The Inspection took place on 21 and 23 November 2017, and 10 January 2018 and was announced. At the last inspection, there were no breaches of regulation and the service was rated good. At this inspection the service remained good overall and had improved to outstanding in responsive. Sherbutt House is a care home that provides accommodation and support for up to 19 adults who may have a learning disability. People in care homes receive accommodation and 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. There were 18 people living in the service when we inspected. We found the service had considered the national plan to develop community services for people with learning disabilities and/or autism - ‘Building the Right Support’. This plan was introduced in 2015 and advises certain criteria that providers should meet when delivering good quality care, these are; quality of life, keeping people safe, and choice and control.
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.
Everyone we spoke with described the service as extremely person centred with excellent staff that went above and beyond to meet people’s needs. People continually received personalised care that was tailored to their individual needs. The service promoted engagement and encouraged people to build links with the wider community. People were extremely positive about their lives and told us about their holidays, trips to Cities, work within charity shops, local church groups and lunches out at local cafes. People told us they had made good friends and one relative said their loved one had a better social life since moving into Sherbutt House. Staff and relatives praised the service and its management. They spoke highly of the care and support they provided.
People's care and support needs were assessed using a holistic approach to ensure that their diverse needs could be met. Staff demonstrated the skills, knowledge and experience to care for people effectively and as they had chosen. Where people found it difficult to communicate their needs, staff used a variety of communication methods with them so that their needs were met.
Management were always available, supportive and worked closely with staff, people living at the service and their relatives. Families were invited to attend local events run by the service and able to share meals with them if they wished. People had the use of technology such as mobile phones, email systems and computer applications which enabled them to maintain contact with their families. People were supported by staff if they were unsure of how to use the computer.
All the processes and systems in place were governed by management that supported an inclusive person centred culture and celebrated people’s individuality. These empowered people to access and build relations in the wider community, live fuller independent lives and really engage with each other, their relatives, friends and staff in a way that brought a sense of satisfaction and well-being to everyone in the service.
People were consistently cared for by kind, caring, respectful and compassionate staff. They felt valued and that their thoughts and opinions were listened to. Staff were passionate about their role and had exceptional knowledge about the needs and preferences of people they supported. People and their relatives felt that staff, “exceeded their expectations” and, “would go to any lengths to help them.” Staff were described as, “amazing” and, “kind and compassionate.”
Staffing ratios were more than sufficient to meet everyone’s needs, with some people receiving additional one to one support. People received their medication safely as prescribed and the records were of a good clear standard. Staff had been trained in the prevention of infection and there were sufficient staff employed to ensure the environment was well maintained, kept clean, safe and hygienic.
The service had effective quality assurance systems in place and welcomed external agencies to inspect and give constructive feedback to drive improvements in the service. The registered manager told us they always ensured that people were listened to and that their needs were always at the heart of everything management and staff did.
People were protected from the risk of harm by the systems, processes and practices in the service. Staff knew how to protect people and had been well trained. They knew how to report any potential concerns of abuse using their internal company structure and to outside agencies when required. The registered manager ensured that competent staff were recruited and retained, understanding the importance of on-going training and supervision to support them to carry out their roles.
People were supported as detailed in their care plans where they needed help with meals and drinks. They were involved in menu planning and could choose what they wanted to eat from a wide selection of available foods each day.
People told us they were very happy living at the service and one relative told us they could not ask for any more in respect of the services delivered. Complaints were dealt with effectively and processes in place to ensure lessons were learnt. The service spoke to people and their relatives about their end of life wishes if it was appropriate to do so and recorded the details in people’s care files.
The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. People were supported to maintain their independence whilst staff ensured they were kept safe by minimising risks. Where people were deprived of their liberty for safety reasons the service had completed the appropriate forms and had authorisations in place to do so.