Background to this inspection
Updated
30 April 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was carried out by one adult care inspector.
Service and service type: Rivendell and Lorien are two bungalows situated in one location with a 'care home' status. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The care service has been developed and designed in line with the values that underpin the 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 service had a registered manager registered with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: The inspection was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and we needed to be sure that people would be in and the provider was available.
What we did: Prior to the inspection we reviewed all information we held about the service, such as details about incidents the provider must notify CQC about. The provider sent us a Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
People using the service did not have mental capacity or verbal communication. We used observations to gather examples of people’s interactions with staff and others.
We spoke with four family members and asked them about their experience of the care provided to their relatives. We looked at four people’s care records and at their medicine records.
We spoke with the registered manager and four members of staff. We looked at four staff members files around staff recruitment, supervision, appraisal and staff training records. We also looked at quality monitoring records relating to the management of the service. We sought feedback from health and social care professionals who worked with staff at the home and received a response from one of them.
Updated
30 April 2019
About the service: Rivendell and Lorien provides accommodation and personal care for up to 10 people who require specialist support relating to their learning and physical disabilities. The location comprises of two separate bungalows which sit side by side. Each bungalow has the capacity to accommodate five people. At the time of our inspection 10 people were living at the service.
People’s experience of using this service: Risks of abuse to people were minimised because staff demonstrated a good awareness of each person's safety needs and how to minimise risks of abuse for them. The environment was safe, and regular health and safety checks were carried out.
Since the previous inspection the service had reviewed the way referrals were made to local authority safeguarding teams to ensure they were timely and appropriate to ensure people were protected. Where restrictions had been put in place to keep people safe this had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards. Any restrictive practices were clearly recorded and regularly reviewed to check they were still necessary and proportionate.
People were supported to develop and maintain their independence and have choice and control over their daily lives. Staff supported people according to their individual preferences and needs. There was a drive to deliver person centred care which focused on getting the best outcomes possible for people.
The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; independence, choice and control over day to day routines and inclusion and involvement in the local community. People's support focused on them having as many opportunities as possible for them to gain new skills and develop and maintain their independence.
People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. People’s health had improved because staff promoted healthy active lifestyles. They worked in partnership with a range of healthcare professionals and followed their advice.
People were supported in the least restrictive way possible; the policies, systems and culture in the service supported this practice.
People's concerns and complaints were listened and responded to. Accidents, incidents and complaints were used as opportunities to learn and improve the service.
People gave us positive feedback about the quality of people's care. They said the provider and member of staff were approachable, listened and acted on feedback. The registered manager and staff members were enthusiastic and keen to share their experiences with us. They had high expectations for people and this was evident throughout the inspection.
Rating at last inspection: At the previous inspection the rating was Good. (Report published 11 October 2016).
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we may bring our inspection forward.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk