Elysium Care Partnerships Limited - 78 Park Road

Elysium Care Partnerships Limited - 78 Park Road is a residential care home providing personal care to up to seven people. The service provides support to younger people with a learning disability in one adapted building. At the time of our inspection the home was at full capacity.

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

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.

Right Support: People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service had enough staff, including for one-to-one support for people to take part in activities and visits. The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. People received support to eat and drink enough to maintain a balanced diet.

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.

Right Care: Staff assessed people’s sensory needs and did their best to meet them. People were supported by staff who had received relevant and good quality training in evidence-based practice. This included training in the wide range of strengths and impairments people with a learning disability and or autistic people may have, mental health needs, communication tools, positive behaviour support, trauma-informed care, human rights and all restrictive interventions. Multi- disciplinary team professionals were involved in and made aware of support plans to improve as person’s care. Staff were calm, focussed and attentive to people’s emotions and support needs such as sensory sensitivities. Staff provided people with personalised, proactive and co-ordinated support in line with their communication plans, sensory assessment and support plans. Staff provided person-centred support with self-care and everyday living skills to people.

Right Culture: Management were visible in the service, approachable and took a genuine interest in what people, staff, family, advocates and other professionals had to say. Management and staff put people’s needs and wishes at the heart of everything they did. The registered manager had the skills, knowledge and experience to perform their role and a clear understanding of people’s needs/ oversight of the services they managed. The provider sought feedback from people and those important to them and used the feedback to develop the service. The service worked well in partnership with advocacy organisations and other health and social care organisations, which helped to give people using the service a voice and improve their wellbeing.

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 the service under the previous provider was outstanding, published on 05 February 2019.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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 COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elysium Care Partnership – 78 Park Road on our website at www.cqc.org.uk.

Follow up

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

78 Park Road 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. At the time of inspection there were seven people living in the home.

At our last inspection in February 2016 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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 and associated Regulations about how the service is run.

The care service 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.

People continued to receive a service that was safe. All aspects of people’s safety were very well managed, including the security of the home, individual risk assessments and medicines management. In addition, robust staff recruitment systems continued to be followed which ensured that people were supported by suitable staff.

The service was well maintained and clean and correct procedures were taken with regard to the storage and handling of hazardous substances. Staff adhered to good infection control practices.

The service continued to provide care that was extremely person-centred and staff were proactive in ensuring people were supported to live fulfilled and meaningful lives. “Person-centred” means that care was tailored to meet the needs and aspirations of each person, as an individual. The vision of the service was shared by the management team and staff and quality audits focused on how the home achieved good outcomes for people.

The provider continued to ensure staff were sufficiently supported to provide a range of excellent social opportunities for people, including work-related activities, community events and hobbies and involved families, relatives and the local community. As a result, people had genuine experience of autonomy and choice, as well as of feeling included in their wider community.

People continued to receive effective care, which was based on best practice, from staff who had the knowledge and skills they needed to carry out their roles and responsibilities. Staff received support and training which enabled them to care and support people effectively. Additional support was provided by external professionals or consultants engaged by the provider.

Staff continued to ensure that people's emotional needs were supported at sensitive moments in their life and had worked closely with them, their relatives and health care professionals to achieve the most positive outcomes for the individual.

Staff displayed a strong team culture and supported each other whilst offering care and support to people that was compassionate and kind. Respect for people’s privacy and dignity was evident throughout the inspection. The manager and staff continued to ensure that people’s consent to care and treatment was always sought in line with legislation and guidance. Decisions made on behalf of people that did not have the capacity to consent were made in their best interests. Staff showed a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People continued to be supported to eat and drink enough and maintain a balanced diet, whilst staff respected individual choices based on preferences, culture and faith. Staff continued to support people to maintain good health, have access to healthcare services and receive ongoing healthcare support, which was provided by both community and specialist services, where required.

Quality assurance systems continued to be robust and used regularly by the management team to continuously improve the service. The registered manager had a thorough system in place to ensure audits and quality assurance checks were carried out and included seeking the views and experiences of people, staff and relatives. Continuous improvement was driven by engagement with people using the service and staff.

The registered manager demonstrated an excellent understanding of the needs of people as individuals and a commitment to supporting staff through training and supervision and involving families in putting the vision and values of the service into action. Senior managers had a strong presence in the home through regular visits and provided strong leadership.

