The Chase

About the service

The Chase is a residential care home registered to provide accommodation and personal care support for up to 9 people with a learning disability and autistic people. At the time of the inspection 9 people were living at the home.

The home was spacious and arranged over 2 floors. People were able to move around freely and enjoy a large communal space and garden.

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

Right Support: People living at The Chase were kept safe. Care plans and risk assessments were effective in keeping people safe and reducing the risk of harm. People were supported to make choices and have staff provide explanations if they were unable to do something. The home met people’s individual needs and provide sensory activities for people who needed them. Independence was encouraged as much as possible, and people enjoyed being able to help out in the kitchen. 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.

Right Care: The care people received was from kind, compassionate and patient staff. People’s privacy and dignity was protected, and staff did not discriminate against people at the home. Each person living at the home had an individual care plan detailing their preferences and how to clearly support them if in distress. Staff understood their safeguarding responsibilities and how to identify and report potential abuse. People were supported to make choices about what to eat and drink and were supported to eat culturally specific meals if they wished. Staff received training to support them in their role and could approach the registered manager for additional support.

Right Culture: The atmosphere was welcoming and positive. Staff were observed to have time for each person living at The Chase. The care and treatment of people was a priority at the home to ensure they received good health outcomes. Quality monitoring took place to embed good practice and to check staff knew what was expected of them.

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 requires improvement (published 25 March 2020). 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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 nine people. Nine 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 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

We found care was not always delivered in line with guidance for managing behaviours that challenged the service and staff training in this area was either out of date or had yet to be completed. We found out of date food stored in the refrigerator. Records related to daily care did not include details of the personal care provided by staff. Consent to take pictures was not always obtained from relatives or people. We found ineffective audits and notifications of incidents and authorised deprivation of liberty safeguards (DoLS) had not been submitted to the CQC as required to do so by law.

People and relatives told us they felt safe. Staff checks were carried out to ensure they were safe to work with people who used the service. Risks to people were assessed and manged to reduce the risk of avoidable harm. People were supported to take their medicines safely. Staffing levels were based on people’s level of need. Systems to manage the risk of the spread of infection were in place, however, out of date food was not disposed of.

People and relatives were mostly asked their consent before care was provided. 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. However, we have made a recommendation in relation to consent to obtain photographs.

People’s needs were assessed and used to develop their plan of care. Daily records required further details in relation to personal care provided by staff. We have made a recommendation in relation to good practice in record keeping.

People received sufficient amounts to eat and drink to maintain their health. Staff received training relevant to their role and understood people’s individual needs. We noted a number of repairs and improvements were required to the kitchen and communal bathrooms. We made a recommendation in relation to developing an action plan with timescales for completing these.

Relatives told us people were treated well by staff who were caring and knew them well. People were supported to maintain their independence where possible. People were encouraged to make daily living decisions about their care and were supported by staff to make choices.

People were supported by staff who knew them well and understood their needs and preferences. Relatives told us they felt their relative was well cared for by staff who understood them well.

Relatives were involved and said they were notified by staff whenever there was a change in people’s needs. People were supported to participate in activities and follow their own interests. People’s communication needs were taken into account during the assessment process. Information was provided in an accessible format for people who used the service. Relatives knew how to raise a concern if they were unhappy about the service provided to their relative.

People and staff were given the opportunity to share feedback about the service. However, feedback from people was not always independent. We made a recommendation in relation to the provider obtaining impartial feedback from people who used the service. Audits were in place to monitor the quality of the service; however, these were not always effective.

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 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 15 August 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to meeting the needs of people whose behaviour challenged the service, infection control, management and oversight and failure to notify CQC of notifiable incidents.

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.

At the last inspection of 7 and 8 August 2014, the service was rated Good. We carried out this unannounced inspection of the service on 6 July 2017. At this inspection, we found that the service had maintained its ‘Good’ rating.

People remained safe at the service because staff assessed and managed the risks to each person’s welfare. Staff mitigated risks of abuse to people and their training in safeguarding adults enabled them to identity and report any concerns.

A sufficient number of suitably qualified staff were deployed at the service and provided safe care. Safe recruitment procedures ensured only suitable staff worked at the service. People received their medicines safely in line with current good practice guidelines.

Staff received adequate training and had the skills and knowledge to carry out their roles effectively. Appropriate support provided through induction, regular supervisions and an annual appraisal ensured staff reflected on their performance and improved the quality of care provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, and the policies and systems in the service supported this practice.

People were encouraged to make choices and involved in decisions about their day to day lives. Best interests meetings ensured people who did not have the capacity to make decisions about their care received the support they required to do so. People received care from staff who understood and applied the principles of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards.

People received sufficient food and drink and the support they required to have a healthy and balanced diet. People had access to healthcare professionals when required to maintain their health and well-being. Staff delivered people’s care as planned and were responsive to their individual needs. People using the service, their relatives where appropriate and health and social care professionals were involved in designing and reviewing care plans to ensure they were person centred.

Staff continued to treat people with respect and deliver their care with dignity and compassion. People received personalised care that met their individual needs. Staff had clear information about how people wanted their care delivered, things that mattered to them and how they wished to spend the day. People enjoyed taking part in a wide range of activities at the service and in the community. People lived in suitably designed and adapted premises.

A culture focused on people prevailed at the service. People using the service, their relatives and health and social care professionals made positive comments about the registered manager and the service. The registered manager continually improved the quality of care people received through regular monitoring and auditing of the service. People’s quality of care was in line with current practice because of the close working relationships between the service and other agencies.

We looked at four care plans and they detailed very clearly what support people should receive. People were developing independence skills and we found that one person was now able to tell staff how they wanted a cup of tea by clicking the kettle switch. People who were not able to communicate were engaged in the service as staff had the relevant skills to do so, for example they used sign language.

We observed lunchtime at the service and found that the food given was a healthy portion. Two people we spoke to in the morning told us what they had eaten for breakfast which was cereal. Staff who prepared food had completed food hygiene training.

Staff knew how to protect people from abuse and management discussed safeguarding at all their supervision meetings with staff every month.

All of the views expressed by the people who live at the home were positive about the service they receive, as were the staff about the provider and the training and support they had received.

We observed processes for decision-making as well as care plans, policies and procedures and risk assessments. Records were complete and up to date. We saw a complaints procedure displayed on a notice board and safeguarding and whistle-blowing policies.