Butler House

Updated 15 October 2021

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Butler House is a ‘care home’. 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, and both were looked at 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.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider/registered manager would be available to support the inspection.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people who lived at Butler House, a relative, four support staff, the manager and the registered manager/owner. We looked at a range of records. This included one person’s care records, recruitment files of two people, medication records and audits of the service.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at their quality assurance systems and maintenance records of the premises.

Updated 15 October 2021

About the service

Butler House is a respite centre for people with learning disabilities. They are registered for three people. At the time of the inspection three people lived at the home. The building is on two floors with stair access.

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

People we spoke with were extremely positive about the service and support they received. For example, one person said, “I love going fishing with [staff member] they are brilliant.” Staff were recruited safely, and sufficient staff were on duty to support people. Staff demonstrated a good understanding about safeguarding people from the risk of abuse and training was provided. Staff managed medicines according to national guidelines. There was a system to record and analyse any incidents that occurred and lessons learnt from them. Support for people was planned to ensure the persons needs and wishes were considered. Risk assessments were completed to support people retain their independence and receive care with minimum risk to themselves or others. Staff had focussed on positive risk taking to enable people to participate in activities of their choice within a risk framework. People were protected from the risks associated with the spread of infection. We found parts of the home were cluttered and presented a risk of accidents, in addition part of the communal area was being used inappropriately for laundry. We have made a recommendation about this. The registered manager assured us this would be rectified to ensure people were safe.

People received support with their healthcare and nutritional needs. They 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. People’s needs were assessed prior to them staying at Butler House. Detailed transition plans were developed to ensure people were comfortable moving into the home. The provider had appropriate arrangements to ensure staff received training relevant to their role. One staff member said, “Despite the pandemic there is an emphasis on training”. Staff felt supported by the management team.

Staff treated people with kindness, dignity and respect and spent time to ensure peoples individual needs and wishes were met. Our observations during the inspection were of positive and friendly interactions between staff and people.

The service had a complaints procedure which was made available to people they supported. People we spoke with told us they knew how to make a complaint if they had any concerns. Care was personalised to the individual and social stimulation was an important part of people’s lives.

Butler House had auditing systems to maintain ongoing oversight of the service and make improvements where necessary. Quality assurance processes ensured people were able to give their views of Butler House and improvements made when they were identified or suggested.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Right support:

• Model of care and setting maximises people's choice, control and independence.

Care and support had been developed around individual assessed needs. Staff worked in a way which promoted the persons independence. For example. People told us staff encouraged them to participate in their care and make choices where possible.

Right care:

• Care is person-centred and promotes people's dignity, privacy and human rights

Care support plans were person centred and ensured the individual and family were involved in the development and review of their plan as far as possible. Training and support for staff ensured human rights was at the heart of the delivery of care and support.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The ethos of the agency was to develop and target support which suited the individual and helped them live the best life possible.

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

Rating at last inspection

The service was registered with us on 30/06/2020 and this is the first inspection.

Why we inspected

This was a planned first inspection based on their registration.

We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively

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.