Archived: Options Vernon

Options Vernon is a residential care home that provides care and accommodation for people with learning disabilities. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 14 people. 12 people were living at the service on the day of our 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. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Some people were not able to fully verbalise their views and used other methods of communication, for example pictures. Due to people's needs we spent time observing people with the staff supporting them.

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.

People received personalised care and support specific to their needs and preferences. This had been effective in supporting people to achieve goals and encouraged them to learn and grow as individuals. People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. There were enough staff working to provide the support people needed. Staff understood the risks associated with the people they supported. Risk assessments provided guidance for staff about individual and environmental risks. People received their medicines safely, when they needed them.

Due to the COVID-19 pandemic, the provider had ensured that appropriate infection control procedures for the pandemic were in place to keep people safe. This included increased cleaning and ensuring adequate supplies of personal protective equipment (PPE) were available. Staff completed training in relation to COVID-19. We were assured the provider managed infection prevention and control through the COVID-19 pandemic.

Despite the need to keep people safe during the COVID-19 pandemic taking priority, the provider and staff had worked hard to develop strong leadership. Quality monitoring systems had been embedded and morale was high amongst the staff team. We received positive feedback in relation to the care people received and how the service was run. One relative told us, “[My relative] and us are very content and happy. She has a great bond with the staff, and I get on great with the manager”.

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

Rating at last inspection and update

The last rating for this service was Good (published 28 February 2018). At this inspection we found no concerns in the key questions we looked at.

Why we inspected

We undertook this focused inspection on 22 September 2020 in light of concerns we had received in respect to the care people were receiving. Concerns included, support for staff, accidents and incidents not being reported appropriately and a negative and closed culture at the service. A decision was made for us to inspect and examine those risks. Therefore, this report covers our findings in relation to the Key Questions: Is it Safe? and Is it Well-led?. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-led sections of this full report.

For those key questions not looked at on this occasion, the ratings from the previous comprehensive inspection were used in calculating the overall rating at this inspection. The overall rating for the service has not changed from Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Options Vernon on our website at www.cqc.org.uk.

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.

The inspection took place on 11 and 12 January 2018 and was unannounced on day one. Options Vernon provides care and accommodation for up to 14 people with learning disabilities.

The service did not currently have a registered manager in post. 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. However, an interim manager was currently overseeing the service and interviews for the permanent post of registered manager were planned for February 2018.

We met and spoke with 12 people during our visit. People were not all able to fully verbalise their views and used other methods of communication, for example pictures. Due to people’s needs we spent time observing people with the staff supporting them. A relative said, “[Person’s name] is happy and safe there.” Another relative said, “Couldn’t be in a better place.” A healthcare professional commented that when they saw the person they supported they always looked happy and comfortable.

Staff had completed safeguarding training and staff had a good knowledge of what constituted abuse and how to report any concerns. Staff knew what action to take to protect people against harm and were confident any incidents or allegations would be fully investigated.

People had support from sufficient levels of staff to meet their needs. Staff had completed suitable training and had the right skills and knowledge to meet people’s needs. New staff completed an induction programme when they started work and staff competency was assessed. Staff also completed the Care Certificate (A nationally recognised training course for staff new to care) if they did not have any formal care qualifications. Staff confirmed this training covered the Equality and Diversity policy of the company. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people.

The company’s website states; “Options Group (the provider company that own Options Vernon) successfully provides person centred services to vulnerable people, and as such all programmes of care/support, education/learning and therapy are individually tailored and subject to thorough risk assessment and planning.” People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. People’s safety was paramount. Information on all significant events and incidences had been document and analysed. Evaluation of any incidents had been used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback from relatives, professionals and staff had been sought to assess the quality of the service provided.

People lived in a service which had been designed and adapted to meet their needs. The service was roughly divided into two living areas. Four people lived upstairs with their own bedrooms, kitchen, laundry and bathroom areas. People lived in an environment that was clean and hygienic. The environment had been assessed to ensure it was safe and meet people’s needs. The service was monitored by the interim manager and provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

People were supported to live full and active lives and were able to access a wide range of activities that reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. People had input as much as they were able to in preparing some meals and drinks. People who required assistance were supported in a respectful and dignified way.

People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought.

People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received medicines training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to external health and social care professionals, such as physiotherapists. This helped to ensure people’s health and wellbeing was monitored and appropriate actions taken.

People’s care records were detailed and personalised to meet individual needs. Staff showed they understood people’s needs and responded when needed. People were not all able to be fully involved with their support plans, therefore family members or advocates supported staff to complete and review people’s support plans. People’s preferences were sought and respected.

People’s emotional and behavioural needs were recognised and met. People were treated with kindness and compassion by the staff who valued them. People were engaged in different activities during our visit and enjoyed the company of the staff. People were busy and there was a happy and relaxed atmosphere within the service.

People’s family told us they were always made to feel welcome. People visited family with staff support. Families spoke very highly of the staff supporting their relatives.

People’s equality and diversity was respected and people were supported in the way they wanted to be. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. Information included people’s previous history, including any cultural, religious and spiritual needs.

People who had complex communication needs had these individually assessed and met. Staff informed us how they changed their approach to help ensure each person received individualised personal support.

People’s end of life wishes were documented to help ensure staff understood people and families wishes if required.

People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Relatives, professionals and staff spoke positively about the interim manager and the company. The interim manager was committed and passionate about the service, including the people and staff, and the company they worked for. Staff also spoke passionately about the people they cared for and the respect they held for people.

People benefited from an interim manager who worked with external agencies in an open and transparent way and there were positive relationships fostered. A professional spoke highly of the two way working relationship they had with the service. The interim manager kept their ongoing practice and learning up to date to help develop the team and drive improvement. They notified the Commission of significant events which had occurred in line with their legal obligations. For example, regarding safeguarding concerns, and injuries.

The provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.