There continued to be a strong emphasis on continually striving to improve. The service was able to sustain outstanding practice through regular internal quality assurance processes, providing an open and transparent culture, maintaining links with external organisations relevant to its work and developing its practice through recognised quality accreditation schemes such as accreditation and award with the National Autistic Society and Investors In People (IIP).

The provider also continued to be innovative in how they empowered people, for example through using people who use their services to contribute to the quality assurance checks of the home, in the recruitment process for staff and through using a whole team approach in supporting people with their planned care, which meant that everyone was equally committed to helping people maintain their desired lifestyle.

London Care Partnership 78 Park Road provides care and accommodation for up to seven people with learning disabilities. It is located in Hampton in the London Borough of Richmond-upon Thames. At the time of the inspection the home was fully occupied.

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 using the service, their relatives and health and social care professionals told us that people were kept safe within the service. We found staff members were aware of what steps they would take if they had concerns about people’s safety and we saw that they followed clear guidance on what steps to take if an incident or accident occurred at the service.

Although some people displayed behaviours that challenged the service, the provider took proactive steps to understand the possible causes of this and implemented methods to manage these behaviours. These methods included the use of a behaviour analyst and nationally recognised positive behaviour support techniques recognised and accredited by the British Institute of Learning Disabilities (BILD). These were incorporated into personalised support plans for each individual. The service also made use of other services such as speech and language services in order to ensure that people were able to communicate how they felt and be understood by the staff team.

Relatives of people using the service we spoke with were enthusiastic in their praise for the service and how well staff cared for, supported and responded to the needs of people living at the home. Relatives praised the home for the consistent support provided to people, which ensured their safety and for the person-centred care plans and activities which enabled people to live individual lives.

Relatives told us they were impressed with how the staff supported people in all aspects of their daily lives, including managing their healthcare needs and accessing activities, which included the use of specialists such as physiotherapists, behaviour analysts and speech and language therapists within the organisation to ensure that people who needed extra support were provided it quickly.

Staff spoke positively and knowledgeably about their work and the people they supported. Staff who were assigned as keyworkers to people worked closely with them to achieve goals in relation to their daily living skills.

Staff members went through robust recruitment procedures which included all mandatory checks, including a Disclosure and Barring Service (DBS) check. They took part in a thorough induction process before being given unsupervised responsibilities. Staff undertook mandatory basic training as well as additional training relevant to the support needs of the people living at the home.

Staff told us, and records confirmed, that they received ongoing support and were given both training opportunities and opportunities to progress within the organisation to more senior roles.

Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and they demonstrated a good understanding of the act and its application. Where people did not have the capacity to make decisions about their care, meetings were held with people, their relatives, and health and social care professionals to help ensure that any decisions were made in the best interests of people using the service.

The registered manager was familiar with the service’s vision and goals and supported staff well. Together with the staff team the manager had in place a distinctive approach to care planning and activity planning that ensured people had a successful balance of therapeutic, social, home-based and vocational opportunities. The outcomes for people were that they had care packages that met their support needs and which also greatly enhanced their integration and involvement with their local community instead of spending all their time in segregated settings with other people with disabilities. Staff knew how to meet people’s individual preferences and were innovative in developing approaches with people that enhanced their sense of wellbeing and quality of life.

People’s care and support was planned proactively in partnership with them and their families. Staff used innovative and individual ways of involving people so that they felt consulted, empowered, listened to and valued.

There was a strong emphasis on continually striving to improve. The service was able to sustain outstanding practice through regular internal quality assurance processes, providing an open and transparent culture, maintaining links with external organisations relevant to its work and developing its practice through recognised quality accreditation schemes. For example the provider had achieved autism accreditation with the National Autistic Society and was currently working towards an award with Investors In People (IIP).

The service also found innovative and creative ways to enable people to be empowered and voice their opinions, for example through using people who use another one of their services to contribute to the quality assurance checks of the service at 78 Park Road by speaking to people and commenting on the atmosphere and facilities of the home.

Relatives of people who used the service told us that they were happy with the care provided at the home and commented, "Very pleased with the quality of care provided', and 'Absolutely delighted, this should be a model for all care homes'.

Care plans were person-centred, structured and detailed the care and support people required. People's health was regularly monitored and included input from health and social care professionals. People were provided with a choice of suitable and nutritious food and were involved in menu planning.

Appropriate arrangements were in place for the management of medication. Staff were appropriately trained and supported by the management team. A variety of methods were used to seek feedback and monitor and improve service delivery. A relative we spoke with told us, 'Always receptive to what we say'.

In this report the name of a registered manager (Greg Anstead) appears who was not managing the regulatory activities at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.