Background to this inspection
Updated
31 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 15 January 2019 and was unannounced. The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We checked the information we held about the registered provider and the home. This included statutory notifications sent to us by the registered manager about incidents and accidents that had occurred at the home. A notification is information about important events which occur at the home that they are required to send us by law.
We used a range of different methods to help us understand people's experiences. Most of the people who lived at the home had limited verbal communication. Therefore, we observed the interaction between people and the staff who supported them in communal areas throughout the inspection visit.
We spoke with six people who lived in the service and with three relatives. We spoke with the registered manager, deputy manager, a senior support worker and three other support workers.
During the inspection, we looked at four care plan files, four staff recruitment files, four medication administration records (MARs), all the staff training records, complaints, policies and procedures and other records that related to the running of the home.
Updated
31 January 2019
This comprehensive inspection took place on 15 January 2019 and was unannounced.
Hobbs Field is a care home for 15 adults with a learning disability and or autistic spectrum disorders. Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. At the time of our inspection there were 14 people living at the service. The service is made up of two detached houses situated in a residential area of Horsham. The properties had level access throughout and adapted communal bath and shower rooms. The houses are linked by a shared patio area and surrounded by shared gardens.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.
The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. At the time of inspection, consultations were in progress to change the use of the building. Registering the Right Support is CQC guidance on how to register learning disability services in line with accepted best practice. However, the provider had taken steps to ensure people and relatives were involved in the process and adaptations had been made to ensure people received personalised care. Despite the building type, the provider managed to ensure these values were displayed including choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection in May 2016 we rated the service as good overall. We found the provider's quality assurance systems had not identified shortfalls in records relating to the delivery of care. This limited the rating for well-led to requires improvement. At this inspection we found improvements to the quality assurance systems and the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered person’s'. 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.
Relatives told us they felt their family members were safe living at Hobbs Field. Staff described procedures that were in place to safeguard the people they supported. They fully understood the safeguarding policies and procedures, felt confident to raise a concern and thought they would be listened to. Risks to people's safety had been assessed and care records contained risk assessments to manage identified risks.
Recruitment systems at the home continued to be safe and robust. There were sufficient trained and competent staff to meet people's individual assessed needs. The staff were supported by the management team through on-going supervision and team meetings.
People received their medicines as prescribed and staff knew how to manage medicines safely.
People received care that was personalised and responsive to their needs. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. 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 were involved in the planning of meals and menus. They received appropriate nutrition and hydration support to maintain their health and wellbeing.
We observed kind and caring interactions between people and staff. People living in the home praised the caring nature of the care staff and registered manager. People were involved in planning their care and supported to engage in meaningful activities of their choice.
The registered provider had a clear complaints policy and procedure that people and their relatives were familiar with and felt confident any concerns would be listened to.
The registered manager was accessible, supportive and had good leadership skills. Staff were aware of the values of the provider and understood their roles and responsibilities. Morale was good within the workforce. The service had a quality assurance system and any shortfalls were identified and addressed. There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result, the quality of the service continued to develop.
Further information is in the detailed findings below.