L'Arche Preston Moor Fold

Updated 18 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 05 December 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because it is small and the core members are often out of the service at work or social activities. We needed to be sure that they would be in.

The inspection team consisted of two adult social care inspectors 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. The Expert by Experience had experience of caring for people with a learning disability.

Before the inspection, the provider 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 reviewed previous reports and notifications that are held on the CQC database. Notifications are important events that the service must let the CQC know about by law. We also reviewed safeguarding alerts and information received from a local authority.

During the inspection we used observations to gain feedback on people's experience at the service. People we spoke to at the service were not always able to provide us with verbatim comments. However, we sat with people in communal areas and observed the support people received and this provided us with a good understanding of how people were engaged with. We contacted people’s representatives during the inspection and asked them for feedback.

During our inspection, we spoke with two people who lived at the service, four relatives, the registered manager, the community leader, the deputy community leader, the team leader, the deputy team leader, two live-in assistants and one live-out assistant. The provider operated a scheme were staff are recruited on a temporary live-in basis to gain experience of supporting people who live at the service. At the time of the inspection seven assistants lived-in.

We carried out a pathway tracking exercise. This involved us examining the care records of people who lived at the service closely to assess how well their needs and any risks to their safety and wellbeing were addressed. We carried out this exercise for two people who lived at the service.

We looked at a sample of records including three staff files, staff rotas, training and supervision records, incident records, minutes from meetings, complaints and compliments records, medication records, maintenance records and certificates, policies and procedures and quality assurance audits.

We asked for feedback from professionals who had contact with the service. We received feedback from an Epilepsy Specialist, a Psychotherapist and a Social Worker.

Updated 18 January 2019

This inspection took place on 05 December 2018 and was announced.

At the last inspection in September 2017 we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the safe handling of medicines, cleanliness and the premises and good governance. We also made recommendations in relation to the environment.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe and well led to at least good. At this inspection we found that the provider had improved the cleanliness and safety of the environment. People’s medicines were managed in a safe way and overall governance of the service had improved. They were no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

L’Arche Preston Moor Fold is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide accommodation for up to six people over the age of 18 who have a learning disability or autism/autistic spectrum disorder. There were five people living in the home at the time of our inspection. People who used the service liked to be known as core members and staff liked to be known as assistants.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in post at the time of our 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 was run.

The service had systems in place to protect people from abuse, neglect and discrimination. People who lived at the service and their representatives told us they were happy with the care and support provided and made positive comments about the staff.

People’s individual risks were assessed and their safety was managed and monitored. L’Arche Moor Fold were confident in positive risk taking and this enabled people to maintain their independence.

Staff were safely recruited and we found sufficient numbers of staff to support people who lived at the service.

We found a medicines management had improved, medicines were stored in a safe area and people were administered their medicines by staff who followed safe procedures.

The service was clean and well maintained. Maintenance work and redecoration had been prioritised since our last inspection.

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.

Staff told us that they were supported and listened to. We saw evidence of staff training courses and found that the provider made sure staff were suitably trained and experienced to support people who lived at the service.

People had access to quality food and encouraged to make choices around meal preparation. The service supported people to eat and drink enough to maintain a balanced diet.

People told us that staff were caring and compassionate. L’Arche as an organisation embraced a ‘community’ ethos and this was evident throughout the inspection findings.

We looked at people’s care records and found a very good standard of person-centred information. Care records showed how people were involved in the development of care plans and supported by accessible information, for example, care records and review documents had been created in an easy read format.

People who lived at the service were supported and encouraged to maintain their independence and the service focused on helping people maintain their identity by tailoring their support around what was important to them. This included people being supported to work and access the wider community.

People who lived at the service and their representatives knew how to raise a concern or to make a complaint. The complaint’s procedure was available and people said they were encouraged to raise concerns.

The service did not support anyone with end of life needs. However, we discussed this with the registered manager and team leader and they told us about the organisations end of life care procedures and gave examples of how they would initiate end of life discussions when appropriate.

There was evidence of regular audits and monitoring of the service taking place and records we saw confirmed feedback had been obtained from those who lived at L’Arche Moor Fold, their relatives and the staff team. In general, we received positive feedback about the leadership and management of the service from those who lived at the service, their relatives and staff members.