with confirmed they attended a range of valuable learning opportunities. They told us they had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their support practice and identify further mandatory and vocational training needs. We also viewed records that showed us there were robust recruitment processes in place.
Medicines were stored, managed and administered safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and how this was monitored.
We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views about the support and service they received at meetings and via surveys.
We inspected Bewick House on 25 November 2014. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
Bewick House provides care and support for six people who have a learning disability and/or mental health problems. The home does not provide nursing care. It is a large detached house situated on a housing estate in Darlington and is close to large supermarket and other amenities.
The home had a registered manager in place and they have been in post since the home opened. 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 majority of the people living at the home required staff to provide support to assist, to develop impulse control, and to manage their behaviour and reactions to their emotional experiences. The structured environment staff provided was similar to that offered in mental health nursing services but people’s level of need could be managed within a residential setting. We found that the manager had taken appropriate steps if people’s needs changed and staff struggled to meet their needs.
People we spoke with told us they felt safe in the home and the staff made sure they were kept safe. People told us that the staff worked with them to see how to reduce risks when going out and about. We saw there were systems and processes in place to protect people from the risk of harm.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. A designated infection control champion was in post and we found that all relevant infection control procedures were followed by the staff at the home. We saw that audits of infection control practices were completed.
We found that people were encouraged and supported to take responsible risks and positive risk-raking practices were followed. Those people who were able to were encouraged and supported to go out independently and others routinely went out with staff.
Staff had received a range of training, which covered mandatory courses such as fire safety as well as condition specific training such as mental health disorders. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards training and clearly understood the requirements of the Act which meant they were working within the law to support people who may lack capacity to make their own decisions. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that four to five staff routinely provided support to people.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We observed that staff had developed very positive relationships with the people who used the service. We saw that the staff were able to discreetly keep people focused on the present, reduce the impact of the difficulties people experience with impulse control and anger management. There were interactions between people and staff that were jovial and supportive. Staff were kind and respectful, we saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice.
People told us they were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight and nutritional needs.
We saw that people living at Bewick House were supported to maintain good health and access a range healthcare professionals and services. We found that staff worked well with people’s healthcare professional such as consultants and community nurses. People were encouraged to have regular health checks and staff accompanied people to their hospital appointments.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them.
People told us how staff encouraged them to develop their daily living skills and supported them with their courses, hobbies and leisure interests inside and outside of the home. During the visit we saw staff join people doing creative work and identify activities people would enjoy doing.
We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
The provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the manager had implemented these and used them to critically review the service. This had led to the systems being extremely effective and the service being well-led.