Shaftesbury Court (Manor Close)

Shaftesbury Court is a residential care home providing accommodation and personal care for up to 17 adults with learning and/or physical disabilities. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of this inspection 14 people were living at the service.

The service has recently moved back to this location following a complete rebuild. The accommodation is on a single storey level and is comprised of two open plan communal kitchen dining rooms and lounge areas. Each bedroom has en-suite facilities and a door leading to outside.

There are also two bungalows on the site which provide accommodation for up to four people. Three of the 14 people being supported were living in these at the time of this inspection.

The service is also registered to provide personal care to people living in their own homes. At this time no one was receiving this 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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Not all key questions were inspected at this time, but the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture in relation to the Safe and Well-led key questions.

Right support:

• There were positive opportunities within the service for people to be engaged and involved.

• The new build had been designed very much with the people who lived there in mind. They had been involved in the design and plans at an early stage to ensure it worked for them.

• We saw that people were involved in the creating and ongoing review of their care plans.

• The service worked with people towards more independent ways of living.

Right care:

• We did not look at the caring key question at this inspection. However, we did observe some care interactions and saw these demonstrated genuine care for people from staff.

• People were extremely comfortable with staff and people’s permission was sought at every support interaction.

• The service was dedicated to being led by the people who lived there and people were active in choosing how they lived.

• The service had used exceptional advances in technology to effectively enhance and promote peoples experiences.

Right culture:

• The service has a exceptionally positive culture that was person-centred, open, inclusive and empowering. It had a well-developed understanding of equality, diversity and human rights and put these into practice. Staff at every level demonstrated a genuine passion to promote and support people’s rights within the service.

• People living at the service were valued for the individuals they were.

• There were many opportunities provided for people to be engaged and involved in the daily running of the service and their wider community.

• Staff members were visibly proud to work in the service and keen to share their knowledge of people and ways their practice supported people.

The service had excellent and well thought out infection control measures in place. Information folders and updates regarding the pandemic were readily available for staff to keep well informed and Easy read documents were in place to support people’s understanding. The provider had introduced a new policy in which new employees joining the organisation had to receive their COVID-19 vaccine within three months. The service had received extremely positive feedback from a health professional about the organisation of staff when they had visited to undertake COVID-19 immunisation to people and staff. This had been shared with the GP as an example of excellence.

The service had a clear structure of accountability and defined roles. Staff felt well supported and spoke positively about their roles within the service. Staff shared their positive feedback about the support and care they had experienced from the registered manager during the last difficult year. The registered manager had been the provider's chosen winner for their last year awards ceremony for their excellent leadership and commitment to the service.

Staff followed an admirable ethos that centred around promoting independence and people's choice. Staff knew people well and relationships between people and staff were comfortable and built on mutual trust.

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 Requires Improvement (published 26 February 2018).

Why we inspected

This was a planned inspection based on the previous rating. The service undertook an extensive rebuild and we wanted to make sure people’s needs were being met at this location and that they were safe.

This was a focused inspection and the report only covers our findings in relation to the Key Questions of Safe and Well-led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

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 coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shaftesbury Court (Manor Close) on our website at www.cqc.org.uk.

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.

The accommodation is on a single storey level and is comprised of a large communal lounge area, with four ‘wings’ leading off of the lounge. Each wing has four bedrooms, shared bathroom and kitchen area. There was a bungalow attached to the service, which provides accommodation for up to four people. The service is also registered to provide personal care to people living in their own homes. This service was only being provided to one person at the time of the inspection.

A registered manager was in post; and both the registered manager and deputy manager were present during our inspection, as well as the regional 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. Staff told us they felt supported by the management team. Staff also expressed that they felt they could raise any concerns or feedback and that they would be listened to.

Infection control risks in relation to the environment were not always identified. We found out of date food stored in the fridges, as well as flaky paint and chipped surfaces preventing thorough cleaning of door frames and worktops. Other risks for individuals were identified, such as the risk of falls. These were assessed and detailed with appropriate actions and risk assessments in the care plans.

At the last comprehensive inspection in August 2015, the service was rated as ‘Good’ overall, with ‘Requires Improvement’ in Safe. In the domain of Safe feedback was provided regarding the maintenance of the environment. Changes were made to address this; but at this inspection there were environmental areas of the service that had continued to need attention and these may not have been present at the last inspection – such as flaking paint, missing cupboard doors, stained flooring. Staff raised concerns at the length of time equipment took to be repaired and explained the knock on effect this had to the time they could spend with people

The management and staff teams had a very positive approach to the care and support that the service provided. We saw the team working efficiently and effectively together, with staff positively engaging with one another and each person they supported. Staff understood the values of the service and were invested in wanting to do the best for each person.

As part of the inspection we asked the registered manager to provide contact details for health and social care professionals who had involvement with the service. After the inspection, two professionals responded with their views. One professional said they had “no concerns at all” and another described the service as “very good, it is very person centred and they try everything they can to help people maintain their independence”.

Each person had a care plan and where possible staff encouraged and supported the person to be involved in the care planning process. There was a creative and modern approach to supporting people to be involved, including the use of a mobile phone application and an electronic tablet. One person preferred to discuss their care plan while receiving one-to-one time with a member of staff outside of the home, while on a walk.

Consent was sought before support was provided and staff evidenced an understanding of how to communicate with each person – using the communication tools where possible. Staff had a strong understanding of the Mental Capacity Act (MCA) and could relate the principles of the act to the people they supported.

During the inspection there was sufficient staff available to ensure that two people could receive one-to-one support for an activity of their choice; others were engaged in a group activity baking a cake with the chef and there were staff available in the communal areas as well. Those who required one-to-one support during meal times received this and the staff displayed an understanding of the needs of the individuals they were assisting.

Providers are required, by law, to display their CQC rating to inform the public on how they are performing. The latest CQC rating was displayed in the service and these details were also on the provider’s website.

We carried out this unannounced focused inspection on 3 March 2017 to check the provider had followed their plan; and to confirm that they now met legal requirements. We found that action had been taken to improve the safety of people who use the service. Care plans and risk assessments included detailed information and guidance for people and staff to follow regarding the safe use of grab and bed rails. The home had undergone redecoration and refurbishments.

This report only covers our findings in relation to that requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk.

Shaftesbury Court (Manor Close) provides accommodation (without nursing) and personal care for up to 19 adults, some of whom have learning disabilities, autism and physical disabilities. The accommodation for people is on single story level and comprises of a large communal area and four ‘wings’ each with four bedrooms, shared bathroom and kitchen area and a bungalow for up to four people. The service is also registered to provide personal care to people living in their own homes.