Background to this inspection
Updated
18 April 2020
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
The inspection was carried out by one inspector.
Service and service type
Care Home for Special Needs 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 provider is an individual who also manages the service. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 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 speak with us.
What we did before the inspection
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 information we had received about the service since the last inspection. We sought feedback from the local authority. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service about their experience of the care provided. We spoke with one member of staff, a student on a one-week placement and the manager (provider).
We reviewed a range of records. This included two people’s care records and medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with one relative on the telephone.
Updated
18 April 2020
About the service
Care Home for Special Needs is a residential care home providing personal care to two people with a 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
The provider continually checked that people were satisfied and confident in the standard of care provided within the service. However, there was a lack of formal auditing systems and records in place. Quality assurance systems needed development to ensure they consistently identified and addressed any shortfalls.
Some areas of medicine practice and management of risk regarding water temperatures and the fire risk assessment needed review regarding the fire exit arrangements.
People received safe care by the provider and staff who understood how to recognise signs of abuse or risk and understood what to do to safely support people. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible. People received support from staff when needed.
People’s care and support reflected their individual assessed needs. Staff had the appropriate skills and knowledge to meet people’s needs and received training and ongoing support. People had been supported to maintain their health and wellbeing and had access to healthcare services when required. People were supported to have enough to eat and drink to maintain their well-being.
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.
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.
People received help and support from a kind and compassionate staff team with whom they had positive relationships with. Staff showed respect for people's rights, privacy, dignity and independence. People were involved in making decisions about their care and support needs.
The provider and staff were committed to delivering care in a person-centred way based on people's preferences and wishes. They were knowledgeable about the people they supported and had built trusting and meaningful relationships with them. People were supported to maintain relationships with those that were important to them. Activities were tailor-made to people's preferences and interests. People were encouraged to go out and form relationships with members of the community. People knew how to make a complaint if they were unhappy.
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 30 April 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.