Balby

Balby is a residential care home providing personal care to up to 8 people. The service provides support to younger adults who live with a learning disability, mental health conditions or autistic people. At the time of our inspection there were 8 people using the service.

People’s experience of the service and what we found:

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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

People were supported extremely well by staff who had a strong understanding of how to promote their independence and provide the maximum choice possible. Staff supported people to achieve their goals and aspirations, by empowering people and identifying people's strengths. People enjoyed a fulfilled life, participating in activities meaningful to them both within the service and while accessing their local community. The support people received was adjusted to specifically meet their individual needs, to provide the best outcomes for them 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's diverse needs were considered in all aspects of their care; this included care planning, risk assessing and the day to day support people received. Staff were guided on how to provide exceptional individualised person-centred support with detailed care plans which provided clear guidance on people's wishes. The provider worked in partnership with external professionals involved in people's care and ensured decisions involved them, the people important to them and people who knew them well. Staff had a good understanding of how to support people safely and demonstrated their knowledge of safeguarding. People’s individualised communication needs were clearly recorded. The provider and staff understood the importance of adjusting their approach to people's preferred way of communicating. People's medicines were managed safely, and they were consulted on how they wished to take their medication; staff encouraged people to become independent on administering their own medicines.

Right Culture

One of the key strengths of the service was the registered manager and the leadership and values they implemented within the service. People led inclusive, empowered lives. This was consistently driven by the registered manager and subsequently staff who felt they were supported well by the registered manager. People were continuously supported to achieve their goals and develop their aspirations through innovative care and support. Quality of life was enhanced by a culture of consistent development, improvement and working in partnership with people, and those important to them including external professionals. Any concerns or complaints were managed professionally, transparently and with integrity.

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 13 March 2018).

Why we inspected

This inspection was prompted due to the time since the last inspection.

Follow Up

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

We undertook a focused inspection to review the key questions of safe, caring, responsive and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Balby on our website at www.cqc.org.uk.

The care home accommodates eight people. The home provides care and support to people with autism, learning disabilities and mental health conditions. Nursing care is not provided.

The unannounced inspection took place on 22 January 2018.

At our comprehensive inspection in December 2016 we found one breach of regulations and rated the service as 'Requires Improvement'. At this inspection we found the service had made improvements and we have rated the service as 'Good'.

People felt safe and were comfortable with the staff who supported them. Staff understood how to protect people from harm and abuse. Risks to people's safety were identified and clear support plans were followed. Incidents and accidents were monitored and action was taken to reduce risks to people. Environmental risks were assessed and managed appropriately. Improvements had been made to ‘as required’ medicines. People received their medicines safely and as prescribed.

Staff were only employed after they completed a thorough recruitment procedure. There were enough staff on shift to ensure that people had their needs met in a timely manner. Staff received the training they required to meet people's needs and were supported in their roles.

The CQC is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider had completed capacity assessments and DoLS applications where required. The provider could demonstrate how they supported people to make decisions about their care and the principles of the MCA were being followed.

Staff were kind and caring when working with people. They knew people well and were aware of their history, preferences, likes and dislikes. People's privacy and dignity was respected and maintained.

Staff monitored people's health and welfare needs. People had been referred to healthcare professionals when needed. People were provided with a choice of food and drink that they enjoyed. People were given appropriate support to enable them to eat and drink sufficiently.

People's privacy was respected and they were treated with dignity, kindness and compassion. People were supported to maintain relationships with others who were important to them. People could raise concerns about the service and have their complaints listened to.

People and staff were positive about the leadership of the service. There were systems in place to seek the views of people, their relatives, staff and visiting care professionals. Feedback was taken into account to improve and develop the service provided to people.

The registered provider had effective systems in place to monitor the quality of the service and ensure that areas for improvement were identified and addressed.

Heathcotes Balby is a care home registered to provide accommodation for up to eight people who have a learning disability or who are on the autistic spectrum. The home is located on two floors. Each person had their own individual room. The home had a communal lounge, kitchen and dining room where people could spend time together. The home had a garden that people had access to. At the time of inspection there were eight people using the service.

At the time of the inspection 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.

Staff were aware of their responsibilities to safeguard people and to keep people safe. Staff were trained in how to respond in the event of a fire and contingency plans were in place to keep people safe. Staff learned from accidents and incidents that had taken place.

There was a suitable number of staff to meet people's needs. Staff had been checked for their suitability before starting work with the provider. Staff received support through an induction and regular supervision. There was training available for staff to update them on safe ways of working and how to meet people's needs.

People were given their medicines when they needed them. There was a system in place to manage medicines in the home although this was not always effective. We found improvements were required in the recording of PRN (as required) medication.

Care plans described people's care and support needs. They were reviewed on a regular basis and also when changes to a person were identified. Health and social care professionals were involved to support people's care and health needs.

People were supported to have a healthy diet and stay hydrated. Staff prepared

meals which people enjoyed and which met their dietary needs.

The care plans were person centred and enabled staff to provide good quality care to people. They detailed people's routines, what they liked, what and who was important to them and how they communicated.

People were encouraged to take part in activities that suited their interests and hobbies. Activities were flexible and based on people's individual needs and preferences.

The complaints procedure was available in an accessible format for people and regular meetings were held to obtain their views.

Quality assurance systems were in place to monitor the quality of service being delivered and the running of the home.

Staff reported that the manager was supportive and responsive.

We found that where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There was an effective complaints system available.