Otterhayes

Updated 10 August 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 Care Act 2014.

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 one inspector.

Service and service type

Otterhayes provides accommodation and personal care for a maximum of five people living with learning disabilities and/or autism in a property known as Hayes House. At the time of the inspection there were five people living in Hayes House. 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.

This service also provides care and support to people living in seven supported living settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

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 not a registered manager in post. The new manager had commenced their role during our inspection and would be registering with the Commission.

Notice of inspection

This inspection was announced.

We gave the service 48 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

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 six people who used the service about their experience of the care provided. We spoke with ten members of staff including the operations manager.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and four medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

After our visit we sought feedback from relatives, staff and health and social care professionals to obtain their views of the service provided to people. We received feedback from six relatives and three health and social care professionals. We continued to seek clarification from the provider to validate evidence found. We provided initial feedback to the service on 26 July 2022.

Updated 10 August 2022

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.

About the service

Otterhayes provides accommodation and personal care for a maximum of five people living with learning disabilities and/or autism in a property known as Hayes House. At the time of the inspection there were five people living in Hayes House. This service also provides a domiciliary care agency service and provides support to a further 14 people living in seven supported living properties, with the aim that they can live as independently as possible. All 14 people living in the supported living properties were receiving elements of personal care.

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

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 was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence;

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. One person commented, “The staff are lovely. I feel safe with them.” Other people were not able to comment on their safety. However, their body language while interacting with staff was relaxed and positive, which indicated they felt safe.

A relative commented, “[Relative] is receiving more and improved support. She is enjoying a more fruitful life with more exposure to the outside world. This has its risks, particularly with somebody like [relative] who is very trusting, but I feel much more confident that these risks are being well managed to [relative’s] benefit.”

People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. There were comprehensive risk assessments in place covering all aspects of the service and support provided.

Medicines were managed as necessary. Infection control measures were in place.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

There were effective staff recruitment and selection processes in place.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights;

Staff relationships with people were caring and supportive. Staff provided care that was kind and compassionate. Comments included,” I like living here, I am happy with the staff.” And “I love living here as the staff are very helpful and caring, they make me feel special. They help me with my house jobs and help me if I ever have any problems.” A relative commented, “[Relative] appears very happy and seems happy with the staff that look after her.”

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives;

People’s equality, diversity and human rights were respected. The service’s vision and values centred around the people they supported. The organisation’s statement of purpose documented a philosophy of maximising people’s life choices, encouraging independence and people having a sense of worth and value. Our inspection found that the organisation’s philosophy was embedded in Otterhayes. For example, people were constantly encouraged to lead rich and meaningful lives.

People were supported by staff who had received relevant and good quality training in evidence-based practice. This included training in the wide range of strengths and impairments people with a learning disability and or autistic people may have, mental health needs, communication tools and positive behaviour support.

The management team worked hard to instil a culture of care in which staff truly valued and promoted people’s individuality, protected their rights and enabled them to develop and flourish.

Staff felt respected, supported and valued by senior staff which supported a positive and improvement-driven culture. A staff member commented, “Otterhayes has come on leaps and bounds. [Operations manager] has been amazing. The day the gates were opened, everything has changed for the better. I feel well supported. Lots more community involvement. The jubilee party was great, local people came, spoke to the guys, they had never known what Otterhayes was. People have progressed, for example, reduction in medication and discharge from Intensive Assessment and Treatment team. There is a calmer environment. I love coming to work.”

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 31 August 2021 and this is their first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We also undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.