We carried out a review of the data available to us about Cabrini House 2 (Diagrama Healthcare) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cabrini House 2 (Diagrama Healthcare), you can give feedback on this service.
Cabrini House 2 is a ‘care home' providing accommodation and support for up to seven people with learning difficulties and or autism. There were seven people living there at the time of the inspection. Cabrini House 2 is one of three similar small homes owned by the provider in the same residential road.
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 building design fitted into the residential area with domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
People’s experience of using this service and what we found
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.
Relatives said they thought the home was well managed; although communication about some things did not always work smoothly. We found this had not impacted on people’s care. The registered manager told us they were working to improve communication. They understood their role and responsibilities. Staff spoke positively about the support they received from the provider and registered manager. They told us they worked well as a team and were well supported by the registered manager.
The provider had systems in place for monitoring the quality and safety of the service. People’s and their relative's feedback was sought informally and through an annual survey. The most recent survey showed that people felt supported and happy with the care they received
People told us they felt safe. Staff understood their roles in safeguarding people from harm. Risks to people had been assessed and staff knew how to manage these risks safely. Staff worked with people to support them to understand possible risks. There was a process to identify learning from accidents, incidents and safeguarding concerns.
There were safe recruitment practices that followed legal requirements. Medicines were safely administered and managed. Staff worked in ways to reduce infection risk.
People’s needs were assessed before they started using the service. Staff asked for people’s consent before they provided care or support. Staff received training and support to meet people’s needs effectively.
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. People’s nutritional needs were assessed and met. Health professionals said that staff worked proactively to meet people’s health needs.
People and their relatives said staff treated people with care and kindness. People were consulted about the support they received. Relatives told us they were consulted and listened to. Staff treated people with dignity, respected their privacy and encouraged their independence, in line with registering the right support. People’s needs in respect of their protected characteristics were assessed and supported.
People had a personalised plan for their care. These were up to date and reflected their needs. People were involved in a range of activities that they enjoyed at the service and within the community, in line with the principles of registering the right support. The provider had introduced new techniques to try and develop people’s skills and confidence. People’s wishes relating to their end of life care needs had been discussed with them or their relatives, where appropriate.
There were systems to monitor the quality and safety of the service. Staff worked in partnership with relatives, health and social are professionals and voluntary organisations.
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 (report published March 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.
Diagrama Health care Service provides accommodation and personal care and support for up to seven adults who have a range of needs including learning disabilities. At the time of our inspection there were four people living at the home. It is one of three homes in the same road owned by the provider that share some aspects of care, support and organisation.
There was a registered manager in post; 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 is run. The registered manager was registered to manage the three homes for the provider.
People were not always able to communicate their views to us at the home so we also observed aspects of the care and support provided. People and their relatives told us they felt safe from harm and well cared for by the service. Staff had received training on safeguarding adults, so they knew the signs of possible abuse. There were suitable arrangements to deal with a range of emergencies if needed. Possible risks to people were identified and guidance was in place to reduce risk. People received their medicines when they should and staff had received training on the safe administration of medicines.
People and their relatives said staff were caring and kind, and, we observed this to be the case. People were treated with respect and dignity and were involved in decisions about their care. People were asked for their consent before care was provided and staff were aware of their responsibilities under the Mental Capacity Act (2005). There were enough staff to meet people’s needs and the provider followed safe recruitment policies. Staff received suitable training and support to carry out their roles.
People’s dietary needs were met and their independence was encouraged where this was appropriate and where they needed support this was provided. The service worked with health professionals, when necessary; to ensure people’s changing health needs were addressed.
People had an assessed and written plan of care which reflected their needs and a pictorial support plan to enable them to understand the plan for their care more effectively. People were provided with a range of suitable activities to encourage social inclusion and develop life skills.
There were systems to monitor the quality of the service and identify any area for action. Staff felt well supported in their roles. People, their relatives and professionals were asked for their views and the home considered any improvements that could be made.