An Diadan House

An Diadan House is a residential care home which can support up to nine people in one adapted building. The service specialises in supporting people with learning disabilities and/or autism. At the time of this inspection there were nine people using the service.

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

People were safe and well looked after by staff. Staff had received training to safeguard people from abuse and knew how and when to report safeguarding concerns if these should arise.

The provider made sure there were enough staff, with the right skills and experience, to support people. They carried out recruitment checks on new staff to make sure they were suitable to support people.

Risks to people had been assessed and plans were in place to manage these in an appropriate way. Staff understood the risks to people and what action to take to make sure these were minimised. This included instances when people displayed behaviour which may have challenged them and/or others.

Health and safety checks were carried out of the premises and equipment at regular intervals. The premises were clean and tidy. Staff followed current practice to reduce infection and hygiene risks at the service. Visitors to the service were given information to help them reduce the risk of catching and spreading infection.

People were supported to take their prescribed medicines.

The provider had arrangements in place to make sure any accidents and incidents were investigated, and people kept involved and informed of the outcome.

Relatives were positive about the service and the outcomes experienced by their family members. Staff knew people well and were enthusiastic about helping people to achieve good outcomes. Relatives and staff said the home manager, was open, approachable and responsive. The home manager was open about when things went wrong and proactive about putting things right.

The home manager encouraged people, relatives and staff to have their say about how the service could improve and acted on this feedback. The home manager had clear priorities for continuously improving the service to enhance the quality of people lives. They had access to resources and support from the provider to make the improvements needed.

There were systems in place to monitor and assess the safety and quality of the service. When issues had been found through checks they had been addressed promptly.

The service worked proactively with other agencies and healthcare professionals. The provider acted on their recommendations to improve the quality and safety of the service for people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. People were supported to have as much choice and control as possible over how their care and support needs were planned and delivered. People were involved in making decisions about how the service was designed and delivered. The provider ensured people’s rights were respected and promoted a culture within the service where people were supported in the least restrictive way as possible.

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

Rating at last inspection

The last rating for this service was good (published 29 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received from Ofsted about one of the provider's other services regarding unexplained injuries on people using the service and poor joint working with other agencies. We also identified a pattern in the types of notifications CQC received from the provider. A decision was made for us to inspect and examine those risks.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post at the time of our inspection. 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.

People were supported with dignity and respect by caring staff who understood their needs, including behaviours which challenged the service. People had ‘positive behaviour support guidance’ in place for staff to follow in helping them manage behaviours which challenged which were personalised for each person. Risks relating to people’s care were carefully managed by staff. Staff knew the best ways to communicate with people and people were supported to develop their independent living skills. People received care in clean, spacious premises which were well maintained and met their needs well.

People took part in activities based on their interests and had structured activity programmes in place. People were supported to maintain relationships with people who were important to them to reduce social isolation.

The provider carried out recruitment checks on staff. People and staff were involved in recruitment. After passing the interview stage candidates spent time at the service working with people and staff while the management team assessed how well suited they were to supporting the individuals at the service. People were supported by the right numbers of staff to keep them safe and to respond to their needs. Staff were well trained and supported in their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People chose their own meals and staff considered people’s cultural needs. Staff supported people to maintain their health and see the necessary healthcare professionals. People’s medicines were safely managed.

People and relatives were involved in care planning and staff followed people’s care plans to meet people’s needs. Care plans reflected people’s physical, mental, emotional and social needs, their personal history, preferences, interests and aspirations. The service had begun to engage people and relatives in end of life care planning as part of a programme run by the local hospice.

The service was well by a registered manager staff who understood their role and responsibilities well. Leadership was visible with a clear hierarchy.

The provider had good governance systems in place to audit and improve the service with frequent checks of the service in line with CQC standards. Systems were in place for the provider to communicate and gather feedback from people, relatives and staff. The provider investigated and responded to concerns and complaints appropriately.

An Diadan House is registered to provide accommodation and personal care for up to six adults. At the time of our inspection there were three young adults living in the home. The service specialises in supporting people with learning disabilities.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

People felt safe. There were procedures and risk assessments in place which staff implemented to reduce the risk of harm to people. Staff had been trained in safeguarding adults. They knew how to recognise the signs of abuse and how to report any concerns.

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Appropriate checks were carried out on staff and they received an induction before they began to work with people. Staff had the skills, knowledge and experience to care for people safely.

There was a sufficient number of staff on duty to care for people safely and effectively. Staff understood their roles and responsibilities and were supported by the provider and management to provide effective care, through relevant training and supervision.

Staff were recruited through an appropriate recruitment process which was consistently applied. Thorough checks were conducted on staff before they were allowed to work with people. This helped to minimise the risk of people being cared for by staff who were unsuitable for the role.

There were procedures in place to ensure that people received their medicines safely which staff consistently followed. All areas of the home were clean and well maintained. People were protected against the risk and spread of infection.

People and their relatives were involved in their care planning. People were supported to express their views. Staff asked for people’s consent before providing care. Staff understood the main provisions of the Mental Capacity Act 2005 and how it applied to people in their care.

There was a calm, relaxed atmosphere in the home. People were happy and at ease interacting with staff. Relatives were satisfied with the care their family members received and told us the staff were kind and caring. All areas of the home were clean and well-maintained.

Staff knew people well and how they preferred their care to be provided. Staff ensured people received a nutritious, balanced diet. People had enough to eat and drink.

There were a variety of activities for people to participate in at home and in the community. Visitors to the home were made to feel welcome by staff. Staff supported people to maintain relationships with their family and friends. This helped to ensure people did not become socially isolated.

People’s healthcare needs were met by suitably qualified staff who worked well as a team. Regular checks were carried out to maintain people’s health and well-being. People also had access to healthcare professionals.

The registered manager had worked in the adult social care sector for many years and knew what was required to provide good quality care. There were systems in place to assess and monitor the quality of care people received and these were consistently applied by staff.