8 December 2015
During a routine inspection
Summer Cottage is registered to provide personal care and accommodation for up to two young adults who may have a learning disability or an autistic spectrum disorder. The service is located on a rural road within a short walk of Palace Farm which is owned and run by the same people as Summer Cottage.
This inspection took place on 8 December 2015 and was unannounced. The service was last inspected on 30 December 2013 when we found the regulations we inspected were being met.
The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Palace Farm is located on the grounds of a small working farm. People who lived in Summer Cottage were able to visit the farm at any time and take part in animal care. The animals included horses, sheep, chickens, ducks and geese. Also located on the farm was a large vegetable garden and a workshop area which offered woodwork and mechanics.
People benefited from a large number of meaningful activities which met people’s individual interests. For example, people took part in horse carriage riding, swimming, cooking, gardening and shopping. On the day of our inspection people were in and out of the home taking part in various activities. We saw people enjoyed the activities they were involved in.
People’s relatives and healthcare professionals were complimentary about the care provided. Comments included “I think it’s great” and “100% marvellous” and “They really look after their residents. It’s really, really good. They know what they’re doing”.
Staff treated people with kindness and respect. People enjoyed pleasant and affectionate interactions with staff which demonstrated people felt comfortable in their presence. Staff knew people’s preferences and spent time speaking with each person individually whilst using different communication methods. Staff communicated with people using pictures, photographs and Makaton (a language using signs and symbols).
Staff received training that was specifically related to the needs of the people who lived at Summer Cottage in order to support them to lead fulfilling lives. Staff told us they felt skilled to meet people’s needs and had received regular training. Staff comments included “Staff have enough training, if you want more training you just ask” and “We are offered loads of training”.
People were supported by staff who knew them well. Staff knew people’s routines, preferences and histories and knew how best to communicate with people.
People’s needs had been assessed and care plans had been put in place to meet those needs. Where people’s needs had changed, staff had taken action to ensure people received the care they needed.
Where people were not able to make decisions for themselves staff involved people’s relatives and appropriate professionals to make sure people received care that was in their best interest. People were supported to be involved in as many decisions as possible and were always asked for their consent and given options. Some people were being deprived of their liberty as they were under constant supervision and were not able to leave the home on their own for their own safety. The registered manager had made the appropriate Deprivation of Liberty Safeguard (DoLS) applications to the local authority and these had been approved.
There were sufficient staff to meet people’s needs. Staff spent time chatting with people individually and helping people to take part in individual and group outings. Staff comments included “There are always enough staff”.
People were helped to eat and drink enough to maintain good health. Mealtimes were a sociable experience with staff eating alongside people. People were supported to help prepare their meals and could choose what they wanted to eat. People’s mealtimes were relaxed and flexible to meet people’s activity commitments and routines.
People’s relatives were involved in the home and always felt welcome. Relatives told us they could visit the home at any time and could contact staff whenever they wanted. One healthcare professional told us they also felt welcome anytime. They said “I never feel uncomfortable turning up unannounced. I always get a warm welcome”. Relatives felt involved in people’s care and told us they were kept regularly informed.
People were protected against the risks associated with medicines because the provider had appropriate systems in place to manage medicines. Staff had received training and competency evaluations in relation to medicines.
People’s needs and abilities had been assessed and risk assessments had been put in place to guide staff on how to protect people. For example, where one person’s behaviours presented challenges and risks to themselves and others, staff had discussed the behaviours and created a specific plan. This plan included specific routines to follow in order to ensure the best outcome for the person. Staff had sought advice from healthcare professionals such as speech and language therapists, the person’s GP and a consultant psychiatrist. This minimised the risk to the person and staff.
Where accidents and incidents had taken place, these had been reviewed and action had been taken to ensure the risk to people was minimised. Premises and equipment were maintained to ensure people were kept safe and there were arrangements in place to deal with foreseeable emergencies.
People were protected by staff who knew how to recognise possible signs of abuse. Staff told us what signs they would look for and the procedures they would follow to report these. Safeguarding contact numbers were accessible to staff and people who lived in Summer Cottage were also provided with information for reporting concerns. There was a disability hate crime poster in hallway which contained contact information for reporting concerns.
Recruitment procedures were in place to ensure only people of good character were employed by the home. Potential staff underwent Disclosure and Barring Service (police record) checks to ensure they were suitable to work with vulnerable adults.
The two owners of Summer Cottage managed the service and one was the registered manager. A third manager had been employed to assist with day to day management. There was an open culture in the service and the management team were available and approachable. Staff members said “They are all really supportive” and “Every single one of the managers is supportive and approachable”. One healthcare professional said “The owners are always around and have a good grip and know what’s going on”.
Relatives told us they felt comfortable speaking with management and felt they would be listened to. They felt confident if they made a complaint this would be dealt with. One relative said “I do know how to make a complaint but I’ve never had to”.
There were systems in place to assess, monitor and improve the quality and safety of care. The registered manager and the manager undertook regular spot checks to ensure people’s care needs were being met, staff were displaying the home’s philosophy of care and documentation was being maintained. The home’s philosophy of care was to treat each person as an individual and enhance people’s independence and living skills through meaningful activity. Staff and management carried out weekly and monthly audit which looked at the care provided, medicines management, fire safety and the environment.