Cavendish House

Cavendish House is a residential care home providing accommodation to up to 6 people requiring personal care. The service provides support to people with a learning disability and/or autistic people across 1 residential property. At the time of our inspection, there were 4 people using the service.

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.

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

Right Support:

Staff supported people to live as independently as possible and have a great level of autonomy over their lives. People were provided with a choice in their day-to-day decision-making and families were involved in people’s care. People's risks in relation to their care were managed well and staff understood how to maintain and encourage people’s independence. There were sufficient staff to meet people’s needs. We were assured the service was following good infection prevention and control procedures to keep people safe. Healthcare professionals told us that staff worked well with them to achieve positive outcomes for people.

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.

Right Care:

People and their relatives told us they were supported by staff in a kind, caring and dignified way and we observed this throughout the inspection. People's differences were respected by staff and they had undertaken relevant training to effectively support people. This included appropriate training for learning disabilities and autism. People and their relatives told us staff knew people’s needs and preferences well. People's right to privacy was respected. The service was situated in a residential area and there were no outward signs to differentiate it from other houses on the street. Staff encouraged people to be actively involved in their care and provide feedback about their care in a format they could understand.

People’s care plans were detailed and included information on people's healthcare needs, oral care needs, communication needs, preferences and social history. People were supported to enjoy the diet of their choice and staff encouraged them to have a nutritionally balanced diet. People had individual goals and objectives which were regularly reviewed by staff.

Right Culture:

The culture of the service was open, inclusive and empowered people to live as independently as possible. Staff understood their legal responsibilities in relation to people’s cultural and spiritual needs. People, their relatives and staff were complimentary about the service and felt their ideas and concerns would be listened to by the registered manager. Management had undertaken audits to look at ways of improving the service. Staff were complimentary about the registered manager and the charity trustee and told us they were able to raise concerns which would be listened to.

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 Good (published 28 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We carried out this unannounced inspection on 23 August 2017. On the day of our inspection there were six people living at the home, although not everyone was receiving the regulated activity.

There was a registered manager in place. 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. The registered manager assisted us with our inspection.

People were supported to see healthcare professionals regularly and they received the medicines they required. Medicines management systems were good. Staff maintained a safe environment, including appropriate standards of fire safety. There was a plan in place to help ensure people would continue to receive care in the event of an emergency.

People were encouraged to fully participate in the running of their home. Staff supported people to make their own decisions, be independent and live as normal a life as possible. People were involved in choosing what they wished to eat and were encouraged to participate in the planning, shopping and preparation of meals.

There was good management oversight of the home. Records were well organised, up to date and stored confidentially where necessary. People’s support plans were detailed and included guidelines to staff on how to provide the care and support people needed. This included addressing any potential risks to people. Accidents and incidents were recorded and action taken to help prevent reoccurrence.

People were cared for by a sufficient number of staff to meet their needs. Staff understood their roles in keeping people safe and protecting them from abuse. The provider carried out good pre-employment checks before staff started work.

People were supported by staff knew them extremely well and were competent in their roles. Staff had access to training and on-going support from their line managers. Staff acted within the principals of the Mental Capacity Act to ensure that the correct processes were followed with regards to decisions for people.

People were supported by caring staff who demonstrated their understanding in ensuring people were treated with respect. People’s privacy and dignity was maintained. People had access to activities both within and outside of the home. People maintained relationships with those close to them and the atmosphere in the house was very relaxed and family orientated.

There was an appropriate complaints procedure in place, written in a way people would understand. People told us they could speak to staff if they felt worried about anything.

Staff worked well together and told us there was a good culture within the home. Team meetings were used for staff to discuss all aspects of the home and resident’s meeting demonstrated people were included in decisions.

Staff made regular in-house checks on the service provided and the environment in which people lived. The Trust carried out their own regular audits to check people were receiving the service they should expect. Any actions identified were addressed.

We carried out this follow up inspection to check that the provider had taken the necessary action which ensured that their recruitment processes were robust and the records they kept that related to people were up to date.

We looked at two staff files and saw they both contained all the necessary information for safe recruitment. This included references, a health declaration and photographic evidence.

The records held that related to people who used the service had been updated and we read in two support plans that risk assessments had been reviewed.

As part of our inspection we spoke with two staff and one relative. We were able to speak to all of the five people who lived in the house; however at the time of our inspection only two were receiving personal care.

The inspector considered our inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Is the service safe?

We saw that people lived in a safe environment. The service was clean and hygienic and people were able to move around the home and garden freely without any risk of harm.

We found that the provider had not obtained all the necessary information on staff to ensure that they were suitable to work with vulnerable people.

Is the service effective?

Our observations told us that staff had a good understanding of people's needs. However, we found that people's care plans were not up to date or written in a person centred way.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people.

People's preferences, interests, and diverse needs were provided. We saw how one person liked to spend their time in the garden, whilst another preferred to watch television or take part in some baking.

Is the service responsive?

Staff were attentive and supported people when they needed assistance.

Is the service well-led?

We saw that there were weekly meetings for the people who lived in the house. The provider did not send out formal questionnaires to relatives, but we were told that relatives were very involved and they (staff) spoke to them on a regular basis.

Checks were completed in the home. These included health and safety, fire and maintenance to ensure the environment that people lived in was safe and appropriately maintained.

People who used the service had been living there between ten and seventeen years. They told us they were well settled and enjoyed living in the village and being part of the community.

People told us they felt safe living in the home and said they would feel confident to discuss any problems or issues with the manager and staff team.

We saw the home was well maintained and presents a homely environment. Individual accommodation was personalised and reflected peoples hobbies and interests.

There were enough qualified, skilled and experienced staff employed to meet people's needs. Staff told us they enjoyed working in the home and felt they had the necessary training to undertake their roles.

People told us that they had a good staff team to support them with their daily living skills.

One person told us that staff supported them to attend Crawley College, and that this was very important to them.

One person told us that the people living in the home were their friends and that they liked going to the caravan on holiday.

People told us that they were good at planning their meals and doing the home's shopping. They told us that they followed a healthy eating plan and knew what food was a good choice.

We were told that some people enjoyed doing voluntary work in the community including helping teach sign language and preparing meals on wheels.

People told us that there were always sufficient staff available to take them to their planned activities and to help them maintain contact with their family and friends.

Staff told us they enjoyed working in the home.