Archived: Chetwynd Road

Chetwynd Road provides personal care and support for adults with a learning disability, who may also have physical disabilities and/or other complex health conditions. This is a supported living service where people reside in self-contained flats. The service operates from an office within the building. There is a communal lounge and kitchen/dining area on the ground floor and a garden to the rear of the building. The service can support up to 14 people. At the time of our inspection 13 people were living at Chetwynd Road.

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.

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

The provider’s governance systems were not always effective in identifying concerns in the service to drive the necessary improvement. At times there was a lack of clear and accurate records regarding people’s medicines, mental capacity and any potential risks to them. We have made a recommendation about this.

People felt safe living at Chetwynd Road and staff had a good understanding of safeguarding procedures. Staff were recruited safely and there were enough staff to support people effectively.

There were some restrictive practices in place around people accessing the community and other aspects of their lives being managed by the service. It was not clear that people had consented to this or had the capacity to do so. We have made a recommendation about this. However, staff supported people to make decisions and respected the choices they had made.

Staff were well supported and received appropriate training and supervision to meet people's needs.

People were happy living at Chetwynd Road and their relatives were complimentary about the service. People were supported by staff who were kind, caring and who understood their likes, dislikes and preferences. Staff understood how to support people in ways that promoted their privacy, dignity and independence.

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. Staff supported people to set and work towards meaningful goals. They provided people with support to access their local community, plan activities and maintain important relationships.

Staff were positive about the management of the service and told us the registered manager was very supportive and approachable. People and their relatives felt listened to and knew how to raise concerns.

The provider used meetings and surveys to gather the views of people and staff, however it was not always clear how suggestions made had been acted on. Staff and the registered manager shared information effectively as a team and with other organisations when needed.

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 Outstanding. (Report published 20 April 2017)

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chetwynd Road on our website at www.cqc.org.uk.

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 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe from abuse and avoidable harm by staff who knew them well. Staff were able to demonstrate a sound knowledge of how to recognise the signs of abuse and how to report this appropriately. People were involved in promoting fire safety at the service. External agencies were invited to help to contribute to people’s safety.

Safe recruitment practices were followed to ensure that those employed were suitable to work in a care setting. Innovative interview practices were used to encourage people living at the service to contribute to the recruitment process. There were enough staff to keep people safe.

Medicines were stored securely in individual people’s flats and administered by appropriately trained staff. Medicine records were kept up to date. Risk assessments were in place to mitigate any potential risk of harm to people and staff.

Staff were up-to-date with annual mandatory training updates which enabled them to care for people effectively. Staff demonstrated a good understanding of the Mental Capacity Act 2005 and provided good examples of seeking consent when providing personal care and support.

Staff supported people to maintain a healthy diet and where people had complex dietary health needs, staff ensured that these needs were met according to guidance within the care plan. People were encouraged and supported to access external health and social care provision.

Staff demonstrated that they knew people well. Interactions between staff and people were observed to be warm, supportive and caring. People’s independence, privacy and dignity were respected at all times. People were actively encouraged to participate in discussions and contribute to decisions relating to their care and support.

People’s care plans were personalised with their individual wishes and preferences taken into account and were reviewed regularly to accommodate people’s changing needs and wishes. People were encouraged and supported to engage in meaningful activity of their choosing. There was a strikingly significant range of initiatives and support available and delivered successfully to help empower and promote people’s choices and aspirations, including the use of tailored communication and the use of technology. Leaders and staff worked innovatively and passionately to ensure people’s lives were their own, and focussed on their abilities and wishes, not on their disabilities.

People and their relatives felt able to raise any complaints or concerns they might have about the service and that they would be listened to and the matter would be addressed appropriately within a timely manner achieving positive outcomes.

The registered manager received very positive feedback from people, relatives and staff regarding the leadership of the service. The service cultivated a warm, welcoming and inclusive culture where people and staff felt able to express themselves.

From senior leadership to front line support staff, a clear vision of people using the service being informed, involved and valued as individuals and as contributors to the life of the home and beyond shone through and there were a number of exceptional examples of governance and leadership excellence.

People and staff achievements were recognised in provider awards ceremonies.

The service was developing links with a local university to offer student social work placements.

There were robust quality monitoring systems in place to continue to meet the needs of people and address any areas for improvement to be made. Residents, relatives and staff meetings were held and feedback received was acted upon in a timely manner. External professional input was sought and utilised to help promote the best outcomes for people using the service.

We observed staff interacting with people in a friendly manner and treating them respectfully. People made requests and staff responded appropriately. Staff knew people well and treated each person as an individual.

We saw that care plans were detailed and up to date, however not all had been signed by people or a representative.

There were processes in place to ensure that people were safeguarded against abuse this included training for staff and their knowledge and understanding of the whistle blowing policy.

There were robust quality monitoring processes in place which involved the staff, relatives and people using the service.

Observation during the inspection showed staff supporting people to make their own choices about what they had for lunch and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected. We observed one person communicating with staff through the use of an electronic communication tool. Staff confirmed that they had tailored the device to "meet her needs and allow her more freedom."

We observed that staff asked people about how and when they wanted their care and support. This indicated that people were involved in planning their care on a daily basis.

People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas watching television and interacting with each other. During our inspection we observed people spending time in their bedrooms listening to their choice of music. We also saw people being involved with cooking in the kitchen with staff members.

During the inspection we observed staff spending the majority of their time with people who used the service. They frequently checked on them to ensure they were alright when spending time on their own.