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Victoria Cottage Outstanding

Reports


Inspection carried out on 18 November 2019

During a routine inspection

About the service:

Victoria Cottage is a care home which provides care and support for people with physical disabilities, learning disabilities or autistic spectrum conditions.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. 10 people were using the service at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

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

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.

We received extremely positive feedback about the service and the care people received. People, relatives and professionals commented positively about the caring and responsive approach of the staff. Everyone said the service was excellent because of how well it was managed. There was evidence that people achieved good care outcomes, and everyone’s comments about the service supported this. This was reflected in a professional’s feedback which said, “I’m very impressed with the care home setting. The management and the staff are very good, caring, and respond to the residents’ needs. High class service!”

People were protected from harm by staff who were trained to identify and report concerns. People were safe because risks had been managed well. There were enough staff to support people safely. People were supported to take their medicines safely. Efforts had been made to reduce the amount of medicines people took to promote their wellbeing. Lessons were learnt from incidents to prevent recurrence. Staff followed effective processes to prevent the spread of infections.

People received effective care to meet their needs. People were supported by very skilled and knowledgeable staff. People were supported to eat well to maintain their health and wellbeing. Working closely with other professionals was central to the good care provided to people.

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.

Everyone said staff were exceptional at promoting a caring environment for people. Staff had respectful, caring and friendly relationships with people. Staff upheld people's dignity and privacy, and they promoted their independence.

People received exceptionally personalised care and support which met their needs, reflected their preferences and promoted their wellbeing. People’s views mattered and the service valued relatives' contributions to discussions about people's care. The registered manager listened to suggestions, concerns and complaints. They used this information to continually improve the service.

There was a positive, open and empowering culture. Staff roles and responsibilities were clear, and staff were supported and encouraged to use creative and individualised methods to support people to achieve their personal goals. The provider's values were reflected in the way staff supported people. The provider's quality monitoring processes were robust, and they evidenced what they did to continually improve the service.

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 good (published 31 May 2017).

Why we inspected:

This was a planned i

Inspection carried out on 25 April 2017

During a routine inspection

Victoria Cottage is registered to provide accommodation and support for up to 12 people with learning disabilities and complex needs. On the day of our visit, there were nine people living at the service.

The service was led by 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 2008 and associated Regulations about how the service is run.

Our inspection took place on 25, 26 and 28 April 2017 and was unannounced.

At the last inspection, the service was rated Good.

The inspection was undertaken as part of our routine re-inspection programme, to review the rating from the first comprehensive inspection completed on 3 June 2015.

At this inspection we found the service remained Good.

The service was extremely caring and all staff worked very hard to support people to feel unique and individual. The leadership of the service and the staff worked in conjunction in a well-coordinated way to focus their full attention on each person and provide them with truly person centred care. We observed showed that staff treated people as individuals and that people were happy and confident in the way they were supported by staff. People and their relatives reported this was always the case. Relatives shared their positive experiences with us and told us about examples where staff had gone the extra mile to give someone the care and support they needed in order they received excellent, high quality care. This high standard of care enhanced people's quality of life and wellbeing. Staff were passionate about providing people with support that was based on their individual needs, goals and aspirations.

There was an open and positive culture within the service of treating people with dignity and respect. The staff and the registered manager were always visible and approachable and listened to people and their relatives; they offered them choice and made them feel that they mattered. Staff spent time with people so they knew them and their needs. People and the staff knew each other well and these relationships were valued. Care was really planned around people's individual preferences and this included their spiritual and cultural wishes. People's diverse needs were considered and their human rights were respected.

People's needs were met in an exceptionally person centred way. They were supported to plan their own care and to pursue the life they wanted to live. The staff showed empathy and understanding and supported people with interests and helped them to feel more confident in their life skills. Care and support was person centred and focused on the needs and wishes of the people who lived at the service. Their individual needs were well known by staff who had an exceptional knowledge of the people who they were caring for and provided the support and care they needed.

Staff had been trained to recognise signs of potential abuse and keep people safe. People felt safe living at the service. People had risk assessments in place to enable them to be as independent as they could be whilst remaining safe. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent. There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Systems were in place to ensure people’s medicines were managed in a safe way and that they received their medication when they needed it.

Staff received support and training to perform their roles and responsibilities. They were provided with on-going training to update their skills and knowledge. Staff

Inspection carried out on 3 June 2015

During a routine inspection

This inspection took place on 3 June 2015 and was unannounced.

Victoria Cottage is a care home for up to 12 adults who may also have a range of care needs including a learning disability or autistic spectrum disorder and physical disabilities. There were 10 people living in the home on the day of the inspection.

Since February 2014, the home had been operating under an administration company due to the financial difficulties of the previous provider. In November 2014, the current provider took over. Shortly after, we were advised that there had been changes in the management of the service and a new manager was appointed in December 2014. The new manager had not yet registered with the Care Quality Commission, but he was able to show us that he had begun this process.

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.

Systems were in place to ensure people’s medicines were managed in a safe way and that they got their medication when they needed it.

Staff had been trained to recognise signs of potential abuse and keep people safe. People felt safe living at the service.

Processes were in place to manage identifiable risks within the service and ensure people did not have their freedom unnecessarily restricted.

The provider carried out proper recruitment checks on new staff to make sure they were suitable to work at the service.

Improvements were required however to update staff training; to ensure there are sufficient numbers of staff with the right skills and knowledge to meet people’s needs, at all times.

We found that the service worked to the Mental Capacity Act 2005 key principles, which state that a person's capacity should always be assumed, and assessments of capacity must be undertaken where it is believed that a person cannot make decisions about their care and support.

People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

The service had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.

Staff were observed providing care and support in a caring and meaningful way, and people were treated with kindness and compassion. People also had regular opportunities to engage in activities within the local community.

We saw that people’s dignity was respected at all times and they were encouraged to maintain their independence as far as possible.

We saw that people were given regular opportunities to express their views on the service they received and to be actively involved in making decisions about their care and support.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.

Systems were also in place to monitor the quality of the service provided and drive continuous improvement.