This inspection took place on 23 March 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.The Alan Shearer care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The Alan Shearer Centre provides residential and respite care across one site. The residential provision is a care home. A short break, respite service for people with a disability is also provided from a separate unit on the main site and is part of the residential provision. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. A maximum of 20 people can be accommodated within both units. At the time of inspection five people were living at the service and eight people were staying for a short break.
At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good apart from the caring domain where evidence was available that showed this rating was exceeded to outstanding.
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.
Due to their health conditions and complex needs, not all of the people who used the service were able to share their views verbally about the support they received but we were able to gather the views of relatives. One relative said, "The care is excellent and their response [staff] to expected difficulties has been most positive which to me evidences their professionalism. Not only was their personal care of a high standard but it was the manner in which it was provided that sets this organisation apart from the others caring and respectful."
We saw that the service worked collaboratively with other healthcare professionals to ensure that people were supported to be involved in decision making as much as possible. This included creative consideration of various techniques that could better enable people to communicate their wishes.
People appeared safe and comfortable with the staff who supported them. There was an open, relaxed and friendly atmosphere around the service.
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. People were given information in a format that helped them to understand and encourage their involvement in every day decision making.
Records were personalised, up-to-date and accurately reflected people's care and support needs. They provided staff with very detailed information to enable them to provide effective, person centred care to people who may not be able to communicate their needs verbally. Staff were informed and enthusiastic. They ensured people, whatever the level of need were kept stimulated and involved in their surrounding and they were introduced to new activities. Other people were supported to follow their interests and hobbies. People were supported to contribute and to be part of the local community.
People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.
There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated everyone with great respect and dignity. The staff team knew people extremely well and provided support discreetly and with compassion. People’s privacy was respected and people were supported to maintain contact with relatives and friends.
People had access to health care professionals to make sure they received appropriate care and treatment. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe and timely way. People received a varied and balanced diet to meet their nutritional needs.
There was regular consultation with people and/ or family members and their views were used to improve the service. People had access to an advocate if required.
Communication was effective to ensure staff and relatives were kept up to date about any changes in people's care and support needs and the running of the service. The provider continuously sought to make improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service. Staff said the management team were approachable.
A complaints procedure, guide about the service and other information for people was available and written in a way to help people understand if they did not read. Complaints were taken seriously and records maintained of the action taken by the service in response to any form of dissatisfaction or concern.
Further information is in the detailed findings below.