Background to this inspection
Updated
8 November 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, looked at the overall quality of the service, and provided a rating for the service under the Care Act 2014. A service provider is the legal organisation responsible for carrying on the adult social care services we regulate.
This unannounced inspection of 2, Farnham Road took place on 4 and 5 October 2018. When planning the inspection visit we took account of the size of the service and that some people at the home could find unfamiliar visitors unsettling. Therefore, this inspection was carried out by one adult social care inspector.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information contained within the provider’s website.
During our inspection we spoke with four people living at the home, some of whom had limited verbal communication. We used a range of different methods to help us understand the experiences of people using the service who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process which enables us to look in detail at the care received by an individual in the home. We pathway tracked the care of three people.
Throughout the inspection we observed how staff interacted and cared for people across the course of the day, including mealtimes, during activities and when medicines were administered. We spoke with the registered manager and five staff.
We reviewed each person’s care records, which included their daily notes, care plans and medicine administration records (MARs). We looked at six staff recruitment, supervision and training files. We examined the provider’s records which demonstrated how people’s care reviews, staff supervisions, appraisals and required training were arranged.
We also looked at the provider’s policies and procedures and other records relating to the management of the service, such as staff rotas covering September and October 2018, health and safety audits, medicine management audits, infection control audits, emergency contingency plans and minutes of staff meetings. We considered how people’s, relatives’ and staff comments were used to drive improvements in the service.
Following the visit we spoke with five relatives of four people, three health and social care professionals and two professionals from the community. These professionals were involved in the support of people living at the home. We also spoke with the commissioners of people’s care.
We last inspected the home in January 2016, when the service was rated good.
Updated
8 November 2018
2, Farnham Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as a 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 home provides accommodation and personal care to a maximum of five people who live with a learning disability, autism and/or associated health needs, who may experience behaviours that challenge others. At the time of inspection five people were living at the home. The home had been developed and adapted in line with values that underpin the Registering the Right Support and other best guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can lead as ordinary life as any citizen.
This comprehensive inspection took place on 4 and 5 October 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People were protected from avoidable harm, neglect, abuse and discrimination by staff who understood their responsibilities to safeguard people. People were involved in managing their risks which were person-centred, proportionate and reviewed regularly. Restrictions were minimised so that people felt safe but also had the most freedom possible.
Medicines were administered safely, as prescribed by staff who had been assessed to be competent to do so.
Prospective staff underwent relevant pre-employment checks to ensure they were suitable to work with the people who lived with autism or a learning disability. There were always sufficient suitable staff with the right experience and skills mix, to provide care and support to meet people’s needs.
Staff effectively managed the control and prevention of infection within the service and adopted recognised safe preparation of food guidance.
The registered manager encouraged staff to raise concerns about incidents and near misses, so action could be taken to avoid further recurrence.
Staff were enabled to develop and maintain the necessary skills to meet people’s needs. People were supported to eat a healthy, balanced diet and had access to the food and drink of their choice, when they wanted it. People’s needs were assessed regularly, reviewed and updated.
People were supported to have maximum 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. Best interest decisions were consistently made in accordance with legislation to ensure people’s human and legal rights were respected.
People experienced consistency of care from regular staff who were kind and compassionate. There was a caring and positive atmosphere within the home, where people were relaxed and reassured by the presence of staff, whom they knew well.
Staff consistently treated people as individuals, with dignity and respect. Staff spoke with passion and pride about people’s achievements and their special qualities, which demonstrated how they valued them as individuals.
People were supported to take part in activities that they enjoyed. Staff supported people to maintain relationships with their families and those that mattered to them, and to develop new friendships, which protected them from the risk of social isolation.
People’s care plans were person centred and detailed how their assessed needs were to be supported by staff. People experienced care that was flexible and responsive to their individual needs, which enriched the quality of their lives and improved their physical and mental wellbeing.
Feedback consistently showed staff had an excellent understanding of individual’s social and cultural diversity, their values and beliefs, and how they wanted to receive their care and support. The service had received no complaints. However, people and their families were confident that if they did complain, they will be taken seriously, and their concern will be explored thoroughly and responded to effectively.
The service was well led by the registered manager, who consistently inspired staff to deliver high quality care. The provider’s values were clearly understood by all staff, which they demonstrated when supporting people. The quality of the support people received was effectively monitored and identified shortfalls were acted on to drive continuous improvement of the service.