Background to this inspection
Updated
9 March 2018
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 6 February 2018 and was announced. We told the registered manager twenty-four hours before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. One inspector undertook the inspection.
We previously carried out a comprehensive inspection on 3 September 2015.
The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at other information we held about the service. This included previous inspection reports and notifications. Notifications are changes, events or incidents that the service must inform us about. We contacted and received feedback from the local authority commissioning team about their experiences of the service provided. We also contacted by Email one person’s relatives for their experiences of the service provided and two health and social care professionals. We received one response.
We used a number of different methods to help us understand the views and experiences of people, as not all were able to tell us about their experiences. On the day of our inspection, we met with the three people living at the service and spoke individually with one person. We also spoke with the registered manager, three care staff, a visiting relative, and a visiting health care professional. We observed the care and support provided in the communal areas. We spent time looking at records, including two people’s care and support records, five staff files, the recruitment records for two new staff and other records relating to the management of the service, such as policies and procedures, accident/incident recording and audit documentation. We also ‘pathway tracked’ the care for two people using the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.
Updated
9 March 2018
The inspection took place on the 6 February 2018.
42 Twyford Gardens 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. Care and support is provided for up to four people with a learning disability, autism and/or other complex needs. At the time of our inspection, there were three people living at the service. The service is a modern, detached bungalow within a quiet residential area in Worthing. The accommodation comprises a large, communal, open-plan sitting, dining and kitchen area with access to a rear garden. People have their own spacious bedrooms with en-suite facilities.
At the last inspection on 3 September 2015 the service was rated overall Good. At this inspection we found the service remained overall Good. At the last inspection we found robust staff supervision procedures had not been in place. We asked the provider to make improvements in supervision procedures and at this inspection this had been addressed. One member of staff told us, “I have had supervision, appraisal and a mid-year review.”
Systems had been maintained to keep people safe. One person told us how they felt safe with the care provided. They knew who they could talk with if they had any worries. They felt they could raise concerns and they would be listened to. People remained protected from the risk of abuse because staff understood how to identify and report it. Assessments of risks to people had continued to be developed. Staff told us they had been supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.
People's individual care and support needs continued to be identified before they received a service. Care and support provided was personalised and based on the identified needs of each person. Comprehensive and detailed care plans provided staff with information about how people wished to be cared for in a person-centred way. People met with their keyworkers monthly to discuss the care to be provided. One person told us how they felt listened to, supported to be independent and they were involved in decisions about their care. Staff had a good understanding of consent.
One person and a relative told us they were happy with the care provided. People continued to be supported by kind and caring staff who knew them well and treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. A relative told us, “The staff here are great.” Staff told us it was a good team. One member of staff told us, “It’s a good team. Friendly and our service users make it a good team. If they are happy, everyone else is happy. We all pitch in.”
The provider continued to have arrangements in place for the safe administration of medicines. People were supported to get their medicine safely when they needed it. People continued to be supported to maintain good health and eat a healthy diet.
Staff and visiting health and social care professionals told us the service continued to be well led. Staff told us the registered manager was always approachable and had an open door policy if they required some advice or needed to discuss something. The registered manager carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted about the care provided through reviews or by using quality assurance questionnaires.