6 September 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection was completed by one inspector.
Service and service type
This service provides care and support to people living in supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because people are often out, and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted six professionals who regularly visit the service by email to seek their views of which we received one response. We also spoke with four relatives on the telephone to gain their views and experience of the service.
6 September 2019
The Hatch is part of Thornleigh Camphill Communities a charity based in the South West of England and is inspired be the work of the international Camphill Movement. The ethos of the service is based on a 'life sharing' model of support. This meant that in some cases staff members and their families lived with the people they supported. People viewed The Hatch as their home and care was based on a 'supported living' model to help them live as independently as possible.
People had tenancy agreements for their home and support plans in respect of the care and support they received. A housing association managed the tenancy agreements. People could choose whether they wanted their care from staff working at The Hatch but could also choose another care provider. At the time of our inspection 30 people with a learning disability were receiving care and support.
There were three houses situated in close proximity of each other St Johns House, Thornbury Cottage and The Hatch House, one a short walk called Watch Oak Lodge and the other in the centre of Thornbury. The main office was separate from the houses but in the grounds of The Hatch.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The service has evolved and 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.
People’s experience of using this service and what we found
People received care that was safe, effective, caring and extremely responsive. People and their relatives spoke extremely positively about the support they received. There was sufficient staff to support people who had the necessary skills and commitment to provide care that was extremely person centred. Staff and people lived and worked together as equals and in partnership.
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. People had information in a format to suit them as individuals enabling them to make decisions about the care and support they needed.
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 service was extremely responsive in this area encouraging people to be fully integrated in life at The Hatch and the wider community.
People were supported by staff that were extremely caring in their approach enabling them to lead the life they wanted. This included supporting people to keep in contact with friends and family. People led People were supported to make decisions not only about their care but life at The Hatch. People had a sense of belonging, ownership and a mutual respect for each other.
The service was well led. There were systems to check and monitor the quality. This again involved people, staff, family and other stakeholders.
The service was continually evolving to meet the needs of people enabling them to continue to live the life they wanted. This included keeping under review the extensive range of activities, work experience and the staffing arrangements. Consultation and involvement were very much embedded into this service ensuring positive outcomes for people.
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 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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 positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
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.