Grasmere Avenue

About the service

Grasmere Avenue is a ‘care home’ that provides care and support for up to 6 people. All the people who live at Grasmere Avenue have a learning disability or were autistic people. There were 6 people living there at the time of the inspection.

CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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

Staff supported people, to be given maximum choices, control, and independence. Personalised communication strategies were used to support people to understand and make their choices and creative ways found to promote learning and for people to develop their existing and new skills. Staff were focused on people's strengths to enable them to lead fulfilling and meaningful lives.

People were recognised as individuals and care was planned according to their personalities and interests. Staff supported people, to pursue their interests and achieve goals and aspirations by overcoming barriers and finding ways to ensure people participated in a wide range of age appropriate social activities. People were supported to be valued members of the local community. The interactive and stimulating environment provided was adapted to meet their individual needs and people benefitted from this. Staff enabled people to access specialist health and social care support in the community.

People were supported with their medicines in a manner that promoted their independence and achieved the best possible health outcome for them. They received a service that was safe for them to use, live and staff to work in. The provider and registered manager regularly reviewed the quality of the service, and changes were made to improve people’s care and support when required. This was in a way that best suited people. There were well-established working partnerships within the home that promoted people’s participation, independence, and reduced their danger of social isolation.

Right Care

People were given kind, compassionate care, and staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs and knew how to protect them from poor care and abuse. The service worked well in tandem with other agencies and staff were trained in how to recognise and report abuse and applied this, as necessary. People were able to communicate with staff and understand information given to them because staff supported them consistently, understood their individual communication needs and had the necessary skills to understand them. People could take part in activities, pursue interests that were tailored to them, were given opportunities to try new activities that enhanced and enriched their lives, and were supported to take positive risks.

Staff were appropriately recruited, and in sufficient numbers to support people to live safely, whilst enjoying their lives. Risks to people using the service and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. Staff who were trained, safely administered people’s medicines.

Right culture

The home’s culture was open, positive, and honest with a leadership and management that was clearly identifiable and transparent. The provider’s vision and values were clearly defined, and staff understood and followed them. Staff knew their responsibilities, accountability and were prepared to take responsibility and report any concerns they may have. The management and staff ethos, philosophy, attitudes, and behaviours meant people could lead inclusive and empowered lives. They received excellent quality care, support, and treatment because trained staff and specialists were able to meet their needs and wishes. Staff understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have and supported them accordingly. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive to them, and supported their aspirations to live a quality life of their choice. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well and people’s wishes, needs and rights were at the heart of everything staff did. The registered manager and provider enabled people and those important to them to work with staff to develop the service and staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

Rating at last inspection

The last rating for this service was Good (published 24 December 2018).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has improved to Outstanding. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Grasmere Avenue on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The provider was following best practice guidance to prevent visitors to the home spreading COVID-19 infection. The provider enabled residents to keep in touch with family members and people's friends through phone calls, emails and video conferencing if requested.

Staff had successfully adhered to infection control and COVID policies so that no challenges or difficulties had been experienced throughout the pandemic in relation to staffing in this service.

All visitors were asked to complete COVID-19 lateral flow test.

All visiting professionals on the national testing programme were asked to show proof of their recent COVID-19 negative test. On entry all staff and visitors were provided with Personal Protective Equipment (PPE). This was to ensure the safety of staff and people.

People were supported to see their family in the garden during summer and markings were done in the garden to ensure social distancing.

To ensure people's well-being the provider performed monthly wellbeing assessments using a tool and people's mental state was monitored. If there was a decline in the mental state of people, they were offered extra support.

The home had multiple clean areas for staff to don and doff (put on and take off) PPE.

Our observations during the inspection confirmed staff were adhering to PPE and Infection Control guidance.

The provider had ensured residents who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing.

Further information is in the detailed findings below.

This was the home’s first inspection since their registration on 16 February 2018.

Grasmere Avenue is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Grasmere Avenue specialises in supporting younger adults with mental health needs, learning disabilities and autism, accommodating up to six people in one adapted building. At the time of our inspection five people were residing at the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post at the time of our inspection. 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 care delivered by staff was of a high quality, with exceptional feedback received from relatives. Staff knew people’s individual needs well and respected their privacy and dignity. People’s independence was enhanced with ample care and attention paid to how they could be supported to do things for themselves.

People at the home were kept safe, in premises that were well maintained and clean. Staff knew how to identify the signs of abuse, and knew the action to take if they suspected someone was at risk. People’s needs were thoroughly risk assessed in order for staff to appropriately support them. People’s medicines were well managed to ensure that people received them when they needed them. Recruitment processes were effective in ensuring that people were supported by staff that were safe to care for them. Any incidents or accidents were reviewed to help prevent their reoccurrence.

The service was effective in meeting the needs of the people at the home. Staff received regular support through ongoing training as well as supervision and appraisal. The team worked with other organisations to ensure that people’s needs were met, with a collaborative approach. People were supported to attend healthcare appointments, in line with their identified needs. In order to ensure people maintained a balanced diet their food preferences were sought, and the home accommodated these within their weekly meal planning. Staff understood the principles of the Mental Capacity Act 2005 (MCA) and people at the home were not unlawfully deprived of their liberty.

The service responded to people’s needs and looked for innovative ways to encourage people to undertake the activities they enjoyed. People’s care plans were regularly reviewed, and the registered manager was aware of how to discuss people’s end of life wishes in a sensitive manner. There was a complaints policy in place to ensure a level of accountability in addressing people’s concerns.

People, relatives and staff were highly complimentary about the support that the management offered them. Staff were passionate about a consolidated team work approach, and reflected a registered manager that led by example. All those involved in the home were supported to express their views and improve service delivery. Quality assurance systems were effective in driving improvements across the home.