We carried out a review of the data available to us about Russell Hill on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Russell Hill, you can give feedback on this service.
Independence Homes Limited - 33 Russell Hill accommodates nine people with a learning disability in one adapted building. The 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. At the time of this inspection there were 8 people using the service.
This inspection took place on 7 February 2018. At the last inspection in June 2015 the service was rated ‘good’ overall and ‘outstanding’ in our key question “is the service responsive?” At this inspection we found the service remained ‘good’ overall and remained ‘outstanding’ in our key question “is the service responsive?”
Since our last inspection, people continued to receive highly personalised care and support, tailored to meet their individual needs, which was leading to demonstrable positive outcomes and enhancements to their quality of life. People remained actively involved in planning and making decisions about their care and support needs. Staff displayed excellent understanding and awareness of people’s needs and how these should be met in line with people’s specific preferences and choices. Staff understood the importance of respecting people's rights and how to promote equality and inclusion within the service so that people did not experience discriminatory behaviours and practices when being supported with their needs. Relatives said the care and support provided to their family members was helping them achieve a good quality of life.
People were safe living at Independence Homes Limited - 33 Russell Hill. Staff protected people from the risk of abuse and used the provider’s safeguarding policy and procedure for reporting any concerns they had about people to the appropriate person and authority. Risks to people's health, safety and wellbeing were assessed and reviewed and staff followed current guidance on how these should be minimised to keep people safe from injury or harm.
The provider ensured risks posed to people by the premises were appropriately managed. The provider maintained a servicing programme of the premises and the equipment used by staff to ensure those areas of the service covered by these checks did not pose unnecessary risks to people. The premises was kept clean and clear of slip and trip hazards so people could move freely and safely around. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care, cleaning the premises and when preparing and storing food. Medicines were stored safely and securely and people received them as prescribed.
There were enough staff to keep people safe. The provider maintained recruitment checks to assure themselves of staff's suitability and fitness to support people. Staff had regular and relevant training to keep their knowledge and skills up to date with best practice. Staff were happy in their work, motivated and supported by the provider to meet the values and vision of the service which were focussed on people experiencing good quality care and support.
Staff used information and guidance, based on best practice and current standards to plan and deliver care that would support people to experience good outcomes in relation to their healthcare needs. People’s care and support needs were discussed and reviewed with them regularly to ensure the support provided continued to meet these. People were encouraged to keep healthy and well, to eat and drink enough to meet their needs and helped to access healthcare services when needed. The provider’s bespoke epilepsy alarm system ensured people received timely support from staff when required.
People were encouraged to do as much as they could to retain their independence and control over their lives. The design and layout of the premises provided people with flexibility in terms of how they wished to spend their time when at home. People were supported to participate in a wide range of personalised and group activities and events to meet their social and physical needs and to build and maintain friendships and relationships with others. They also had access to education opportunities to develop skills and promote their independence.
Staff were warm and welcoming towards people’s relatives and friends. They were kind and caring and treated people with dignity and respect. Staff ensured people's privacy was maintained when being supported with their care needs.
People were asked for their consent before care was provided and prompted to make choices. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way possible. The policies and systems in the service supported this practice.
People, relatives and staff were asked for their views about how the quality of care and support could be improved. Senior staff demonstrated good leadership and were approachable and supportive. Senior staff monitored the quality of care and support provided. They undertook surveys and regular audits of the service and took appropriate action if any shortfalls or issues were identified through these. If people were unhappy and wished to make a complaint, the provider had arrangements in place to deal with their concerns appropriately.
The provider supported the service to continuously improve and worked in partnership with others to develop and improve the delivery of care to people. The provider was assisting in trials of new technology to improve outcomes for people living with epilepsy. Senior staff worked collaboratively with local authorities funding people’s care to support to make appropriate decisions about the on-going and future care and support needs of people. The provider was also currently working with a local authority to deliver advanced safeguarding training to managers to further develop their learning about how to deal with concerns effectively and to use learning from these to reduce risks to people's safety.
The service had a registered manager in post who was aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.
Further information is in the detailed findings below.
We visited Independence Homes Limited – Russell Hill on 17 and 18 June 2015. The inspection was unannounced.
