Welcome Home

Updated 21 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by three inspectors and an Expert by Experience was used. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Welcome Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Welcome Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Welcome Home is also a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 15 September and ended on 26 September. We visited the location’s service on 15 September 2022.

What we did before the inspection

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

During the inspection

We spoke with three people who used the service and 11 relatives. The Expert by Experience telephoned people and their relatives to gain their views. We spent time in the care home lounge, observing staff interactions with people. We talked to eleven members of staff including the registered manager, care home manager, domiciliary care manager, three senior care staff and five care staff.

We reviewed a range of records. This included eight people’s care records and medication records. We looked at six staff files in relation to recruitment. We also looked at staff training and staff supervision. A variety of records relating to the management of the service were reviewed including accidents and incidents and quality checks and audits.

Updated 21 October 2022

About the service

Welcome Home is registered with the Care Quality Commission as a residential care home and a domiciliary care agency.

The residential care home provides the regulated activity of personal care and accommodation for up to five adults with a learning disability. At the time of the inspection there were five people using the service. People had complex care needs, including learning disabilities, autism and physical health needs. Most people had limited verbal communication so were unable to provide feedback by speaking to us directly.

The community based domiciliary care agency delivered personal care to 82 people in their own homes. This included older people, people with dementia, physical disabilities and learning disabilities. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People and relatives were positive about the quality of the service. Comments from people included, “I feel perfectly safe with the ladies (carers). I need help and they do that well” and “The staff are very bright and happy with me. I am happy to see them each day and they know my needs.” A relative told us, “My relative is just happy. That to me is everything. It makes me feel settled knowing they are well cared for.”

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Staff were working towards consistency in supporting people to make decisions following best practice in decision-making. Staff worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

People were supported by a regular team of staff who knew them well, which promoted continuity of care.

People were involved in personalising their rooms so these were decorated to their taste and contained things that were important to them. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that achieved the best possible health outcome.

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.

Right Care: People’s needs and preferences had been assessed prior to receiving a service. People received kind and compassionate care from staff who understood and responded to people’s individual needs.

People who had individual ways of communicating, using body language and sounds, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

There were enough appropriately skilled staff to meet people’s needs and keep them safe. Environmental risk assessments identified and reduced any risks to people and staff. Where appropriate, staff encouraged and enabled people to take positive risks. Staff understood how to protect people from poor care and abuse.

Right Culture: People benefitted from the open and positive culture of the service where the management team was approachable and listened and responded to people’s views. Quality assurance and monitoring systems were used to identify shortfalls and improve the service for the people who used it.

People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. People were supported to maintain good health, were supported with their medicines and had accessed healthcare services when needed. Staff prepared food and drink to meet people’s dietary needs and requirements.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. People received consistent care from staff who knew them well. People and those important to them were involved in planning their care.

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 Requires Improvement (published 25 May 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.