Rawlyn House

Updated 23 July 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of an adult social care inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The area of expertise for this expert by experience was in caring for people with a learning disability.

Service and service type:

Rawlyn House is a care home. People in care homes receive accommodation and nursing and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced and took place on 16 and 17 May 2019.

What we did:

Before the inspection we reviewed the information we held about the service and the service provider. The registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.

During the inspection we spoke with one person who was able to tell us their views of the service they received. We observed the care and interactions between staff and other people using the service in the communal areas. We spoke with three relatives and eleven members of staff including the registered manager, deputy manager, senior manager, training manager, quality assurance and compliance manager, and cook.

We looked at 11 people’s care records on the computerised care planning system and paper records waiting to be transferred across. We also looked at medicines record and viewed feedback received by the service which included the views of 7 visiting health and social care professionals.

Updated 23 July 2019

About the service:

Rawlyn House provides care and accommodation for people with learning disabilities. The provider, Cream II Limited operates a further six homes for people with learning disabilities in the South West.

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 and/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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 16 people and 16 people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated because Rawlyn House is divided into two separate buildings. The main house provides accommodation for ten people. The other unit is purpose built and accommodates six people who require wheelchair access. In addition the building design fitted into the residential area with other large domestic homes of a similar size. Staff were not wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service:

The service was extremely well led. The providers ethos was strongly promoted and modelled by the management team. This was a commitment to valuing people as individuals, supporting them to meet their full potential and achieve their individual aspirations. The management team demonstrated an open and transparent management style and were fully engaged with people and staff at the service. A focus was on developing and encouraging staff, had resulted in high staff retention rates, which meant people were supported by a consistent, knowledgeable and experienced staff team. Robust quality assurance systems ensured the continued quality and safety of the service and continued to drive improvement. This ultimately improved the outcomes for people living at Rawlyn House. Since the last inspection, they had continued to move forward and develop what was an already outstanding service.

People were valued and placed at the centre of the service. Staff promoted their privacy and dignity, enabling them to make choices and have as much control and independence as possible. They had gone the extra mile to achieve this, for example fund raising for technology that would support communication, and challenging social stigma and discrimination against people with a learning disability.

The management team and staff genuinely cared for the people they were supporting. They advocated for them at every opportunity and were proactive in challenging negative stereotypical views of the people they were supporting and the care sector. They offered a truly caring approach to people and their families when they were in hospital or at the end of their lives and made sure hospital staff understood what the person needed. They ensured people were able to maintain contact with their families, even when they were hundreds of miles away, using video telephony so that they could see them.

The environment was warm and homely, and designed to promote the independence and quality of life of the people living there. The service sought to offer people new experiences, through a wide range of individual activities which were meaningful to them., An ‘active support’ approach meant they were as engaged in activities of daily living and maintaining their home as they were able.

Staff knew people exceptionally well and were highly skilled at responding to their needs. Feedback from a visiting health professional stated, “Staff knowledge of each individual is outstanding both from clinical and personal information. Patients are treated as individuals and staff treat them as family members. Phenomenal care.”

Training was of a high quality and informed by research and best practice. It gave staff the skills and knowledge they needed to support people safely and effectively, as well as ensuring they were constantly learning and thinking about how they could enhance people’s lives. The management team were proactive in their own continued professional development, using their learning to improve their leadership skills and develop the staff team.

Rating at last inspection:

Outstanding overall. Published 29 November 2016.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence received about the service to inform when the next inspection should take place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk