Archived: Cavendish

About the service

Cavendish is a care home for up to six people living with learning disabilities and/or autism. The service was fully occupied at the time of our inspection.

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

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: People lived in a homely environment and their quality of life had improved since being supported by Cavendish. Relatives described how people were “Living their best lives” and continuously encouraged to learn new skills and do things that were meaningful and excited them.

There were always enough staff on duty. Staffing levels were set with funding authorities according to people’s needs. Staff worked flexibly to enable people to follow their interests and hobbies. Recruitment processes involved people and ensured that they were always supported by suitable staff.

People experienced choice and control over their lives and staff encouraged them to achieve their own levels of maximum independence. People’s diverse communication methods were understood, and staff were proactive in the way they actively involved people in all decisions about their support.

People were proactively supported to maintain good health and experienced improved health outcomes as a result. The team had excellent working relationships with other professionals to ensure that people received the very best holistic care.

Right care: People were placed at the very heart of the service and were supported by a team of committed, kind and caring staff. Person-centred care was automatic, and staff were passionate about supporting people in a way that not only met their needs but also enabled them to lead happy, confident and fulfilling lives. Staff supported people with skill and expertise to ensure they could enjoy maximum freedom whilst remaining safe. People’s privacy and dignity were upheld as a matter of routine.

Staff had an excellent understanding about how to safeguard people. There were robust systems in place to manage allegations of abuse and staff were confident about their responsibilities in keeping people safe from harm. Risks to the health, safety and well-being of people were addressed in a personalised and enabling way that promoted their independence.

Right culture: The atmosphere in the service was relaxed and friendly with lots of fun and laughter being shared. Positive relationships between people and staff had been developed that were based on trust and respect. Managers had created a culture where diversity was celebrated and equality the norm. People were respected as partners in their own care and empowered to lead happy and independent lives that were free from unnecessary restrictions. People and relatives were confident to raise concerns or suggest changes for the service as well as to the way they received support.

Staff enjoyed working at the service and were trained and supported to be the best that they could be. The registered manager was an excellent role model and there were sound systems in place to develop staff and promote reflective practice. Staff were proud to work at Cavendish and this in turn led to the delivery of high-quality support.

Quality assurance processes were robust and action plans to improve the service were prioritised and completed quickly. Learning was shared from within and outside the organisation and community contacts were well established.

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 the service under the previous provider was good (published 6 December 2016. The provider changed in May 2019 and the service has not been inspected to provide a rating under the new provider.

Why we inspected

This was a planned inspection to provide a rating for the service following its re-registration.

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

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.

We found the following examples of good practice.

The home was clean and hygienic. Staff had implemented additional cleaning schedules since the beginning of the pandemic, including for high-touch areas such as door handles. The provider had an appropriate infection prevention and control (IPC) policy and IPC audits were carried out regularly to ensure standards were maintained.

The provider had implemented measures to reduce the risk of infection. Staff had access to the personal protective equipment (PPE) they needed for their roles and had received training in its use. The provider had implemented measures to manage risks to people who lived at the home and staff. Risk assessments had been carried out to identify and mitigate risks, including for people in vulnerable groups. The provider had a contingency plan for the home, which had been reviewed in the light of changing Covid regulations.

Staff at the home had accessed weekly Covid testing. If positive test results were returned, staff did not return to work until they had completed an appropriate period of self-isolation. People who lived at the home also had access to testing and the provider sought their consent to this. The provider had procedures in place to ensure decisions were made in people’s best interests if they lacked the capacity to make a decision. If people returned positive test results, staff supported them to self-isolate in their bedrooms.

People had access to healthcare advice if they needed it. The registered manager told us the service received good support and regular communication from the local GP surgery. Routine healthcare appointments had taken place via video link. Dental check-ups had been postponed due to the pandemic but the registered manager told us no-one had needed dental treatment.

People’s regular activities had been suspended due to the pandemic. As a result, staff had focused on the provision of in-house activities. The registered manager said staff aimed to provide activities that people had enjoyed before the restrictions, such as cookery, arts and crafts and IT.

People’s families were unable to visit the home at the time of this inspection due to national coronavirus restrictions. Some people had mobile phones which they used to keep in touch with their families and staff had supported people to contact their families through video calls. The registered manager said staff had used resources such as social stories to provide information about Covid-19 in an accessible way, which had helped people understand the reasons for Covid restrictions.

There were no plans for new admissions to the home. The provider had appropriate procedures in place to ensure any new admissions were made safely following an assessment and the development of a personalised support plan.

The provider had supported staff during the pandemic through the provision of information and guidance, at team meetings, handovers and individual supervisions. Staff had opportunities to discuss any anxieties or concerns they had. The provider had nominated ‘mental health first aiders’ who were available to any staff needing support in the organisation.

The movement of staff in and out of the home had been minimised. The registered manager told us the staff at Cavendish only worked at this service. The provider had given staff lifts to and from work when they would ordinarily have used public transport. The service had not needed to use agency staff to cover permanent staff who were self-isolating.

The registered manager had sought and implemented advice from relevant agencies and professionals, such as Public Health England and the Clinical Commission Group’s Infection Prevention lead. The registered manager had attended Covid training for managers provided by the local authority.

Further information is in the detailed findings below.