Archived: Candle House

Candle House is a residential care home providing personal care and accommodation to one person. The service is registered to provide support to one person only.

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. The person 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

The service was set up to accommodate one person and support them with their specific needs.

There were enough staff to meet the needs of the person living in the service and staff had worked there for several years. Staff were recruited safely using a robust process.

The building underwent regular safety checks and maintenance issues were resolved promptly. Risks the person faced and those they posed to themselves and others were assessed in detail and reviewed regularly.

The service was spotlessly clean, dust free and tidy. The environment was set up to encourage stimulation in some rooms and have a calming effect in others. It was highly personalised.

Staff were gentle and kind, and used touch, tone of voice and gesture appropriately to encourage and support the person living in the service.

Care plans were detailed and personalised and there were thoughtful and detailed records of support given. The person was supported to access the local community and take part in a range of activities.

The service was well-led. Regular checks were completed on the quality of the service, the day to day running was highly organised. There was no registered manager in post, but the covering manager was intending to apply for registration.

The person 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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for the person using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. The persons support focused on them having as many opportunities as possible for them 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 4 September 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.

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.

The registered manager was well respected by staff and relatives. The registered manager is currently training an acting manager who will register with us when they have obtained additional qualifications. The present registered manager will then step down from that role but will remain on the board of trustees.

At the last inspection, the service was rated Good overall. However it was Requires Improvement in Effective because people were not assessed in line with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards as required.

At this inspection we found the service Good in all areas.

Why the service is rated good:

People continued to receive care from staff who had the skills and knowledge required to effectively support them. People were in the process of having their capacity assessed in line with current legislation. Staff and relatives confirmed any issues where discuss and made with peoples best interest at the forefront of any decisions. Staff were well trained and competent. 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. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

The PIR stated; “Staff ensure they are as discreet as possible with this support, whilst ensuring the service user is kept safe. The service user chooses the activities he wants to do and the food he wants to eat. This is discussed with him in pictorial form, to ensure, as far as is possible, that he is making an informed and understood choice.”

People remained safe at the service. A relative said; “Yes they are safe because there are two staff with them at all times.” There were sufficient staff employed to meet people's needs and support them with activities and trips out. Risk assessments were completed to enable people to remain as independent as possible. People received their medicines safely.

The staff were very caring and people had built strong relationships with them. We observed staff being patient and kind. People's privacy was respected. People or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People were able to make choices about their day to day lives. Complaints were fully investigated and responded to.

The service continued to be well led. Staff and a relative told us the registered manager was approachable. The registered manager and provider sought people's views to make sure they were at the heart of any changes within the home. The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

We were unable to speak to the two staff on duty as they were undertaking their care responsibilities. We observed how they interacted with people and asked brief questions that did not intrude on or distress the people they were working alongside.

The registered manager was not available when we visited but one of the trustees spent time with us and provided us with information during our visit.

We found that consent to care was being sought and a range of materials used to support choices were being used.

We found the care and welfare needs of people were met and the care was responsive to need.

We found that the staff were trained in safeguarding vulnerable adults and there were appropriate policies in place.

We found the staff were trained in essential subjects relevant to the people they were caring for. We found that staff supervision and appraisals were not up to date and only one staff member was trained to administer certain medications people required.

We found there was a complaints procedure and process in place.

We found that all records were not completed fully, required up dating and did not reflect the current needs of the people using the service.

The charity was set up by the person's mother and two other mothers. All three mothers were trustees of the charity. The registered manager was one of these. The charity employed four staff, one of whom was the brother of the person who receives services. The staff provided two to one care and support during the working week. They had been employed specifically to provide a service for one person and had been selected for their ability to do so. For example we were told that the person liked walking fast so it was important that the staff were able to keep up with them.

The premises had been bought specifically to meet the needs of the people who had planned to use it and had been furnished to facilitate their development.

We saw that the charity had put into place all the policies and procedures that they were required to.

We found that the service was designed and tailored to meet the person's individual needs. The charity was working hard to ensure that they provided a professional and appropriate service.