We carried out a review of the data available to us about Ciderstone House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ciderstone House, you can give feedback on this service.
Ciderstone House is a residential care home providing personal care and support for up to 6 people who have a learning disability and autistic people. At the time of the inspection, 6 people were being supported. Ciderstone House accommodates 4 people in one building and 2 people in self-contained annexes attached to the building.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
People lived in a domestic dwelling within walking distance of local shops and amenities. Staff promoted people's independence and supported their access to the local community.
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.
Right Care:
People received kind and compassionate care and were supported in a person-centred way. Staff had the training and knowledge to support people effectively keeping them safe and promoting their human rights. Staff promoted people's equality and diversity and knew them well as individuals. People's care, treatment and support plans reflected their range of needs and this promoted their health, mental wellbeing and enjoyment of life.
Right Culture:
The registered manager led by example to create a positive person-centred culture. People received consistent support from a staff team who knew them well. Staff worked hard to achieve good quality care and good outcomes for people and understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have.
Staff were responsive to people's needs and worked well together to achieve good outcomes for people. Feedback from relatives and stakeholders about the service was positive. The registered manager and staff team were passionate about continually improving the service and supporting people to achieve their goals and aspirations.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 May 2021).
At our last inspection we recommended the provider included information about systems to address any shortfalls in their response to official complaints. The provider had made improvements.
Why we inspected
This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions of Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ciderstone House on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Ciderstone House is a residential care home providing personal care and support for up to six adults with learning disabilities and autism. At the time of the inspection, six people were being supported. Ciderstone House accommodates four people in one building and two people in self-contained annexes attached to the building.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives. Staff did not provide people with care in the least restrictive way possible and did not act in their best interests; the policies and systems in the service did not support this practice.
One person had specific conditions included in their Deprivation of Liberty Safeguards (DoLS) authorisation. However, the conditions were not met at the time of the inspection.
We have made a recommendation on meeting conditions of DoLS.
Most people’s relatives told us they knew how to complain. However, some relatives of people using the service were not always satisfied with responses to their complaints.
We have made a recommendation on taking action to address complaints raised with the service.
The provider’s governance and auditing systems were not always effective in monitoring the quality of the service or driving improvements where needed.
People and relatives told us they felt safe with staff and there were enough staff on duty to meet people's needs. Staff understood safeguarding procedures and knew when and how to escalate concerns.
People were protected by safe recruitment processes. Systems were in place to ensure staff were recruited safely and were suitable to be supporting people who might potentially be vulnerable by their circumstances.
Staff received appropriate support to carry out their roles on a day-to-day basis through structured supervisions and appraisals.
People were supported by kind and caring staff who respected people's privacy and dignity, and supported their independence.
People's individual care plans included information about what was important to them.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture. The service promoted people’s dignity, privacy and human rights. Staff working at the service demonstrated their dedication so people using the service could lead confident, inclusive and empowered lives. However, people were not always enabled to make their own choices and people’s consent was not always sought from them.
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 requires improvement, published on 14 January 2020.
Why we inspected
The inspection was prompted in part due to concerns received about errors in administration of medicines, suspected abuse and poor culture within the service. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We made recommendations in relation to meeting specific conditions of DoLS and acting upon complaints. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.