Background to this inspection
Updated
28 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector.
Service and service type:
3-4 Prior’s Court Cottage is a “care home” which is also known as Robin Cottage. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided. We looked at both during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was also responsible for two other services on the same site and another service located a few miles away. There was also home manager who was responsible for the day to day management of 3-4 Prior’s Court Cottage.
Notice of inspection:
The inspection was announced. We gave short notice of the inspection, so staff could prepare people for our visit. This was to minimise the risk of our visit causing anxiety to people due to their needs relating to autism.
What we did:
Before the inspection we looked at information we held about the service.
We asked the provider to complete a Provider Information Return. This is key information providers are required to send about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
The law requires providers to notify us of certain events that happen during the running of a service. We reviewed the notifications received since the last inspection.
We contacted local authority teams engaged with the service, including clinical commissioning groups, continuing health care groups, the local fire authority and environmental health for information to aid the planning of our inspection.
During the inspection:
We communicated with six people living at 3-4 Prior’s Court Cottage.
We spoke with the registered manager, the home manager, the nominated individual, the transition officer, the workforce coordinator responsible for recruitment, the provider’s occupational therapist and eight staff members who were known as autism practitioners.
We observed medicines being administered and the support people received in communal areas, including the preparation and consumption of meals.
We looked at six people’s care records, eight staff recruitment and training files, the provider’s policies, procedures, quality assurance systems and other records demonstrating how the service was managed.
After the inspection site visit:
We spoke with six relatives of people who use the service, five health and social care professionals who support people living at the service and one person’s advocate.
Updated
28 June 2019
About the service:
3-4 Prior’s Court Cottages is a residential care home. It provides accommodation and personal care for up to six people living with autistic spectrum disorder, who exhibit behaviours which may harm themselves or others. It provides a continuing education service to young adults from 19-25. At the time of the inspection there were six people living at the service.
The service offers on-site educational and vocational services via a learning centre, attended daily by the young adults, based on individual assessments and needs. Some people also attended off-site supported work placements.
The service effectively applied the principles and values of Registering the Right Support and other best practice guidance. These ensured that people who used the service lived as full a life as possible and achieved the best possible outcomes, that include control, choice and independence.
People's experience of using this service:
People experienced high quality care that was safe, effective, caring, responsive and well led.
People consistently experienced outstanding person-centred care, which had significantly reduced their anxieties, the level of behaviours that may challenge others and the incidence of self-injurious behaviour.
There was a strong, visible person-centred culture in the service which drove staff to provide care and support that was exceptionally caring and compassionate.
Staff consistently cared for individuals in a way that exceeded expectations and demonstrated a real empathy for the people they cared for.
Staff had developed close and trusting relationships with people, which supported people to achieve their ambitions and extremely positive outcomes.
Feedback from people, relatives and professionals was overwhelmingly positive.
Staff were exceptionally sensitive when people needed caring and compassionate support. They discussed this with them and helped people to explore their feelings.
Staff found innovative and creative ways to communicate with each person and were particularly skilful at helping people to express their views and choices.
Staff positively welcomed the involvement of advocates and were intensely supportive of their ideas and strategies to promote people’s independence and protect their rights.
People were protected from discrimination, neglect, avoidable harm, and abuse by staff.
Risks to people's safety had been identified, assessed thoroughly and were managed safely.
People received their medicines safely, as prescribed from staff who had completed the required training and had their competency to do so assessed.
Staff effectively involved people and their relatives where appropriate, in decisions about their care, so that their human and legal rights were upheld.
Staff felt valued and respected by the management team who had created a true sense of family within the service and a strong team spirit.
The registered manager ensured enough staff were always deployed to meet people’s needs.
The provider completed comprehensive pre-employment checks to ensure prospective staff were suitable to support people living with autism.
Effective training and support ensured staff had the required skills to meet people’s needs and promote their quality of life.
Staff responded quickly to changes in people’s needs. The service liaised well with internal and external healthcare professionals and demonstrated an effective multi-disciplinary approach.
People’s health, dietary and emotional wellbeing needs were well supported.
Staff knew people’s interests and preferences and supported them to access community activities of their choice and to pursue employment and education opportunities, which enriched the quality of their lives.
People’s care plans were comprehensive, individualised, and regularly reviewed, providing staff with the required information about people's needs and how to meet them.
Staff and relatives felt their views were listened to and that the service was well managed.
The service was well led, effectively monitored and staff sought to constantly develop and improve the quality of care. External accreditation and evaluation had also been sought.
The registered manager had worked effectively with local organisations, health and social care professionals and multi-disciplinary teams.
Rating at last inspection:
At the last inspection the service was rated Good (16 May 2016). At this inspection the rating remained Good overall, although we found the service to be Outstanding in Caring.
Why we inspected:
This was a planned inspection to review whether the service remained good.
Follow up:
We did not identify any concerns at this inspection. We will therefore aim to re-inspect this service within the published time scale for services rated good. We will continue to monitor the service through the information we receive.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk