Archived: Individual Care Services - 1 Dexter Way

The service is a ‘care home’ operated by Individual Care Services. The service, 1 Dexter Way provides accommodation with personal care for up to five adults. People cared for at the home are living with learning disabilities, and complex health and physical disabilities. People in care homes receive accommodation and 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. At the time of our inspection visit, there were five people living at the home.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

At the last inspection in March 2016 all five key areas were rated as Good. At this inspection we found the overall quality of care had been maintained and people continued to receive a service that was caring, effective and responsive to their needs. However, we found some improvements were needed in relation to the safety of the service. The overall rating continues to be Good.

There were enough staff on shift with the appropriate level of skills, experience and support to meet people’s needs and provide effective care. Staff knew what action to take in the event of an emergency and had been trained in first aid.

Staff understood their responsibilities to protect people from the risks of abuse. Staff had been trained in what constituted abuse and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.

Overall risks of harm and injury to people had been assessed and management plans were in place. However, risks of falls had not consistently been mitigated by the provider. Risks of cross infection had not been minimised by staff or the provider.

People were encouraged and supported to maintain good health. Staff frequently liaised with other healthcare professionals. People received their prescribed medicines in a safe way.

Staff worked within the principles of the Mental Capacity Act 2005. The registered manager understood their responsibilities under the Act. Four people had authorised deprivation of liberty safeguards in place when their care and support included restrictions in the person's best interests.

Staff supported people in a kind and compassionate way. Relatives felt staff were caring. People had varying levels of communication which were largely through gestures and non-verbal communication. These had been assessed so staff knew the appropriate communication methods to use to enable people to express themselves non-verbally, and make choices about day to day things such as what to wear.

People had detailed individual care and support plans which provided staff with the information they needed to respond to people’s needs. Staff recognised people as individuals and care was given in a person-centred way. This included people being supported with various activities both inside and outside the home.

The registered manager checked the quality of the service to make sure people's needs were met. Feedback about the service was encouraged.

Further information is in the detailed findings below.

The service provides accommodation and personal care for up to five people with learning disabilities or autistic spectrum disorder. There were five people living there at the time of our visit.

A requirement of the service’s registration is that they have 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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection.

People had positive and meaningful relationships with staff who knew them well and were available when they needed them. Staff were attentive and caring towards people and took time to listen to what they had to say. People were relaxed around staff and approached them confidently. Staff had a good understanding of their responsibilities in relation to safeguarding in order to protect people from the risk of or potential of abuse. Staff told us they would be vigilant for signs that people with limited communication were unhappy or upset.

Staff received training and support so they could carry out their roles effectively and safely. Staff understood people's different communication needs and interpreted people’s gestures, expressions and actions to support them in making choices. Where people did not have the capacity to make their own decisions, decisions were made in their best interests. The registered manager had considered where people’s liberty may need to be restricted to keep them safe and made appropriate applications to the authorising body.

Each person had a care plan which provided staff with information about their needs in relation to conditions such as autism and epilepsy. Staff supported people to remain healthy and well and to have their medicines at the right time to promote good health. Staff responded to changes to people's health and referred them to external healthcare professionals when a need was identified. People were supported with their nutritional needs and staff were aware of any risks to people when eating or drinking.

People participated in activities both within and outside the home. There were opportunities to engage in pastimes and interests and staff provided sensory stimulation to those who had more complex needs.

The registered manager maintained an open culture at the home. There was good communication between staff members and staff were encouraged to share ideas to make improvements to the service. Staff felt well supported by the registered manager and the registered manager valued the staff team. There were processes in place to ensure good standards of care were maintained for people.

People appeared relaxed and comfortable in their environment. Two people confirmed this by telling us that they were content in their home when we asked. They said, "Yes I am" and "I like it here." Other people indicated their satisfaction with the service by smiling and laughing. People were clearly comfortable in the company of the staff as we saw that they approached them with ease.

People had up to date care and support plans which were clear and provided staff with information they needed to care for people. Staff told us that they read the information about people to ensure that they were up to date with people's needs. "The care plans tell us what care and support people need, what they like and don't like and if anything has changed," was a comment made.

There were systems in place to manage people's medication safely.

The environment was suitably designed, homely and comfortable for people. Specialist equipment was in place and maintained in good order for people.

People living in the home had complex needs which meant that they were not always able to tell us their experiences. We spent time during our visit observing care to help us understand their experiences.

A relative we spoke with told us that they were very happy with the service. One comment made was, "it has taken a huge weight off our shoulders, it's lovely." One person we spoke with who lived in the home answered "Yes" when we asked them if they were happy in the home.

We observed positive relationships between people living in the home and the staff on duty. We saw that people appeared comfortable and relaxed.

People had care plans in place that contained information to assist staff with meeting their care and support needs. Staff we spoke with knew about people's care and support needs and were able to tell us about them. We saw that personal care and support was provided in private.

We saw that people were being supported to lead active lifestyles with a variety of outings and activities being provided.

We saw that the organisation carried out an annual survey to find out people's perceptions of the service being provided. We saw the results for the survey undertaken in 2011 indicated satisfaction with the service provided. We saw that the health, safety and welfare of people living, working and visiting the home were monitored through appropriate checks and measures.