Skelton Court

We found the following examples of good practice.

¿ Safe arrangements were in place for professional visitors to the service. These included temperature checks, risk questionnaire, hand sanitisation and wearing a mask. Visitor plans were being developed to support visits by relatives when it became safe to do so.

¿ Staff had received additional training in infection prevention and control and how to use personal protective equipment (PPE) properly. There were sufficient stocks available including masks, gloves, aprons and hand sanitiser. Staff were seen to be wearing PPE appropriately.

¿ Hand sanitisation stations were located around the service. These were decorated with brightly coloured rainbows. This helped people feel positive about using them, particularly if they didn’t understand why they needed to regularly clean their hands.

¿ There was a regular programme of COVID-19 testing in place for staff and people using the service. This meant swift action could be taken if anyone received a positive test result.

¿ The service did not use any agency workers and permanent staff did not work in any other care settings. This reduced the risk of infection spread between care services.

¿ Furniture in communal areas had been moved to support social distancing. Two additional rooms were also used as smaller dining and quiet areas. This reduced the risk of cross infection.

¿ The service made effective use of zoning to help keep people and staff safe. When people were supported to self-isolate in their rooms, posters were put up to confirm it was a ‘red’ zone. Other rooms and areas were ‘green’ zones. These zones were also used to support laundry processes.

¿ Cleaning schedules were in place and updated to included additional cleaning which took place during the pandemic period. This included high touch areas and deep cleans after anyone finished a period of self-isolation. This reduced the risk of cross contamination.

¿ Infection prevention and control audits took place and action plans were developed to follow up on any required actions. This ensured the registered manager had effective oversight of all aspects of infection control.

Further information is in the detailed findings below.

Skelton Court is a residential care home providing personal care and support. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people. Twelve people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

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

Staff knew how to minimise risks to people, and followed good practice guidance as detailed within risk assessments and care plans. People were supported by sufficient numbers of staff who had undergone a robust recruitment process. People had their medicines safely when they needed them. People lived in a service which was well maintained and clean.

People’s needs were assessed and kept under review with consideration to best practice guidance. People were supported by staff who had the necessary skills and knowledge. Staff received ongoing support through training and supervision, to enable them to provide good quality care. Staff promoted people’s health, and people accessed health care services. People were encouraged to eat a diet which supported their needs and choices.

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 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 were positive about the relationships they had developed with staff. People’s privacy and dignity was promoted, and care was provided by staff in a kind and caring manner.

Staff responded to people’s needs by following their individual support plans, which reflected their hobbies and interests and encouraged people to access a range of community-based activities.

The registered manager was aware of their role and responsibilities in meeting their legal obligations and were supported by staff from other departments of the provider to achieve these. Systems to monitor the quality of the service were used to drive improvement, and included seeking the views of people, family members and stakeholders.

Rating at last inspection

The last rating for this service was good (published 09 June 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.

Skelton Court provides residential care for up to 15 people diagnosed with learning disabilities and/or autistic spectrum disorders. The service specialises in supporting people with learning disabilities, autistic spectrum disorders, mental health needs and dementia. At the time of our inspection there were 13 people using the service.

The service has a registered manager. This 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 told us they were happy living at the service and the staff were kind and caring. All the staff we spoke with had a caring attitude and said they enjoyed supporting people to lead independent and fulfilling lives. The service had a homely atmosphere. The presence of two friendly cats contributed to this. These belonged to the people using the service who were seen to value and interact with them. People also took pride in the garden which they helped to look after, growing their own plants and vegetables.

People told us they felt safe using the service and we saw they were relaxed and comfortable around staff and happy to approach them for support. The staff knew the areas where they people they supported might be at risk, for example when going out, and what they needed to do to help ensure they remained safe. Staff were knowledgeable about people’s day to day needs and knew their likes, dislikes, and how they preferred to be supported.

Medicines arrangements were personalised and the people we spoke with knew their own medicines routines and how staff supported them to have these safely. People were supported with their health care needs and told us they saw GPs and dentists and other health care professionals when they needed to.

Staff told us they were satisfied with the training they’d received and told us about some of the recent courses they’d attended which included mental health, challenging behaviour, and dementia care.

Records showed that all the people using the service had been assessed with regard to their ability to consent to their care and to make informed decisions about their daily lives. Staff had had training in the MCA and DoLS and understood the importance of people consenting to their care.

People told us they liked the food served and they chose what meals they wanted. The cook was working with people to introduce a healthier eating programme based on lots of vegetables and other fresh produce. People met weekly to decide on the menu and have their say about the food provided.

The premises were clean, spacious and well-laid out. There was clear signage and picture prompts for people to help them find their way around, large ensuite bedrooms, and spacious communal areas for socialising, dining and doing activities. The premises had been adapted where necessary to meet people’s mobility needs and were decorated to a high standard throughout.

One of the features of the service was the particularly large bedrooms each with their own ensuite. All the people we spoke with commented on how much their liked their bedrooms. Each had a different coloured ‘front door’ with spyhole and knocker. This gave people the sense of having their own private space where they could spend time alone if they wanted to.

People were encouraged to be independent and to get involved in the day to day running of the home. People said they enjoyed helping at the service. Each person had a personalised pictorial agreement in place regarding domestic tasks which set out their responsibilities. This helped to ensure that staff were able to support them with these in line with their abilities.

People told us about the many different activities they did which they said they could choose themselves. These included attending a local college, arts and crafts, cooking, discos, holidays, cafes, restaurants, parks, and pubs. The service had a small activities room equipped with a range of activity resources including arts and craft materials, guitars, games, a pampering box, and a TV and DVD player.

People told us they had a say in how the service was run through group and one-to-one meetings. They had also been supported to complete resident satisfaction surveys which gave them another opportunity to share their views. Staff also had meetings where they could discuss good practice and how best to work with the people they supported.

Since the service was registered ongoing improvements had been made to the premises, staffing levels, and activities. The provider and the registered manager carried out regular quality monitoring audits of all aspects of the service. Records showed that any actions required had been promptly addressed.