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Inspection carried out on 14 February 2019

During a routine inspection

About the service

Foxhill is a care home that offers care and support to people with Learning disabilities or autistic spectrum disorders and or physical disability.

There were three people using the service at the time of our visit.

At our last inspection on 17 May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

People’s experience of using this service

• People were happy living at Foxhill. They felt safe and liked the staff who supported them. Staff enjoyed their work and were proud of the service.

• Staff knew about safeguarding and how to protect people from abuse and avoidable harm.

• Risk was assessed and managed so that people could continue doing the things they liked to do.

• Staff knew people extremely well. They knew what made them happy and sad and about the things that may trigger risky behaviour and the best way to a manage this.

• Staff managed medicines in a safe way.

• There was a consistent staff group matched to the needs of people. This meant that people received the support they required from staff they knew them very well.

• Staff were recruited in a safe way to make sure that only staff with the right skills and characteristics were employed.

• Regular maintenance and checks were carried out on the premises and equipment to make sure it was in safe working order.

• The service was clean and tidy and staff knew how to prevent and control infection.

• Staff had the right skills, experience and support to meet people’s needs.

• People were supported to have a balanced diet with a choice of meals and snacks.

• Staff knew how to recognise changes in people’s health and wellbeing and sought medical advice as soon as this was required.

• The premises met people’s needs and provided a safe, comfortable and homely environment.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. This meant that the person’s liberty was only deprived following authorisation and a best interest decision.

• People felt cared about by staff. They had developed positive relationships and were treated with kindness and respect.

• Staff had time to spend with the people and supported them to do the things they liked to do.

• People had access to advocates to make sure that care and support was being provided in their best interests.

• Staff protected people’s privacy and dignity and promoted their independence.

• People were supported to maintain relationships with their family members.

• People received care and support which was personalised to suit their needs and preferences.

• They were able to pursue their hobbies and interests including holidays.

• People were supported to raise concerns should they needs to.

• People and staff felt supported by the registered manager.

• The staff team enjoyed working together and supported each other and the registered manager.

• The quality of the service was monitored and people were asked for their feedback and this was acted upon.

• Staff worked in partnership with other professionals and organisations to make sure that people received joined up care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Good (report published on 29 June 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Inspection carried out on 17 May 2016

During a routine inspection

The inspection took place on 17 May 2016. It was an announced visit, as we gave the provider notice the day before the inspection. The home provided accommodation for persons with mental health or neurological support requirements and required nursing or personal care. There were four people living in the home when we inspected.

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. There was a registered manager in post.

The home was safe and staff understood their responsibilities to protect people from harm or abuse and had received relevant safeguarding training. Staff were confident in reporting incidents and accidents should they occur. People were safely supported to take their medicines.

There were effective processes in place to minimise and review risks to individuals. Assessments had taken place regarding people’s individual risks and clear guidance was in place for staff to follow in order to reduce risk. Recruitment processes were in place to ensure that staff employed in the service were deemed suitable for the role.

Staff had received training in areas specific to the people they were supporting and this helped to make sure that people received care individual to their needs. Staff gained people’s consent to the care they were providing.

Some people had applications submitted for the lawful deprivation of their liberty (Deprivation of Liberty Safeguards (DoLS)) and staff were able to explain how they promoted choice where people had variable capacity. The home complied with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported to access healthcare promptly wherever necessary. People’s nutrition and hydration needs were encouraged and they were able to have drinks when they liked.

People’s privacy and dignity were promoted and they had strong relationships with staff who were kind and compassionate. People were encouraged to be as independent as possible and make their own choices.

Staff had good knowledge about the people they cared for and understood how to meet their needs. People planned their care with staff and relatives, and numerous activities were carried out in line with people’s preferences.

The management team was visible within the home and people found them approachable. People were encouraged to provide feedback on the service and regular meetings took place within the home.

There were many systems in place to monitor the quality of the service and these were used to develop and improve the service. The provider had developed bespoke ways of assessing, reviewing and documenting, in accordance with the client group.

Inspection carried out on 1 August 2013

During a routine inspection

Foxhill was opened by the manager/owner, in order to replace another location that was no longer entirely suitable to meet the needs of the people living there.

One person, who had moved from a different Beeshaw location said: “…I like it here, I’m a lot happier now. I’m hoping to have my own place one day and they [staff] are going to help me with that.”

A second person had recently moved into Foxhill from the location that had closed, gestured to us with ‘thumbs up’ and said, “yes.” when we asked if they liked their new home.

Records showed that one person came and went as they pleased, within agreed boundaries, regularly accessed the local community by themselves and had a mobility scooter.

One of the people we spoke with said: “they make me laugh if I say I feel down…”

Both people we spoke with answered, “Yes.” when we asked if they felt safe living in Foxhill. They also confirmed to us that they would tell the staff if they had any concerns.

One person we spoke with told us that they could talk to staff when they wanted and said: “They know if there’s something wrong or I’m not happy because I tell them.”

A second person responded, “Yes.” and nodded when we asked if they could let the staff know if they had any problems or concerns.