Background to this inspection
Updated
23 February 2022
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Three inspectors and a member of the CQC medicines team carried out the inspection.
Service and service type
Smallwood is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they 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
This inspection was unannounced.
What we did before inspection
The provider was asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We liaised with the local safeguarding team and the Police. We used all this information to plan and inform our inspection.
During the inspection
We communicated with six people who used the service and five relatives about their experience of the care provided.
We are improving how we hear people’s experience and views on services, when they have limited verbal communication or don’t use words. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we used this communication tool with six people to tell us their experience.
We spoke with seven members of staff including the registered manager, team leader, care staff, and the operations manager.
We spent time observing people including their interactions with staff.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We received a PIR while the inspection was in progress and reviewed this to help inform our judgements.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We liaised with the provider to discuss actions they had taken in response to the concern that had led to our inspection. We spoke with four health professionals who visit people at the service.
Updated
23 February 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Smallwood is a residential service that provides 24-hour care and support to autistic people living in two separate buildings on the same site. The home comprises of the Main House, which accommodates up to five people and the Cottage which can accommodate up to three people. At the time of the inspection there were five people living in the Main House and two people living in the Cottage. The home is set in a rural location in Blandford Forum.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture
Right Support
¿ People were supported by staff to pursue their interests.
¿ Staff enabled people to access specialist health and social care support in the community.
¿ The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative to keep them and others safe.
¿ Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Right Care
¿ Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
¿ Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
¿ The service had enough appropriately skilled and knowledgeable staff to meet people’s needs and keep them safe.
¿ Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture
¿ Staff placed people’s wishes, needs and rights at the heart of everything they did.
¿ People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
¿ People and those important to them were involved in planning their care.
¿ Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 07 June 2018).
Why we inspected
We received concerns in relation to an incident of inappropriate conduct by a staff member which was then not reported by another staff member present. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained good. This is based on the findings at this inspection.
We found evidence that an isolated incident occurred that did not involve or cause harm to people living at Smallwood. We referred the matter to the Police and local safeguarding team who reviewed the available evidence and decided to take no further action. When we brought the incident to the provider’s attention they immediately conducted a thorough investigation and took appropriate action.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
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.