Foundation House

Updated 28 April 2020

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.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Foundation House 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.

Foundation House also provided a domiciliary care service to one person. It provided personal care to the person who was living in their own flat on the premises of Foundation House.

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

We gave the service 24 hours’ notice of the inspection as the service had notified us they had implemented additional infection control procedures, and we needed to ensure the registered manager and provider could support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including the provider, registered manager, assistant manager, senior care workers and care workers.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four 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.

After the inspection

We spoke with one professional who regularly visits the service.

Updated 28 April 2020

Foundation House is a care home providing personal and nursing care to 12 people with acquired brain injuries, physical disabilities, learning disabilities and mental health needs at the time of the inspection. The service also supports one person who lives on-site in their own self-contained flat with personal care support. The service can support up to 12 people in a residential setting.

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.

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

The vision of Foundation House was to promote "A world in which people with disabilities are able to realise their potential as equal and active citizens in control of their lives". All staff and senior management demonstrated this clear vision and a highly positive person-centred culture was seen throughout. Staff had set high standards for themselves and this promoted an exceptionally positive culture which challenged disability perceptions and had improved the confidence of people and the opportunities available to them. Throughout the inspection, we found people and staff were motivated and passionate about equality and empowering people to live the lives they want.

People and carers spoke overwhelmingly of the positive support, guidance and healthcare interventions people had received. They were full of praise for the staff in terms of their kindness and compassion. People were 'very happy' with the service they had received. We received positive comments about their views and experiences. People told us they felt very safe living at Foundation House. People and their families viewed the staff as exceptionally skilled and knowledgeable when supporting them with complex health needs.

People were supported by staff who had received exceptional training and support to carry out their role. The service had developed very thorough staff training programmes. These were bespoke to the needs of the people living at Foundation House and ensured staff were highly skilled in meeting very specific needs. The training systems developed had received local and national recognition and were used to train staff in other agencies as well as other professionals.

There was a strong sense of "family" and teamwork. Staff were proud of the work they did and were fully committed to ensuring people were at the centre of everything that took place at Foundation House. 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 service’s focus on challenging expectations and misconceptions of disability had led to excellent outcomes for people. Staff told us how the ethos of the service was that disabilities should never be considered a barrier to opportunities for people. Throughout our inspection we heard comments from people about how staff had supported them to achieve their goals and aspirations.

Staff were constantly looking for ideas on how to improve people's quality of life. Assistive technologies were used creatively, and innovative technologies were developed with young people to enhance their communication and independence. People's goals and aspirations were explored with them and plans were made to achieve these. Staff worked hard to make sure people had opportunities to lead as full a life as possible. They ensured daily activities were tailored to meet people's individual needs, preferences and abilities. Staff made sure people had opportunities to enjoy themselves. People's suggestions and ideas were sought and valued when it came to plan these activities.

The registered manager and extended leadership team offered excellent leadership and had a clear vision about the direction of the service. They were committed to improving people's lives and ensuring they had the best care they could receive. They expected the same high standards from the staff who were also committed to these shared values. The management team were very much part of the overall care team at Foundation House. They were very involved in people's care, visible and approachable. Staff working at the service clearly understood their role and worked hard to promote a homely atmosphere. The provider had developed excellent partnerships with other stakeholders to enable better outcomes for people with disabilities.

There was a robust quality assurance system in place to ensure people received the best possible service. The registered manager and provider worked closely with partner agencies and services to promote best practice within the service and make a positive impact to people’s lives. The service was constantly striving to innovate to ensure they were providing the best possible care to the people they were supporting. The registered manager had developed a strong leadership team within the service to ensure the high standards implemented were sustained in their absence.

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 them having as many opportunities as possible for them to gain new skills and become more independent.

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 5 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.