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Inspection carried out on 11 February 2020

During a routine inspection

About the service

Poplars is a care home providing personal care to 12 adults aged 18 and over at the time of the inspection.

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 registered for the support of up to 12 people. 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 and style.

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

There were systems in place to reduce the risk of harm to people. Where risks were identified, care records included the actions to be taken to reduce future risk. Staff recruitment was safe and there were sufficient numbers of staff employed to meet people’s needs. The management of medicines was safe. The home was clean and odour free.

New staff were supported with a period of induction. There was a programme of on-going training and supervision for all staff. Staff supported people to eat and drink to ensure their individual needs were met. Communication with the staff team was effective and people were enabled to access other health care professionals as required.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. 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 by staff who were caring and kind. Staff respected people’s right to privacy, maintained their privacy and encouraged them to retain their levels of independence. Staff encouraged people to make choices and respected their decisions.

Each person had a person-centred care record which detailed the care and support they needed. People were enabled to maintain contact with their families and to participate in a varied programme of activities. Relatives were aware of how to complain in the event they were unhappy with the service their relative received.

Staff felt supported by the registered manager. There were systems in place to continually monitor the quality of the service. Where shortfalls were identified, actions were taken. House meetings had recently been introduced at the home. There were regular staff meetings and steps were being taken by the senior management team to engage with support workers. The staff were clear in their desire to continually improve the lives of the people they supported.

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 7 July 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.

Inspection carried out on 24 May 2017

During a routine inspection

The inspection of Poplars took place on 24 and 26 May 2017. The visit on 24 May 2017 was unannounced and the visit on 26 May 2017 was announced.

We previously inspected the service on 06 January 2015 and at that time we found the registered provider was not meeting the regulations relating to staff training and support. We asked the registered provider to make improvements. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we found improvements had been made.

The service is required to have 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service had a registered manager in place.

Poplars is a purpose built care home serving young adults with profound and complex needs. It is part of the Holly Bank Trust which is an organisation specialising in providing education, care and support for young people and adults with profound and complex needs. At the time of this inspection there were 12 people using the service. The service has two units each with its own lounge and dining kitchen plus a sensory room and assistive technology suite. Each bedroom has direct access to an enclosed garden area.

There were enough staff on duty to meet people’s individual needs and keep them safe.

Staff had a good understanding about safeguarding adults from abuse and knew who to contact if they suspected any abuse. Risk assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

The provider had effective recruitment and selection procedures in place.

Medicines were managed in a safe way for people.

Staff had received an in depth induction, supervision, appraisal and specialist training to enable them to provide support to people who lived at Poplars.

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 capacity was always considered when decisions needed to be made. This helped ensure people’s rights were protected in line with legislation and guidance.

People enjoyed the food and were supported to eat an individualised balanced diet. A range of healthcare professionals were involved in people’s care and people had access to a dedicated multi-disciplinary therapy team.

We observed staff interacting with people in a caring, friendly and respectful manner. Staff were able to clearly describe the steps they would take to promote the privacy and dignity of the people they cared for and supported. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed personalised care plans and risk assessments. People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation and needs changed.

People were able to make choices about their care. Care plans detailed the care and support they required and included detailed information about people’s likes and dislikes.

Community engagement was promoted and people engaged in social activities which were person-centred. Care plans considered people’s social life which included measures to protect them from social isolation.

Relatives told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

People told us the registered manager was approachable and the culture of the organisation was open and transparent. The registered manager was visible in the

Inspection carried out on 6 January 2015

During a routine inspection

The inspection of Poplars took place on 6 January 2015 and was unannounced. We previously inspected the service on 3 April 2013. The service was not in breach of the Health and Social Care Act regulations at that time.

The Poplars is a purpose built care home. It is part of the Holly Bank Trust which is an organisation specialising in providing education, care and support for young people and adults with profound complex needs.

The service had a registered manager in place. 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.

Relatives we spoke with told us they felt their relative was safe. The registered manager and staff all received regular training in safeguarding vulnerable adults and were able to describe a number of different types of abuse.

We looked at two support plans. Both of the support plans contained up to date, individual risk assessments. People’s care and support was delivered in a way that reduced risks to people’s safety and welfare. The registered provider had a system in place to maintain the building and equipment.

Staff were recruited safely and staff we spoke with all told us there were enough staff to meet people’s needs.

We saw that people’s medicines were managed and administered safely.We saw staff had received both training in medicines and a regular assessment of their competency.

We saw the registered provider had a system in place to support new staff in their role. Staff received regular supervision and told us they felt supported however, when we looked at the provider’s training matrix we saw that not all staff had received training in a number of topics including moving and handling and fire.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager and staff we spoke with demonstrated knowledge and understanding of the Deprivation of Liberty Safeguards and Mental Capacity Act 2005 and how that impacted upon the people they supported.

We saw people were supported to eat and drink in a calm and relaxed environment. Staff offered support to people in a discreet manner which promoted people’s independence. Both of the support plans we looked at provided detailed about the equipment and support the person needed.

During the time we spent at The Poplars we found the atmosphere at the home to be relaxed and homely. Staff supported people in a caring but professional way. Staff we spoke with were knowledgeable about indiviuals’ support needs, preferences and dislikes.

We saw examples of how staff promoted people’s privacy and dignity, for example by knocking on bedroom doors before entering them. Staff also explained to us how they supported people to make simple lifestyle choices about what they wore or the food they ate.

People were supported to participate in a variety of activities, some of which were provided by the registered provider and others which enabled people to access the local community. This included activities such as hydrotherapy, crafts and pamper sessions.

We saw that people’s support plans detailed the individual care and support people needed. We saw evidence people’s plans were reviewed and relatives told us they had input into the plan at the person’s annual review.

All the staff we spoke with told us they felt supported by the registered manager and that they could speak openly with her. The registered manager told us she promoted good practice within the home by acting as a role model for staff and challenging staff where she felt practice could be improved.

We found the registered provider had a system in place to assess and monitor the safety and quality of the service provision. This included monitoring accidents, incidents and safeguarding matters.

Inspection carried out on 3 April 2013

During a routine inspection

Due to the complex needs of people living at the Poplars and our inability to communicate with them non-verbally, we were unable to ask people their views about the care they received. However, we spent a significant proportion of our time observing care practice. We observed staff were attentive to people's needs and appeared to know them well. Although people did not have capacity to consent to complex care decisions, we observed staff involving people in decisions such as what they wanted to eat and drink and what activities they wanted to participate in.

We reviewed people's care records and spoke with commissioners involved in funding the care for these people. The care records we looked at were person centred and provided an accurate and up to date picture of their care needs and how their care needs were to be met. The commissioning staff we spoke with were happy with the quality of care the people they funded received.

The staff we spoke with told us they provided good care and received the necessary training and support to enable them to so.

Inspection carried out on 6 August 2012

During a routine inspection

Due to the complex needs of the people living at the Poplars, we were unable to seek their views about the service they received. In order to gain an understanding of people�s views about the service we spoke with the relatives of four people. One person�s relatives told us that they knew their relative was happy living at the Poplars because they were always happy to return after an outing. They also told us that they had no concerns and people always appeared well looked after. However, this did not reflect the views of the relatives of two people living at the Poplars. They provided examples of when they felt their relative�s needs were not met and raised concerns about the lack of involvement of the family in developing their care plans. One relative told us that they felt very frustrated with the attitude of care staff when they tried to discuss their relative�s needs, they told us, �I�ve given up; I don�t feel involved.� The relatives of three people who use the service told us that they had not been involved in developing new care plans following their relatives move to The Poplars earlier in the year.