Chard Manor

Chard Manor is a care home providing personal care for up to 10 people. Care is provided to autistic people, people with a learning disability and/or a physical disability. There were 10 people living at the home when we inspected.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

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

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

People had choice and control over their lives. 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 received personalised care and support built around their needs and wishes. They had a staff team who they knew and trusted, although staff changes had affected them.

Staff were trained to support people. People were relaxed and comfortable with the staff who supported them. Staff now supported people with their medicines in a safe way.

Right Care

People's care plans described the care being delivered by staff and people’s chosen lifestyle. The staff team had a good understanding of people's needs and were flexible to enable them to meet changing needs and wishes.

People were once again enjoying regular activities and interests outside of the home. Staff had worked with people to help re-establish routines and activities, try new things and achieve their goals. People’s achievements were recorded and celebrated.

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff were understanding and responded well to people’s needs.

People were kept safe from avoidable harm because the service had a clear policy to support staff to recognise and report abuse or poor care. Staff spoken with did not have any concerns about possible abuse or poor practice. Relatives had no concerns about people's safety.

Staff recognised signs when people experienced emotional distress and knew how to support them.

People’s individual ways of communicating had been focused upon recently. The training in, and improved use of, sign language by staff had been particularly beneficial. People interacted confidently with staff because staff had the necessary skills to understand them.

Staff felt well supported. There was ongoing training and supervision for staff to make sure practice always followed best practice guidelines.

Right culture

There had been significant changes in the home’s management team over a period of time. This had led to instability and a decline in the quality of the service. The service had been steadily improving since the current registered manager had been in post.

Relatives told us they had renewed confidence in the management of the home. Most relatives were closely involved with the service and had regular contact with staff.

People were supported by a small management team. The provider and registered manager consistently assessed, monitored and improved the quality of the service where possible. There had been cultural issues within the team, but these had been addressed and the culture had improved.

People and those important to them were involved in planning their care. Relatives told us they were involved in their loved one’s life and they were now being listened to once again.

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 outstanding (published 26 April 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed to good following this inspection.

Follow up

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

Chard Manor has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the service had improved to outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

At this inspection we found the service had improved to Outstanding overall.

Why the service is rated outstanding

People were protected from the risk of harm as the provider had effective policies and procedures in place to guide staff on how to keep people safe.

There was a stable, well trained, experienced staff team supporting people to become more independent in a way which put people in control of their lives and the support they received.

People and relatives told us the service was very well managed and the registered manager was very good at their job. It was clear the management team led by the registered manager provided clear guideline for staff and promoted the values of the service.

People were supported to participate in a wide range of activities, including sailing, cycling, visits out and holidays.

People were supported by staff to develop the service. They had helped redesign the garden and were consulted on any changes planned for the service.

Relatives told us communication with the home was excellent. The service supported people to maintain contact with relatives and friends by using 'skype'. People told us they liked using this and it was better than the telephone. The service also provided staff to facilitate home visits where required.

The service kept up to date with best practice in supporting people with autism and/or a learning disability. These practices were then embedded in the service by the staff team. This led to a huge reduction in people behaving in a way which challenged other and staff.

The registered manager and provider had effective systems in place to review the quality of the service provided to people. Where they found shortfalls, action plans were developed and implemented to address these.

The service met all relevant fundamental standards and exceeded in some.

People are 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.

Further information is in the detailed findings below.

Since the last inspection of this service the registered provider’s name has changed and therefore this is the first inspection of Chard Manor since the change.

There is 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 and senior staff team worked alongside other care staff to constantly monitor the service offered to people and implement improvements to enhance people’s quality of life. People and staff told us the registered manager was very open and approachable.

Staff felt well supported and staff morale was good. This created a very happy atmosphere for people to live in. There was a consistent staff team who knew people well. People were very relaxed and comfortable with the staff who supported them. One person said “It’s my second family.” A relative said “It’s like a loving family.”

Staff used a variety of communication methods to make sure people were able to have their say and make choices about all aspects of their day to day lives. There were ways for people and staff to raise concerns and make suggestions about individual care and the running of the home. People and relatives felt listened to and were confident any concerns raised would be addressed.

Everyone had a care plan which was personal to them and people or their representatives were involved in reviews of their care. Care plans gave information about people’s needs, wishes and preferred routines. This meant staff had enough information to provide appropriate support to each individual.

People had access to healthcare professionals to meet their individual needs. Any recommendations from healthcare professionals were incorporated into care plans to make sure people received effective care and support.

People had opportunities to take part in a wide range of activities at the home and in the wider community. Risk assessments were completed with people to minimise the risks to people and others. Staff supported people to keep in touch with friends and family.

Risks of abuse to people were minimised because the provider had a robust recruitment process and staff all knew how to recognise and report any suspicions of abuse. The staff worked in accordance with up to date legislation to make sure people’s legal rights were protected.