Background to this inspection
Updated
20 August 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 consisted of two inspectors.
Service and service type
Choice Support – 6 Bowley Close 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. However, the registered manager had been on maternity leave since January 2019 and had resigned during this period of leave, with their last day scheduled for 22 July 2019. An interim manager had been in place but was no longer in post at the time of the inspection. A new manager had only recently been recruited and it was their second day of employment on the day we visited.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to meet and speak with us. As there was no registered manager in post, we also wanted to be sure that the provider or a senior member of the management team would be available to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included any significant incidents that occurred at the service. 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 reviewed the last inspection report and spoke with three relatives about their experience of the care provided. We used all of this information to plan our inspection.
During the inspection
We met with the three people who used the service and introduced ourselves. We were unable to speak with them as they were not fully able to communicate with us. We carried out observations throughout the day to help us understand the experiences of people as they could not talk with us. We spoke with six members of staff. This included the manager, a deputy area manager and four support workers.
We reviewed a range of records. This included three people’s care and medicines records, four staff files in relation to recruitment, training and supervision. We also reviewed records related to the management of the service, which included incidents and accidents and minutes of team meetings.
After the inspection
We continued to seek clarification from the provider to validate evidence found in relation to recruitment, training, incident and accidents and quality assurance processes. The deputy area manager sent us further documents on 18 July 2019. We spoke with one health and social care professional who had experience of working with the service.
Updated
20 August 2019
About the service
Choice Support - 6 Bowley Close is a small residential care home providing personal care to three people with a complex learning disability at the time of the inspection. The service can support up to four people.
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
Relatives were positive about the kind and caring nature of the staff team. People were relaxed with staff and we observed people were treated with kindness, dignity and respect.
People were supported to a range of healthcare appointments and staff followed up any issues or concerns. People had accessible records in place that helped health and social care professionals understand their conditions and how they liked to be supported if they went to hospital.
People received personalised care and staff knew how to meet their needs. As people were unable to fully communicate, staff had a good understanding of people’s body language and facial expressions to ensure they responded appropriately.
People were cared for by a long serving staff team who were dedicated to support them to live meaningful and fulfilling lives. Relatives were positive about the relationships staff had developed with their family members.
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.
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.
The provider acknowledged that recent changes in management had led to some shortfalls in the monitoring of the service. A new manager had just started and an action plan was in place for issues to be addressed.
We have made a recommendation about the effectiveness of their quality monitoring.
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 23 March 2017). Since this rating was awarded, the registered provider of this service merged with another provider and altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
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.