All inspections: Futures - Care Quality Commission

Overall service commentary (2000)

Futures is a care home which consists of 3 bungalows located on the site of Chailey Heritage Foundation. The provider, Chailey Heritage Foundation, is a registered charity that supports children and young adults with complex physical and learning disabilities. Futures is registered to support up to 21 people. They support people between the ages of 16 and 25. At the time of inspection there were 16 people being supported.

We undertook this comprehensive assessment due to the length of time since our last visit. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The service was fully compliant with these principles. There was a registered manager in place who had been at the home for 11 years.

The provider liaised with other healthcare professionals to provide continuity of care and treatment, this ensured people had safe transitions and pathways of care if moving between different services. Although the service is not registered to provide nursing care, people had access to clinical services on site which allowed for a range of specialist clinicians and therapists to assist them when needed; this included 24-hour support from an NHS nursing team. Environmental risks were well managed, and safety checks were completed as required. There was an established recruitment process in place and the registered manager ensured there were enough staff to safely support people. Staff completed a variety of training courses and visual competencies prior to starting work, allowing them to deliver care with confidence and developed a range of skills, including supporting people requiring clinical interventions.

People received their medicines safely as prescribed. Staff could consult with the clinical services team for advice and guidance on medicines or people’s care. People’s independence was encouraged, and people were supported to make simple decisions about their daily routines.People were assisted to lead full and busy lives with a range of activities and outings being offered. Opportunities to go on holidays with their peers, or families, were facilitated for people, with the required staffing support in place. A quality assurance team provided a high level of oversight, and regularly monitored and evaluated any risks, incidents and accidents. Clear feedback pathways were evident with regular team meetings, and attention was given to learning and improving the service. The home provided regular feedback opportunities for staff and families and acted to implement positive change when necessary. The service promoted a culture of openness and transparency and had a welcoming friendly atmosphere. The provider had all required policies in place, and these had been regularly reviewed.

This inspection took place on 6 February 2018. Futures 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.

Futures consists of three bungalows which are located on the site of Chailey Heritage Foundation. The provider, Chailey Heritage Foundation, is a registered charity supporting children and young people who have complex physical and learning disabilities and health needs. Futures provides care for up to 21 young adults between the ages of 16 and 25. It is a transitional service that supports young people with the development of life skills in preparation for adulthood. At the time of the inspection there were 19 young people living at the home. Some people were not living at the home permanently but had regular periods of planned respite care.

The home had a registered manager and they were present throughout the inspection. 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.

At the last inspection, on 3 February 2015, the home was rated as Good overall. At this inspection the rating remained Good overall, however we did find some areas of practice that needed to improve.

Staff demonstrated a firm understanding of their responsibilities with regard to safeguarding people. Incidents were recorded and addressed promptly. However, consideration had not always been given to ensuring the proper external scrutiny in line with the provider’s own policy. This was identified as an area of practice that needed to improve.

Incidents and accidents were being recorded however not all recording was complete. This meant that the registered manager could not be assured that all incidents and minor injuries were being investigated thoroughly. Maintaining complete and accurate records to show what actions have been taken for each recorded incident is an area of practice that needs to improve.

People and their relatives told us that they felt people were safe living at the home. Medicines were stored, managed and administered safely. Staff had a good understanding of how to identify and manage risks. There were enough staff to care for people safely. The provider had robust procedures for recruitment.

Staff told us they received the training and support they needed. People and relatives felt that staff were knowledgeable about people’s needs. One relative told us, “All the staff are skilled across the board.”

People were supported to have enough to eat and drink. They were able to choose the food they wanted, and nutritional risks and needs were managed effectively. A staff member explained, “The young people have meetings every week and decide what meals they would like to have.”

Staff supported people to access the health care services they needed. The provider had partnership arrangements with a health care provider based on the Chailey Heritage Site. This meant that people could access a range of specialist clinicians, nurses and therapists.

People’s needs were assessed in a holistic way. Care records were comprehensive and included people’s choices and preferences.

Staff worked effectively with each other and with health care professionals to support people. Staff demonstrated a firm understanding of their responsibilities with regard to the Mental Capacity Act. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives spoke highly of the staff. A relative told us, “All the staff are very caring.” Staff knew people well and understood how to support people with their communication needs. People were actively involved in making decisions about their care. Staff were respectful and actively promoted people’s dignity and independence.

People were receiving care that was personalised and responsive to their needs. One relation told us, “The staff know my relation very well, so they act more quickly when some thing’s wrong.” People were living full and busy lives. They were supported to pursue their interests and to maintain relationships that were important to them.

There was a complaints system in place and people and their relatives were confident that any concerns would be responded to effectively.

People, their relatives and staff spoke highly of the management of the home. There was clear leadership and staff understood their roles and responsibilities. Quality monitoring systems were used to drive improvements. People and staff were involved in development plans and they told us their ideas were welcomed. Staff had developed effective working relationships with partner agencies.

We inspected Orchard bungalow on 3 February 2015. This was an unannounced inspection. Orchard bungalow is one of two, purpose built, residential services for young adults aged over 19, with complex physical disabilities. The location forms part of the innovative 'Futures' project, which was developed to support young people with disabilities gain life skills in preparation for their 'transition' into adulthood.

A registered manager was in post. 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 were procedures in place to keep people safe and there were sufficient staff on duty to meet people’s needs and personal risk assessments relating to specific areas, such as choking and swallowing, were in place.

Safe recruitment procedures were followed and staff said that they undertook an induction programme which included shadowing an experienced member of staff.

Staff were appropriately trained and told us they had completed training in safe working practices and were training to meet the specific and complex care and support needs of people. They were knowledgeable about people’s needs and we saw that care was provided with patience and kindness and people’s privacy and dignity were respected.

Medicines were stored and administered safely and handled by staff who had received appropriate training to help ensure safe practice.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking.

People and their relatives told us meeting social needs was promoted and we saw activities reflected people’s individual interests and preferences. We saw people were regularly supported to access facilities and amenities in the local community.

The registered manager assessed and monitored the quality of care. Surveys were carried out for people and satisfaction questionnaires were used to obtain the views of relatives and other stakeholders.

Audits and checks were carried out to monitor and address a number of areas such as health and safety and medication.