The Homesteads

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There were sufficient numbers of staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health and wellbeing. The provider had a good management and monitoring structure in place for medication.

The provider’s recruitment processes ensured that appropriate checks were carried out before staff commenced employment. There were sufficient numbers of staff on duty to meet the needs of people and keep them safe from potential harm or abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and when there was a change in people’s care needs. People were supported to follow their interests and participate in social activities. Complaints were responded to in a timely manner.

The service had systems in place to monitor and provide good care and these were reviewed on a regular basis. The registered manager told us that current systems and processes where being updated and improved.

Further information is in the detailed findings below.

A registered manager was in post who was also the registered provider. 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 was supported by a deputy manager to ensure the daily management of the service.

The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. There were sufficient numbers of staff available to meet people’s care needs. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. There were systems in place to manage medicines and people were supported to take their prescribed medicines safely. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

The service provided good care and support to people enabling them to live fulfilled and meaningful lives. People were supported by skilled staff who ensured people were safe and encouraged them to achieve their full potential and live as independently as possible. The registered manager understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).

There was a strong emphasis on person centred care. Care plans were person centred and included people’s preferences and individual needs. Care plans were regularly reviewed and people were involved in the planning of their care. The service was flexible and responded to people’s changing needs.

People told us they were happy with the care and support they received; they were treated with dignity and respect and care was provided in a kind and caring way. People’s nutritional needs were met and people were supported to maintain a healthy and balanced diet. People’s health needs were managed by staff with input when required from relevant health care professionals.

There were effective quality assurance systems in place to regularly assess and monitor the quality of the service provided.

This is a summary of what we found

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they cared for. Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had been trained to understand when an application should be made, and in how to submit one. All people who used the service had received an assessment of their capacity and staff recognised the importance of choice and consent.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The service was safe, clean and hygienic. Environmental audits were carried out regularly therefore not putting people at unnecessary risk.

The provider had safe and effective staffing rotas. Policies and procedures were in place to make sure that unsafe working practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them. Psychological, physical and social needs had been identified in care plans where required. People told us that they had been involved in writing them and that they reflected their current needs.

Is the service caring?

People were treated with respect and dignity by the staff. People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. One person we spoke with told us, 'The staff are very good here and I get to go out most days and often with my keyworker. I am planning to move into more independent accommodation and this is really important for me."

People who used the service, their relatives, friends and other professionals involved with the service completed a twice yearly satisfaction survey. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to raise a concern or complain if they were unhappy.

The service worked well with other agencies and services to make sure people received care in a joined up way.

People completed a range of activities in and outside the service regularly. The home had its own minibus, which helped to keep people involved with their local community.

Is the service well-led?

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. We were therefore assured that the provider had taken steps to continually improve the service.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We saw that people had choices of food and drink that met their diverse needs. The menus and nutrition records showed that people had received a healthy balanced diet. People said that they had lots of fresh fruit and salad. They told us that they chose what they wanted to eat.

People told us that they felt safe and secure living in The Homesteads. The provider's safeguarding policy worked within the local multi-agency procedures. They had responded appropriately to any safeguarding issues. Staff had been trained and showed a good knowledge of safeguarding procedures.

The service had effective recruitment procedures in place. They had carried out all of the appropriate checks before staff started work. People's concerns, complaints and comments were listened to and acted upon effectively. The provider had a good complaints system in place which provided people with sufficient information on how to complain.

People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.

Our findings showed that each person had a detailed support plan identifying their specific care needs and how these were to be delivered and supported by staff.

Medication practices and procedures at the service were good and maintained people's safety and wellbeing. Staff confirmed to us that they received opportunities for personal development and formal supervision.