The service provides specialist residential care for up to nine adults with epilepsy and other neurological or physical needs. At the time of our inspection there were eight people using the service.
The service had a registered manager. 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.
Relatives of people using the service and staff told us people were safe. Staff had completed safeguarding training and knew how to recognise abuse and report safeguarding incidents. They were aware of how they could escalate concerns and whistle blowing procedures. The service was a safe place for people, visitors and staff as the building and equipment used was well maintained. People were regularly checked by staff throughout the day and night and there was a range of personal and room alarms that indicated when a person might need assistance. People’s needs were assessed and reflected in detailed risk assessments. There were sufficient numbers of staff to meet people’s needs and safe recruitment procedures were followed. People received their medicines as prescribed and at the appropriate time.
Staff had the skills, knowledge and experience to deliver effective care and treatment. Mental capacity assessments were completed to establish each person’s capacity to make decisions and consent to care and treatment. We saw evidence of family involvement, consent to care and treatment and where appropriate best interests meetings. Where it was necessary to deprive people of their liberty the service was obtaining appropriate authorisations under the Deprivation of Liberty Safeguards. People had a healthy diet and were supported with their complex healthcare needs.
Relatives and visiting professionals commented positively about relationships between people using the service and staff. We observed and listened to numerous incidences of positive interactions between people and staff. People and their relatives were actively involved in all aspects of care and treatment. People’s preferences were taken into account and staff treated people with dignity and respected their privacy.
People received first rate personalised care that was responsive to their needs. Care plans were person centred and focused on people’s complex social and healthcare needs. The service was very proactive and responsive in addressing and meeting the needs of individuals. The provider invested in staff and equipment to ensure the care and support provided was of a high standard. People using the service benefited from the wide range of activities that enhanced their lives and reduced the risks social isolation. Although people using the service had complex needs the staff had a ‘can do’ attitude and found innovative ways to enable people to take part in activities. Relatives were confident that they could raise concerns with staff and those concerns would be addressed.
Staff spoke positively about the management team and were confident they could raise any concerns or issues. Staff meetings were held on a regular basis. The service had a system of audits and performance monitoring to assess the quality of service they provided.
One relative said 'Russell Hill is an amazing place. They really know what they are doing'. Another relative said 'I am really pleased and really happy with the service my son receives. The care of his epilepsy is second to none'. Another relative said 'I think the support workers are excellent. My daughter is as well cared for as she can be and she's happy living at Russell Hill'.
We found that people's needs were assessed and care was planned and delivered in line with their individual care plan.
There were effective recruitment and selection processes in place.
The provider had effective systems in place to assess and monitor the quality of service that people received.
Relatives told us they were aware of the homes complaints procedure. All said they would contact the registered manager if they needed to discuss any concerns they had or to make a complaint.
We saw and were told that people at Independence Homes Russell Hill received a good quality care. Most people who live there are unable to communicate verbally but one who could told us that he 'liked living there' and showed us pictures of holidays he had been taken on with other people in the home. A parent said that 'it has a homely feel and the support workers are very good. My child is very happy there. The medical care is exemplary'.
The systems in place to ensure that care was appropriate and safe were thorough and up to date and the building was appropriate for the needs of people, very pleasant and well maintained. The staff we met were committed, highly skilled and experienced and they liked working at Independence Homes.
Two of the parents we spoke to were confident that people living there were happy and were safe although they did mention issues which they had taken up with the home over the last year.
People living at 33 Russell Hill do not have the capacity to fully share their views regarding their care. In order to make judgements about the care that individuals receive, we observed care practices; interactions with staff and tracked three people's records of care. Case tracking means we looked in detail at the care people receive.
During our visit people were offered choices, spoken to respectfully, made to feel involved and showed signs of well being when interacting with both the staff and other people using the service. Staff were alert to changes in people's mood, behaviour and general wellbeing and knew how they should respond to individual needs.
The manager and staff team have developed good relationships with those who live at the home and understand their needs, wishes and aspirations to enable them to live a fulfilling life. Comments from staff we met included, 'the care is really good, service users are put first,' and 'good teamwork, people are well looked after and can do what they like.'
We also met with two social care professionals from a purchasing local authority who gave positive feedback about the home.
Please refer to the outcomes within the main report for more detailed comments about specific aspects of the service.