Fiveways

Updated 21 February 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by one inspector.

Service and service type

Fiveways is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority safeguarding and commissioning staff and from Healthwatch (Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England). The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We met all the people living in the service and spoke with three who were able to tell us a little about their experience. We met and spoke with four support staff, the registered manager and, quality assurance manager. We looked at one care plan in detail and two others for specific information. We reviewed information about the operational management of the service such as staff records and quality assurance. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional training and quality assurance information sent to us. We spoke with two relatives who had regular contact with their family members and received feedback from a health professional and two social care professionals who know the service.

Updated 21 February 2020

Fiveways is a small care home for five adults with learning disabilities sited in a residential area of the town. At the time of this inspection the service was full.

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.

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

We observed that people were calm, happy and relaxed during our inspection. Those who could told us about the things they liked to do when at home in the service and when out in the community. We saw that people with more limited verbal communication were able to make their needs and wishes understood by staff who understood their preferred means of communication. People received information in formats they could understand. They showed themselves to be comfortable around staff, approaching them to make requests for support.

We observed and heard staff speaking respectfully and kindly to people. Staff showed they understood people’s needs. New staff told us how they had spent time reading peoples plans when they first commenced work to help them understand peoples support needs Staff said they were kept informed about any changes to these at shift handovers and staff meetings, so they could continue to provide the care people needed.

Relatives and health and social care professionals spoke positively about how people were treated and cared for by staff. They told us that they were asked to contribute feedback about service quality which was analysed and published.

People ate well and enjoyed their meals. Easy read menus with pictorial prompts were developed to help them make meal choices. Any special dietary requirements were taken account of in meal planning.

Easier to read version of the complaints and safeguarding procedures were provided. People were asked by staff about any concerns they might have at resident meetings and when they spent one to one time with staff. Relatives told us they had not had cause to make a complaint and thought that any minor concerns they had raised had been dealt with immediately and resolved.

People had received support from staff and relatives to make known their preferences in how they would wish their last wishes to be carried out. These had been recorded and added to the support plan to ensure people received the care they wanted when they approached the end of their life.

Staff received an appropriate induction to the service, so they had the basic care skills and knowledge to support people safely. Training updates were provided to all staff at regular intervals. Staff had learned about abuse and how to respond to any suspicions they may have by raising and escalating alerts, they showed commitment to protecting people and keeping them safe.

There were enough staff available to support people’s individual needs safely and provide the appropriate level of support to them when at home and out in the community. Peoples consent was sought daily and where people lacked capacity appropriate authorisations had been applied for and obtained. People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

Staff showed respect for people’s privacy dignity and confidentiality and were alert to people’s wellbeing. They supported them to access health appointments and receive medical attention when needed. Accidents and incidents were recorded and improvements in their recording ensured these made clear the actions taken. When things went wrong the provider and staff learned from this and implemented changes to practice and procedure to minimise recurrence.

People lived in a safe, clean and well-maintained environment. Staff attended fire training and drills to understand how to respond in the event of a fire. Policies and procedures guiding staff practice were kept updated. People were able to spend time alone but had worked with staff to develop activity programmes tailored to their own interests and preferences. Relatives told us they were consulted and informed about the important things in their family members life and had become involved in best interest decisions as required.

People were supported by staff that enjoyed where they worked, felt well supported and worked well together as a team.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating inspection for this service was requires improvement (published 12 February 2019) when there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found enough improvement had been made and the provider was no longer in breach of regulations.

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.