We carried out a review of the data available to us about Crimson Hill Support Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Crimson Hill Support Limited, you can give feedback on this service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People's experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right Support
The person being supported had choice and control over their life. 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 person received personalised care and support built around their needs and wishes. They had a staff team who they knew and trusted, although staff changes did affect them.
Staff were trained to support the person, who was relaxed with the staff who supported them. Staff supported the person with their medicines in a safe way.
Right Care
The person's care and support plan described the care being delivered by staff and the person’s chosen lifestyle. The staff team had a good understanding of the person's needs and were flexible to enable them to meet changing needs and wishes.
The person enjoyed regular planned activities and interests outside of the home.
The person received kind and compassionate care. Staff protected and respected the person's privacy and dignity. Staff were understanding and responded well to the person’s needs.
The person was kept safe from avoidable harm because the service had a clear policy to support staff to recognise and report abuse or poor care. Staff spoken with did not have any concerns about possible abuse or poor practice. Relatives had no concerns about the person's safety.
Staff recognised signs when the person experienced emotional distress and knew how to support them.
The person who had individual ways of communicating, using speech, body language and pictures. They interacted confidently with staff and others involved in their care and support because staff had the necessary skills to understand them.
Staff felt well supported. There was ongoing training and supervision for staff to make sure practice always followed best practice guidelines.
Right culture
A relative told us they had confidence in the management of the home but felt they could be more proactive at times. They were very closely involved with the service and usually had daily contact with staff, but felt sometimes they were not listened to.
The person was supported by a small management team. The provider and registered manager consistently assessed, monitored and improved the quality of the service where possible.
The service had been designed around this person’s needs and had supported them to develop.
The person was supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities the person with a learning disability and/or autistic the person may have. This meant the person received compassionate care from their staff team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 29 December 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
This was a focussed inspection looking at safe and well led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crimson Hill Support Limited on our website at www.cqc.org.uk.
The overall rating for the service has remained good following this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good:
The person was supported to have maximum choice and control over their life and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff recruitment, deployment, training and support ensured competent, skilled and safe staffing. The premises was safe and was designed specifically for the person using the service who had been involved in choosing the decor.
Medicines were managed in a safe way.
The person was supported to receive a varied and nutritious diet. Their health care needs were met with the support of external health care professionals.
Risk was well understood and managed following in-depth assessment and planning of the person’s support needs. Staff were clear on how to provide the support the person needed.
There was continual, gradual improvement in the person’s life, described by a health care professional as “Quite good”. Staff looked to introduce new options and support the person through change.
The service was caring and advocated for the person to promote their opportunities and well-being. Staff had a very good insight into the person’s needs and of communication, so the person’s views were taken into account and choice was promoted.
The service was well led by a provider who was passionate about people’s care. They worked closely with the registered manager and supported staff to ensure all views were taken into account. They looked for continual improvement.
Further information is in the detailed findings below
This inspection was unannounced and took place on 25, 28 and 30 September 2015. The inspection was carried out by one inspector. The last inspection of the service was carried out on 12 September 2013. No concerns were identified with the care being provided to one person at that inspection.
The Bungalow is a care home for one person. It is registered to provide accommodation and personal care for one person with autism and complex support needs. The property has been specially adapted to suit their needs. The provider also runs a personal care agency known as Crimson Hill Support which is separately registered. The inspection of The Bungalow was carried out at the same time and in conjunction with the inspection of the personal care agency known as Crimson Hill Support.
Two directors make up the provider Crimson Hill Support Limited. At the time of this inspection one of the directors was the registered manager of the service. However, they have recently promoted a senior member of their management team to the post of manager for The Bungalow. The new manager planned to submit an application to register as soon as possible. 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 person who used the service had been involved and consulted in drawing up and agreeing a plan of their care and support needs as far as they were able. A close member of their family had also been consulted. The care plan was detailed and set out the goals the person had identified that would help them gain greater independence. Risks to their health and safety had been assessed and there were detailed measures in place to reduce the risks where possible.
There were enough staff to meet the person’s complex needs and to care for them safely. Some of the staff and management team who regularly worked at The Bungalow also carried out shifts for the personal care agency. This meant there was a large team of staff the provider could choose from when selecting suitable staff to work at The Bungalow.
The person was protected from the risk of abuse and avoidable harm through appropriate policies, procedures and staff training. Staff received relevant training to effectively support the person’s mental and physical health needs.
The provider worked closely with health and social care professionals to ensure the person received a support package that was tailored to meet their individual needs. A health professional told us, “The current home manager presents as very competent and professional, and the organisation appear to have developed a relatively good reputation.” They said they received prompt replies to any communication with the manager, including requests for information, or suggestions for care plan updates.
Medicines were administered safely by staff who had been trained and were competent.
Staff understood the things the person enjoyed doing each day. They knew the person’s preferred daily routines, the activities they wanted to do and the places they wanted to go to. Staff also supported the person to introduce new activities and outings. These were carefully planned and any associated risks were assessed and actions taken where possible to minimise the risks. .
Staff supported and encouraged the person to maintain good health and well being and choose from a variety of healthy and nutritious foods. Staff from the service supported the person to attend hospital and community appointments when needed.
The provider had a range of monitoring systems in place to ensure the service ran smoothly and to identify where improvements were needed. Action plans were in place to show how improvements would be addressed. Regular staff meetings were held and staff told us they could speak out in these meetings and that any issues would be listened to and acted upon as part of ongoing improvement. The person’s relative confirmed they were fully involved and consulted about the care and services provided. They were confident they could raise any concerns or complaints and these would be listened to and acted on satisfactorily.
We saw staff respected and acted on decisions made by the person regarding their day to day living choices. Where the person lacked mental capacity to make certain important decisions multi-disciplinary meetings were held to make decisions in their best interest.
We saw from care plan documentation, conversations with staff and our observations that the person's needs had been fully assessed. We saw care and treatment was planned and delivered in line with their assessed needs. A member of staff said 'They get fantastic care and a very high level of choice'.
Details of the person's prescribed medication and how they wished to take their medication were recorded in their care plan. Members of staff were able to describe the correct medicine administration procedures to follow.
When we inspected there were enough qualified, skilled and experienced staff to meet the person's needs. The staff received training in a range of relevant subjects and had access to specialist advice when needed.
We observed personal care records and other records relevant to the management of the service were accurate and fit for purpose.
We found the home was well decorated, clean and comfortable. The rooms were personalised to reflect the preferences of the person living there. We found furniture and fittings to be of a good standard. We observed the atmosphere of the service was relaxed and informal.
We spoke with three members of staff working at The Bungalow. One staff member told us 'It's a good environment; we can make positive changes with people'. Another staff member told us 'I love working here; we have sufficient training before starting to work here so we are confident we know how to best support the resident'.
The provider demonstrated how they used widget picture boards to help the person understand, plan and take decisions about daily activities.