Fiorano

Updated 26 November 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. 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

This inspection was carried out by one inspector.

Service and service type

Fiorano 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.

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 the inspection

We reviewed information we received from the service by way of notifications. Notifications are required by law and identify incidents that had happened in the service and the actions taken in response, including safeguarding and serious injury.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to 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 used all this information to plan our inspection.

During the inspection

We spoke with one person who used the service about their experience of the care provided and carried out observations of people receiving care and support. We spoke with the registered manager and one member of staff.

We reviewed a range of records. This included two people’s care records and medicine records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

Following our inspection visit to the service, we spoke to and received feedback from a relative of a person living at Fiorano.

Updated 26 November 2019

About the service

Fiorano is a residential care home providing accommodation and personal care to people who have a learning disability or autism.

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 service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. Six younger men were using the service when we inspected. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

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

There were enough staff on duty to enable people to remain safe and receive care in a timely way. Staff were safely recruited, they knew how to keep people safe from avoidable harm. Accidents and incidents were analysed to prevent re-occurrence. People were supported to take their medicines in a safe way. The environment was safe, and people had access to appropriate equipment where needed. The premises were clean, and staff followed infection control guidelines.

People were supported to have 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.

People had access to health professionals when needed. People were supported to maintain a healthy diet and support was planned to meet the assessed nutritional and health needs. Staff received specialist and accredited training to ensure they could meet the needs of people living at Fiorano. Staff also received intensive supervision and support so that they could learn and reflect on their practice to ensure people with very high support needs received safe care and treatment.

Staff were kind, caring and promoted people’s dignity. Staff understood the importance of treating people with respect and ensured they did this. People were observed to have good relationships with the staff team. Staff actively ensured people maintained links with their friends and family.

People were supported to pursue their hobbies and interests including volunteer work roles within the local community, and holidays abroad. The provider had a clear complaints system, relatives told us they felt able to raise concerns, and that these were dealt with quickly.

The registered manager provided staff with leadership and was visible and approachable. Staff were motivated and enjoyed strong team work. Information from audits, incidents and quality checks was used to drive continuous improvements to the service people received.

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 3 May 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.