We carried out a review of the data available to us about Bobbins on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bobbins, you can give feedback on this service.
We found the following examples of good practice
• Safe arrangements were in place for professionals visiting the service. This included a confirmed negative lateral flow device test result, proof of vaccination against COVID-19, temperature checks, hand sanitisation and wearing personal protective equipment (PPE).
•The home was clean, tidy and smelled fresh. Rigorous cleaning schedules ensured the home was maintained to a safe and hygienic standard.
•The provider participated in the Covid-19 regular testing programme for both people and staff.
• There was a comprehensive contingency plan of what to do in case of an outbreak. The management team completed risk assessments to assess and mitigate risks in relation to COVID-19.
•We were assured the service were following safe infection prevention and control procedures to keep people safe.
Bobbins is a residential home providing care to children and young adults with learning disabilities. The accommodation is a detached house in the town of Swindon. There is a parking area in front of the building secured by electric gates and an enclosed garden at the rear. The home is registered to provide care for up to six people. There were six people living in the home at the time of our visit.
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 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.
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 registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
People’s experience of using this service and what we found
People received safe care and treatment. Risks associated with people's care needs were assessed, planned for and monitored. Staff were knowledgeable about risks and had detailed guidance on the action required to manage and reduce risks.
Staff understood their safeguarding responsibilities and knew how to report their concerns. People were supported by staff who had been recruited safely. There was a process in place to for learning from accidents, incidents and safeguarding concerns.
Medicines were managed and stored safely. The service was clean and care workers followed good infection control practices to minimise the risk of infection.
People's needs were assessed before they started using the service. Staff asked for people's consent before they provided care or support. Staff received training and support to meet people's needs effectively.
People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and acted in their best interests; the policies and systems in the service encouraged this practice.
People's health was supported as staff worked with other health care providers when needed to meet people's healthcare needs.
People were supported by care staff that were caring, showed compassion and expressed genuine interest in the people they cared for. People received person-centred care and support based on their individual needs and preferences. People's communication needs were known and understood by staff. People were involved in a range of activities that they enjoyed at the service and within the community
People’s relatives, staff and professionals spoke positively about the new management of the service. The service actively sought feedback from all involved in people's care and used this to improve the service. Quality assurance systems were effective to check people were receiving care that was of high quality.
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 inadequate (published 22 May 2019).
The provider completed an action plan after the last inspection to show what they would do and by when they were going to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This service had been in Special Measures since 5 April 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.
Bobbins is a residential home providing care to young adults with learning disabilities. The accommodation is a detached house in the town of Swindon. There is a parking area in front of the building secured by electric gates and an enclosed garden at the rear. The home is registered to provide care for up to six people. There were six people living in the home at the time of our visit.
People’s experience of using this service:
People were unsafe due to risks not being managed effectively. Where risks were identified clear guidance on how to manage these risks was not available to staff. Staff told us they sometimes did not feel safe.
Accidents and incidents were not always investigated or used as an opportunity for learning and to prevent future reoccurrence. Staff understood their responsibilities in relation to safeguarding, but safeguarding incidents were not always fully investigated and recorded.
Medicines were not always kept secure.
The environment was not always clean or safe for people using the service and all environmental risk assessments were out of date.
Consent forms were signed by people’s relatives who had no legal rights to do so.
Some people had no opportunity to engage in activities outside of the service.
The provider did not have effective systems in place to monitor the quality of the service they provided or to drive improvements where needed. Some records were not always available, accurate or complete.
People were treated with kindness and respect. People’s right to privacy and confidentiality was respected. People were all involved in making decisions about the premises and environment, regardless of their ability to communicate.
Rating at last inspection:
Good (Last report published 25 March 2017).
Why we inspected:
This inspection was brought forward in response to incidents that had occurred at the service and concerns that had been raised about the safety and management of the service.
Enforcement:
Please see the ‘action we have told the provider to take’ section towards the end of the report.
Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
Follow up:
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
Following the inspection we referred our concerns to the local authority responsible for safeguarding. In addition, we requested an action plan and evidence of improvements made in the service. This was requested to help us decide what regulatory action we should take to ensure the safety of the service improves.
Bobbins is a residential home providing care to children and young adults with learning disabilities. The accommodation is a detached house in the town of Swindon. There is a parking area in front of the building secured by electric gates and an enclosed garden at the rear. The home is registered to provide care for up to 6 people. There were five people living in the home at the time of our visit.
At the time of our inspection the service did not 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. The service was managed by a nominated individual. The nominated individual has overall responsibility for supervising the management of the regulated activity, and ensuring the quality of the services provided.
Statutory notifications had not always been sent to the CQC by the provider. A statutory notification is information regarding specific incidents that have occurred and is required by law to be shared with the commission. These include safeguarding alerts, serious incidents and deaths of people receiving a service. However, this had no impact on people’s health and well-being. All safeguarding notifications had been reported to the local safeguarding team. The nominated individual took immediate action and sent statutory notifications retrospectively.
Staff understood what protecting people from harm or abuse was, and had received training in safeguarding. Staff understood their roles and responsibilities in keeping people safe and took actions when they were concerned about people's safety.
Risks of harm to people were assessed and action was taken to minimise the risks through the effective use of risk management plans. Staff knew people's risks and followed their risk assessments and management plans.
There was a sufficient number of suitably trained staff to keep people safe and meet their needs in a timely manner. Staff had been recruited in line with safe recruitment procedures to ensure they were of good character and fit to work with people who used the service.
Staff helped people manage their medicines safely. Staff had been trained to administer medicines with regard to safety regulations and precautions. Staff’s competence was reviewed regularly to ensure the medicines were administered safely.
Appropriate checks and maintenance of people's living environment were carried out. Contingency plans were in place to ensure safe delivery of people's care in the event of adverse situations such as large-scale staff sickness or accommodation loss due to fire or floods.
Staff understood the importance of gaining people's consent to the care they were providing to enable people to be cared for in the way they wished. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).
People's needs in relation to nutrition and hydration were documented in their care plans. People received appropriate support to ensure that they received sufficient amounts of food and drink. Meals, drinks and snacks provided to people suited their dietary needs and preferences.
People received regular health care support and were referred to other health care agencies for support and advice if they became unwell or their needs changed.
People who used the service were supported by caring and attentive staff who understood their individual needs and knew their preferences for how care and support should be delivered. Staff explained things in a way that people could easily understand. They remembered to make eye contact and treated people with dignity and respect.
Staff provided people with personalised and respectful care based on the guidance included in people’s care plans. The care plans contained detailed information enabling staff to provide care in a manner that respected each person's individual requirements. People were encouraged and supported by staff to make choices about their care. For example, people were asked how they wished to spend their day, whether they wanted to spend it within the home or in the community.
The service was responsive to people's changing needs. Reviews of people's care took place on a regular basis. People and their appointed representatives were involved in the initial and ongoing planning of their care. Care plans had been developed which focused on supporting people to maintain and develop daily living skills whilst remaining safe. People took part in a range of activities and attended social events.
The service had a complaints procedure in place. The complaints policy was available in an 'easy-to-read' version to help people understand how to raise any concerns they might have.
Regular quality and risk audits had ensured that the issues affecting people's care had been identified. As a result, appropriate actions were taken to drive improvements to the quality of the care people received.