Precious Homes Torquay

Precious Homes Torquay provides support for up to 14 people living in a supported living setting in the coastal town of Torquay. At the time of our inspection 13 people were receiving support from the service. People were accommodated by a private landlord in a large adapted building with their own flats. There were also communal areas for people to socialise in such as a large garden and lounge. There was an office in the grounds of the property.

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.

The building design fitted into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, cameras, industrial bins or anything else outside to indicate it was a supported living service. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were supported by engaging compassionate staff who knew them well. People were involved in the planning of their care and supported by a service that was exceptionally caring and wholly person centred. People’s equality and diversity characteristics were protected and explored by people with staff encouragement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where restraint needed to be used it was as a last resort and it was clearly evidenced in what cases this needed to be used. All staff were trained in the use of appropriate restraint.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice 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.

People told us they felt safe and if they were worried about something they could approach staff or the manager. All staff had good knowledge of safeguarding and medicines were managed safely. People were supported with staff who were employed after a robust recruitment process. Staff were aware of the risks people faced and discussed these with people.

People were supported to achieve positive outcomes such as maintaining employment, developing living skills and learning to be out in the community safely. People were encouraged to retain and develop friendships and stay in contact with families.

The service was well-led, by an experienced and knowledgeable management team who cared deeply about their staff team and the people using the service. Staff felt supported and listened to. People told us managers were approachable and helped them solve problems. Quality systems were robust, and performance was monitored, and learning taken from incidents when they occurred.

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 good (published 4 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.

This inspection took place on 30 November and 1 December 2016. The provider was given 48 hours’ notice that the inspection would be taking place. This was because the location provides a supported living service to people who are often out during the day; we needed to be sure that someone would be in.

The service was last inspected on 03 December 2013, when it met the regulations relevant at that time.

A registered manager was employed at the service. 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.

Kind and caring staff ensured people received support that was responsive to their needs and as set out on their support plans. Staff ensured people’s privacy and dignity was respected. Staff knew the people they supported well and ensured their preferences were met. Some people had paid work they attended regularly. Other people spent their time on preferred activities such as shopping and walking. People were supported to attend a variety of events outside of their homes. People attended paid employment as well as social activities such as the cinema, karaoke and discos.

Relatives were complimentary about the support provided by the registered manager and staff. One relative told us the registered manager was “Excellent”. They went onto say that all the staff were excellent and “They are a team.”

People’s support plans described how staff were to support people. They gave staff directions on how to manage any behaviours that may place the person or others at risk. Any risks to people were identified and plans put in place to minimise the risks. For example, one person was identified as being at risk of misusing medicines. Plans were in place to ensure their medicines were managed safely.

People were supported to make choices in all aspects of their lives. One person told us how they had been supported to obtain paid employment. People and their relatives were involved in making decisions about the support provided by staff. One relative told us they were always invited to discuss their relations support plan and said they were always told of any changes to their relative’s needs. They said they had been invited by staff to go shopping with their relation. One relative told us they were going to be picked up by staff and taken out to help their relative choose new items, then go for something to eat.

People were supported to maintain a healthy balanced diet. They were supported to plan, shop for and prepare their meals. Staff ensured people’s health care needs were addressed. People were supported to attend healthcare appointments when necessary. One relative told us their relation was now attending dental appointments. People were supported to take their medicines at the times they were prescribed.

Following the inspection we received emails from two social and healthcare professionals who told us how well people were supported by staff. One social care professional wrote in an email they found the service to “provide correct care, support residents, allow them choice and advocate when appropriate.”

People were protected from the risks of abuse. Staff knew how to recognise and report abuse both within the service and to outside agencies. Thorough recruitment procedures ensured the risks of employing unsuitable staff were minimised. People’s human rights were upheld because staff displayed a good understanding of the principles of the Mental Capacity Act 2005. Staff told us they would always respect people’s decisions.

Staff received training that helped them meet people’s needs. This included first aid and supporting people living with a learning disability. New staff received a thorough induction. Staff received regular supervision to support them in their role. Staff told us the registered manager was very supportive and approachable.

There were effective quality assurance systems in place to monitor care. Regular audits were undertaken to ensure the quality of care was maintained. The registered manager ensured their knowledge was kept up to date by using the internet to access relevant websites.

We saw two support plans and there was evidence that people's right to consent was recognised. One person we spoke with said 'I've seen my care plan, I know what's in it and I've signed it'.

People we spoke with described the activities they enjoyed participating in; these included bingo, football, 'waterobics' and walking. One person said they were 'looking forward to going home' and another person said they had 'got a disco tomorrow'. Some of the people had been supported to obtain employment. People we spoke with said that staff listened to them; one person said this was via surveys and meetings.

Everyone we spoke with who used the service said there was always a member of staff available and they knew the staff by name. People, who used the service, appeared to have a good rapport with staff who understood their care and support needs. We observed positive interactions between staff and people who used the service and people we spoke with said staff were 'good, excellent' and 'alright, good, nice and friendly'.