Rubery Court

Rubery Court is a care home providing care for adults with a learning disability and/or autism, physical disability or mental health conditions. The service provides long term and short stay care. The service is registered to accommodate a maximum of 8 people, and five people were living at the home at the time of our inspection. There were also two people living in their own flats on the top floor, with personal care provided by dedicated staff who were managed by the registered manager.

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 a domestic style property although it did not present as a care home. Support staff did not wear anything that suggested they were care staff when coming and going with people and transport used by the service was not identifiable as anything other than family transport.

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

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.

People were safe, and staff were aware of how to minimise risks to people and promote their safety, whilst considering their rights. Staff knew how to work with people to identify risks and change their approach to minimise these.

People were supported by care staff that were caring and expressed interest in people and the support they provided them. People received person centred care and support based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop a good relationship with people.

People were supported by care staff who had the skills and knowledge to meet their needs. There was some need for training refreshers, but this had been identified and training updates had been booked. Staff understood, felt confident and well supported in their role. People's health was supported as staff worked with other health care providers when needed to support people’s healthcare needs.

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

People enjoyed meals that reflected their preferences and there was access to a range of foods that met people’s needs due to their health, culture or specific preferences. People's care plans reflected people’s needs and preferences. Staff were able to explain how people were involved to ensure care plans were person centred and involved people and their wider family. We saw the service was responsive to information from people and relatives.

People could complain, and concerns were listened to and responded to by staff. Complaints and comments were used as a tool to drive improvement of the service.

People, relatives and staff were able to share their views with staff. People enjoyed living at Rubery Court and were able to follow their chosen routines and enjoyed access to activities at the service or in the community.

Quality monitoring systems included audits and regular checks on people’s satisfaction with the service they received. The provider had systems in place to ensure they kept up to date with developments in the sector and changes in the law.

The registered manager and staff were approachable, organised, listened and responded to them and acted on feedback when they shared this with them. The registered manager demonstrated they wished to improve the service further, for example developing care records further so they would be more person centred.

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 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 01/04/2017).

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.

Rubery Court provides accommodation for up to eight people with learning disabilities. The service also provides supported living. At the time of the inspection there were six people with learning disabilities living at the service. There were also two people living in supported living accommodation and receiving support with personal care. 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 Regulations about how the service is run.

People were supported by care staff who could recognise signs of potential abuse and knew how to report any concerns. People were protected by staff who understood potential risks to them and knew how to keep them safe from harm such as accidents and injuries. People received their medicines as prescribed. People were supported by sufficient numbers of care staff who had been recruited safely for their roles.

People were cared for by a staff team who had the required skills to support them effectively. People were supported to consent to the care they received. Where people lacked capacity, staff made decisions in their best interests in line with the Mental Capacity Act 2005. People were supported to have sufficient amounts to eat and drink. Where people needed additional support with food and drink or a special diet, this was provided for them. People’s day to day health needs were met.

People were supported by a care staff team who were kind and caring in their approach. People were supported to make choices where possible about the care they received. They were encouraged to remain as independent as possible and their privacy and dignity was protected and promoted. People were enabled to maintain relationships with people who were important to them. Relatives were encouraged to provide support in making decisions where appropriate. Where required people were enabled to receive support from an advocate.

People received care and support that met their needs and preferences. People’s care plans were accurate and contained detailed information about the support they required. People and their relatives were involved in developing care plans and reviewing them on a regular basis. People had access to activities in the community. Where people or their relatives raised complaints or areas of improvement needed, these were listened to and responded to appropriately.

People were supported by a care staff team who felt supported and motivated in their roles. The management of the service understood their role and legal responsibilities. They were committed to making improvements to the service provided to people and had developed quality assurance processes to ensure any required improvements were made.