Archived: East View Housing Management Limited - 1 Johnson Close

1 Johnson Close is a residential care home providing accommodation and personal care for up to four people. At the time of inspection, four people were living at the service. People were living with learning disabilities and autism as well as other health conditions.

The building was situated over two floors. Bedrooms were spacious, and person centred, with ensuite facilities and there were large, homely communal areas for people to relax in. There was also an accessible garden that we saw people using throughout the inspection.

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 outcomes for people reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

From what people told us and what we observed, people were safe. Staff knew risks to them well and took action to reduce areas of concern. Risk assessments were detailed and individual to people. Regular health and safety audits were completed by staff, management and external professionals to ensure that the building was safe. There were always enough staff to meet people’s needs. Before staff started working at the service, their previous experience, character and safety checks were reviewed to ensure they were suitable to work with 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.

Staff all received robust training, which included areas required to meet people’s specific health and social needs. Their competency to provide the right care was regularly checked and monitored by management. People’s nutritional needs were consistently met, and they had regular involvement from health and social care professionals to promote their wellbeing.

Everyone we spoke to was complimentary about the staff team at 1 Johnson Close. We observed people to have built good relationships with staff. A relative told us, “Staff are absolutely fantastic. They are very patient and give my relative time to process things. In my opinion they are so much better than other homes.” Staff emphasised the importance of maintaining people’s independence and worked with them to improve skills. People’s dignity and respect was promoted and encouraged.

People received personalised activities based on their preferences and goals. Each activity was reviewed by people, so they only took part in activities they enjoyed. They were encouraged to spend time in the community, building links and relationships. They saw the people that were most important to them regularly.

Additional visual tools were used to support people to be able to make complaints. Any complaints made were managed in a professional and timely way, ensuring people were happy with outcomes. Staff knew people’s communication needs well and had considered this when obtaining people’s views. A new process for recording end of life wishes had been introduced so that information could be gathered in a way that would not upset people.

Everyone we spoke was complimentary about the registered manager and felt the service was well-led. Staff felt encouraged and supported in their roles with regular supervision and team meetings. A team working ethic was promoted. One staff member said, “I think what we do best is listen to people. We work as a team and pool together ideas to make things better for people.” The registered manager continually reviewed ways of working and introduced new ideas that had been adopted by managers from other services.

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

Rating at last inspection (and update)

The last rating for this service was Good. (published September 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place which included the checking of references and personal identification.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options had been considered.

Staff sought and obtained people’s consent before they helped them. Staff training in the Mental Capacity Act 2005 (MCA) and DoLS was effective. People’s mental capacity was appropriately assessed about particular decisions. When necessary, appropriate meetings were held to make decisions in people’s best interests, as per the requirements of the MCA.

Staff received regular one to one supervision sessions and all essential training for their role. The staff supported people to have meals that were in sufficient quantity and met people’s needs and choices. Staff knew about and provided for people’s dietary preferences and restrictions.

Information was provided using accessible language and contained pictures about menus, activities and how to complain, to help people understand this information.

Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

People were promptly referred to health care professionals when needed.

Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. People’s individual assessments and care plans were reviewed monthly or when their needs changed. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

People were involved in the planning of activities and a varied and individualised activities programme was in place which met people’s preferences. People’s feedback was actively sought at house meetings and review meetings.

Staff told us they felt supported by the registered manager and they had confidence in their leadership. The registered manager was open and transparent in their approach. They placed emphasis and priority on the person centred needs of people at the service.

There was a system of monitoring checks and audits to identify any improvements that needed to be made. The management team acted on the results of these checks to improve the quality of the service and care provided.

We saw the layout of the home and the information boards for people and staff. We saw various aids in the kitchen, including pictorial, to ensure menu choices. On their return, people showed us around their home including their rooms and all of the other facilities. People told us about holidays and activities, such as one who had been to the USA and was still excited about the airplane and the dolphins. And one who had received a Valentine's card that day and was chatting about how to respond.

We sat in the kitchen and watched people happily interacting with staff, talking about their day, sorting and doing laundry and other chores. There were occasional anxieties from one person, but we saw that staff were good at deflecting concerns and ensuring understanding of process. We saw that the views of the people were understood and acted upon.

During our inspection we met all of the four people who lived in the house as they returned from activities. We spoke with three of them in particular as they were excited by our presence, and wanted to show us around their house. They also told us about things they liked and about some of the activities and places they had visited.

We were shown around the house which was very homelike and saw that it was clean and tidy. Staff told us they had received training and were able to tell us about the procedures in place to maintain good infection control. We viewed records and saw that infection control audits were undertaken regularly.

We spoke with two staff and observed their interactions with people in the house. We saw that they had developed good ways of working with them and understood their individual needs. Staff said that the information in the care plans told them everything they needed to know, and as key workers they were responsible for keeping this up to date. They told us that they felt supported by the manager and had access to supervision and training. Records viewed confirmed this.

We spoke with the manager who explained how service quality was monitored. We viewed quality audits undertaken by the provider. We saw that actions were highlighted where shortfalls were noted, and progress towards addressing this was monitored. We saw evidence that the views of people living in the house and their representatives were sought and acted upon.