Walsingham Support - 19 Beech Avenue

Updated 19 September 2020

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.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

This inspection took place on 19th August 2020 and was announced. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

Updated 19 September 2020

About the service

Walsingham Support - 19 Beech Avenue [Beech Avenue] is a residential care home providing personal care to five people living with a learning disability and/or autism and a physical or sensory loss. There were five people living in the home at the time of the inspection. It is operated by Walsingham Support, a charitable organisation that provides care and support to people living in England with a learning disability or autism. The home is a bungalow situated in a residential estate on the outskirts of Egremont. It can accommodate up to five people who all have single, ensuite rooms and share other communal areas.

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.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with a registered manager from another service at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

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

People living in the home did not use verbal means of communication so we used observation to judge how people were cared for. People were relaxed in their own home and responded positively to staff. Staff had received suitable training about protecting vulnerable adults. Accidents, incidents, complaints and concerns were responded to appropriately.

We noted there were some vacant hours on the roster and staff said they were working extra shifts until recruitment was complete. Recruitment was suitably managed. New members of staff had been suitably vetted and inducted into the philosophy of care and the individual needs of people in the home.

Staff were appropriately trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles. Staff had extensive knowledge of different disorders people were living with and were skilled in working with people in the home. These included complex personal care skills and moving and handling strategies.

People saw their GP and health specialists. The district nursing team visited three times a week to undertake nursing tasks and give advice to staff. The staff team completed assessments of need with health professionals and with the learning disability teams. Medicines were suitably managed with people having reviews of their medicines on a regular basis. We saw some advice had been given to support sensory loss and staff were developing a plan to introduce this.

People were supported to get suitable levels of nourishment. People needed support to manage issues around swallowing and digestion of foods. The team worked closely with specialist nurses and consultants. We saw people getting the right levels of support. We observed staff preparing thickened liquids and pureed foods and helping people to eat and this was done appropriately.

We observed kind and patient support being provided. Staff supported people in a respectful way. Staff were very aware of the non-verbal communication needs of people. They made sure confidentiality, privacy and dignity were maintained when delivering personal care and when assessing and responding to need. People had the support of advocates if necessary.

Risk assessments and care plans were being updated and developed in the service. The plans reflected the person-centred care that was being delivered.

Staff could access specialists if people needed communication tools like Makaton or other sign languages. Staff worked with psychologists and psychiatrists when necessary. They were looking at ways to use objects to help people understand interventions. For example a person was given their swimming towel so they would know they were going to the pool.

Staff were very keen to help people get out into the community and were careful to look at how people responded to these outings. People went out for drives and for walks in their wheelchairs. They participated in their own and the house shopping. They also went to entertainments and activities, like swimming, social clubs and to a local tea dance. This dance was open to the public and was a way to help people meet others in the community.

The management of the service was going through some transition. The service had an acting manager who had been in the service for a little over a week. She was being mentored by an operations manager and another registered manager. All these managers were suitably skilled and experienced to manage the home. The acting manager had started to make relationships with people and the staff. Staff told us they were comfortable with these arrangements.

The provider had both internal and external ways to measure quality. Managers and staff monitored the quality of care delivery, staffing and the environment. The service also had quality inspections completed by senior officers of the organisation to ensure quality care and services continued to be provided. On the day of our visit there was an audit being completed. The operations manager visited regularly and looked at the quality of care delivery.

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. The staff team were aware of their responsibilities under the Mental Capacity Act 2005.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on finding ways to help them have meaningful experiences, whilst always ensuring they had their physical health needs met.

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

Rating at last inspection Good

The last rating for this service was Good (published February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.