Archived: Stoneybeck

Stoneybeck is registered to provide accommodation and personal care for up to seven people with a learning disability and or autistic spectrum disorder. At the time of our inspection there were seven people using the service. Stoneybeck accommodates people across two separate houses, each of which has separate facilities.

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 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 was appropriate and inclusive for them.

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’s experience of using this service and what we found

People received safe care and the service made sure risks to people’s health and safety were managed well. A relative said the service was safe and people received the support they needed. Staff knew their responsibilities in relation to keeping people safe from the risk of abuse. There were enough staff available to meet the diverse and individual needs of people. Staff were recruited safely. Medicines were managed so people received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff demonstrated a commitment to protecting people's rights in relation to equality and diversity. Staff understood the ways people communicated their wishes and preferences. People received a balanced diet and the staff monitored people’s nutritional health. Staff received training and support to ensure they had the skills and knowledge to meet people’s needs.

People received personalised and responsive care from kind and caring staff. Staff respected people’s privacy and dignity and knew how people preferred their care and support. People’s independence was promoted and encouraged by the staff team.

People were happy with the range of social activities and events available to them. The service actively encouraged people to enjoy a fulfilled life. People had up to date support plans, which clearly set out how staff should meet their care and support needs. The provider had a complaints procedure and systems in place to deal with complaints effectively.

The service was well led by a registered manager and provider who led by example and had embedded a positive culture. Staff enjoyed their work and felt well managed and supported. Quality assurance systems were effective to identify and address any areas that needed improvement. The registered manager was aware of their responsibility to report events that occurred within the service to the Care Quality Commission (CQC) and external agencies.

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 27 July 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.

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

Stoneybeck is a care home providing support for up to seven people living with a learning disability, autistic spectrum disorder, dementia, mental health needs or sensory impairment who require personal care. Accommodation is provided in two buildings on the same site. The home has its own grounds with a rear garden which is private and secure.

At the time of our inspection there was 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 Regulation about how the service is run. The service also had a house manager, who managed the day to day running of the service.

We spoke with staff who were knowledgeable about safeguarding people from abuse. Staff told us they would report anything of this nature, to the registered manager without delay.

We looked at four recruitment files and found the provider had a safe and effective system in place for employing new staff. Pre-employment checks were sought and had to be satisfactory prior to the new staff member commencing their role.

People received their medicines as prescribed and medicines were stored appropriately. Safe procedures were followed for the administration of medicines. This was to ensure people received their medicines in a safe way.

Support plans we looked at contained risk assessments which identified risks associated with people’s care. Risk assessments gave guidelines on how to minimise the risk occurring.

We spoke with staff and they told us they received training and support to help them do their job well. We looked at records in relation to training and found they reflected what staff had told us. Training certificates were available in staff files we looked at. Staff also informed us that they received one to one sessions with their line manager to discuss work related issues.

We found that the provider was meeting the requirements of the MCA and DoLS. We saw support plans in place identified where people lacked capacity and what support they required with various decision making.

People were supported to eat and drink enough to maintain a healthy and balanced diet. People were involved in deciding what they would like to eat and assisted staff in shopping for food and in food preparation where possible.

People had access to health care professionals as required and staff supported people to keep appointments.

We observed staff interacting with people and found they were respectful, kind and caring. Staff were knowledgeable about people’s preferences and knew people well.

We looked at support plans belonging to people who used the service and found they were person centred and incorporated people’s individual needs and preferences.

People were supported to have an active social life and engaged in a variety of different activities. People also enjoyed going on holiday.

The provider had a complaints procedure in place and any concerns raised were dealt with in a timely way. Complaints received were used to reflect on practice and develop the service.

The service was led by a management team which comprised of a registered manager, a house manager and a team of senior support workers. We saw that audits were used as a tool to ensure policies and procedures were being followed and to ensure people received a good standard of care and support.

We spoke to three people who lived in the home. One person said 'I like living here. The staff are nice and I can choose what I do'. Another person said 'I like the staff. I like going on the bus. I like phoning my mum and dad'.

Care records recorded information on people's daily routine. They described what time people liked to get up, what they liked to eat and drink, and how they liked to spend their day. One care plan had information on a person's cultural needs and how these were being addressed.

People's needs were assessed and care and treatment was planned in line with their individual care plan.On the day of the inspection one person was out visiting her mother. This was recorded in the care plan as something the person did every week. This helped the person to maintain contact with her family and also to help her meet her cultural needs. Another person was observed getting ready to go out to do some shopping.

We spoke to two members of staff and two managers. The two members of staff demonstrated a good understanding about the different forms of abuse,what their responsibilities were if abuse was suspected, and how they would respond. Staff were able to explain how they would raise concerns if they observed any changes in a person's behaviour that could indicate possible abuse.

The staff we spoke to said that they felt able to speak out if they had any concerns and felt supported by managers.

We saw that training records had information on staff attending training in areas such as safeguarding, fire safety, first aid, food safety, infection control, autism awareness and Mental Capacity Act ( MCA) awareness.

We saw information on staff having regular supervision. This helpedt to ensure that staff were competent and/or highlighted when further training or support was needed to ensure high standards of care were met.

We saw that the home had policies and procedures in place to safeguard people from abuse. We spoke to two service managers who described a serious safeguarding incident that had occurred during the summer. We saw that policies and procedures had been followed and that three members of staff had been dismissed because of the incident. We saw that the home had addressed a number of issues raised by the local safeguarding team in relation to re- training on restraint techniques, reporting procedures and staff training.

We asked how the provider monitored the quality of the care they delivered. We spent time observing the care and interaction between staff and people who used the service. We spoke with staff, the managers and the registered provider about the care and wellbeing of people who use the service. We also gathered evidence of people's experiences of the service by reviewing care records and quality assurance documentation.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people who used the service understood what was going to happen.

There were good systems and processes, policies and procedures in place. Report writing in the care records was good and reflected the changes in care and treatment that people received. We also found that staff were supported and monitored in their working practice and had training and appraisals programmes in place.

The people who used the service appeared happy and comfortable with their surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities which were personalised to their individual needs and documented clearly in the care plans.