The Bungalow

Updated 1 November 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. 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 completed by one inspector.

Service and service type

The Bungalow is a ‘care home’ which provides short, respite accommodation for people with learning disabilities in the west of Cornwall. 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. The service has nine bedrooms and was regularly providing respite support for approximately 30 people.

The service is required to have 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. There was a registered manager in post.

Notice of inspection

This inspection was announced. The service supports a variable number of people each day and we wanted to ensure people were using the service on the day of our inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We met five people who used the service and observed interactions between people and staff. We also spoke with three members of care staff and the registered manager. We reviewed a range of records. This included three people’s care records. We also looked at three staff files in relation to recruitment and supervision. A variety of records relating to the management of the service were reviewed, including policies, procedures, medicines administration records, staff rotas and the service’s training matrix.

After the inspection

Following the inspection, we spoke with four people’s relatives about the quality of care and support the service provided. We also reviewed a range of documents that we had requested from the service during the inspection.

Updated 1 November 2019

About the service

The Bungalow is a residential care home providing respite support and personal care for up to nine people each night with learning disabilities. On the day of our inspection five people were staying at the service and respite support is regularly provided to over 30 people. The service is a detached building with an enclosed garden at the rear of the property.

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

The service’s recruitment practices were safe and there were enough staff on duty to meet people’ support needs. Temporary closures, one weekend each month, had been introduced with the agreement of people and their relatives as a result of low staffing levels. This had ensured the service was consistently safely staffed. Three new staff were in the process of being appointed and once their induction and training was complete the service would be able to open full time.

Staff had received safeguarding training and understood how to protect people from all forms of abuse or discrimination. Risks were well managed, and staff knew how to support people if they became anxious or upset.

Medicines were managed safely and there were robust procedures in place for the receipt and return of people medicines.

Staff had the skills necessary to meet people’s need and their training was regularly refreshed. Staff told us there were well supported and records showed they received regular supervision and annual performance appraisals.

The service had been redecorated since our last inspection and plans had been developed and funding allocated for the installation of a wet room with specialist lifting and bathing equipment.

Staff and managers had a good understanding of the Mental Capacity Act and people’s choices and decisions were respected. People chose which room they stayed in, how to spend their time and which activities they engaged with.

The staff team provided support with kindness, care and compassion. People told us they got on well with their staff and relatives comments included, “I have found the staff team at The Bungalow to be excellent, competent and perfect. They are so helpful and caring.”

People’s care plans were accurate and detailed. They provided staff with enough guidance to enable them to meet people’s needs. People and their relatives were involved in both the development and review of care plans and told us these documents were up to date. The service had systems in place to ensure any complaint received was fully investigated but relatives consistently told us this had never been necessary. Relative’s responses to a recently completed feedback questionnaire and been consistently complimentary.

The service was led effectively by the registered manager and the staff team were well motivated and focused on providing person centred support. Quality assurance systems were effective and designed to drive improvements in the service’s performance.

The service was operating in accordance with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use this respite service are supported to live as full a life as possible and to have as much choice, control and independence as possible. Although the service is larger than most domestic style properties, people received individualised, person-centred support and were encouraged to develop new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used very few restrictive intervention practices, as a last resort, in a person-centred way, in line with positive behaviour support principles.

Rating at the last inspection

The last rating for this service was good. (Report published 11 March 2017)

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.