New Boundaries Group - 331 Fakenham Road

Updated 1 October 2019

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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

331 Fakenham Road is a care home. People in care homes receive accommodation and nursing or personal care as 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.

This inspection was unannounced.

What we did before the inspection

The inspection planning took into account what we already know about this service and the provider including previous inspection reports, notifications which are important events the service is required to tell us about and any feedback about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We used mainly observation to make a judgement about people’s care and support. People were anxious by our visit and although we spoke with people we were mindful of their anxiety and routines. We met four people and spoke with three. We spoke with the deputy manager and three other staff. We reviewed one care and support plan, staff records and other records relating to the management of the business. We observed the medicines round, meal preparation and activities undertaken in the house.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also contacted two family members who we spoke with at length. We spoke with a health care professional, commissioners and viewed written feedback from health care professionals.

Updated 1 October 2019

About the service

331 Fakenham road is a residential care service providing personal and nursing care to five people under 65. The five people living at the service had complex needs and histories and had learning disabilities, autism and mental health needs. One person had non-verbal communication.

Fakenham road accommodates five people in one adapted building. Each had their own room, ensuite accommodation and shared communal space. The house was in the centre of a busy community and people regularly accessed community services.

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.

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

The service was exceptionally well managed. Staff worked inclusively to provide care and support to people around their individual needs. All staff were involved in decision making and able to influence the service provision. We spoke with the registered manager after the inspection as they were on leave on the day. They were passionate. They told us how they developed and supported staff to work well individually and as part of a team. The registered manager told us about people’s individual progress which was reflected in their care plans and support plans and families spoke very highly of the support provided. People felt safe and secure in the knowledge that staff understood their needs.

We observed staff practice which helped to confirm that they understood people extremely well and were able to provide consistent, supportive care which reduced people’s anxieties and helped them engage in everyday tasks. Staff demonstrated good interpersonal skills in their communication with people. Staff were cheerful and showed tolerance and patience. They supported people to make their own decisions and gave people the tools they needed to overcome the difficulties they faced.

Staff provided people opportunities to engage in regular activity which enhanced their mental and physical health. Staff worked in a holistic way to ensure people had the best opportunity to success and they took into account people’s histories which for some had been restrictive. Negative trends of behaviour were recognised, and staff worked with individuals, families and health care professionals to create positive opportunities for self-growth, learning and development.

People’s health care needs were very well managed, and the staff had been successful in reducing people’s risk factors which were having a detrimental effect on the mental and physical health. People were encouraged to live well, and staff worked creatively to help people achieve this.

The service was exceptionally clean and well organised to ensure the risk of cross infection was reduced and people took a sense of pride in their environment and contributed to its upkeep. Staff supported people to develop new skills and take an active part in meal preparation, cooking and other essential life skills.

Risks to people’s safety were reduced because staff were carefully selected and well supported to ensure they had the key competencies and skills to deliver safe care and carry out every aspect of the regulated activity well. For example, staff administered medicines to people. There were robust processes in place to ensure this was done properly and staff had ongoing training and support to ensure they were comfortable doing it. All staff were able to tell us about people’s needs and how their training and life experience had helped them support people in ways that were appropriate. Staff said they did not work in isolation but always worked with other health care professionals and acted on their advice.

Paperwork and care plans were well kept and reflected the person- centred care we observed. Staff knew how to raise concerns or recognise what might constitute a safeguarding concern and actions they should take.

Management and oversight of the service was robust, and the staff worked in partnership to provide the best possible outcomes for people. There were well developed quality assurance mechanisms which took into account people’s feedback and how the staff were meeting people’s needs in line with their wishes and expectations.

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.

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 (Report published 29 November 2016.)

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Boundaries Group – 331 Fakenham Road on our website at www.cqc.org.uk.