Care at Stennings

Care at Stennings is a residential care home providing personal care to seven people living with a learning disability. The service can support up to eight people. Accommodation is provided in two houses which are linked together with a conservatory.

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 service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service 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 for them to gain new skills and become more independent.

People told us they felt safe. Staff had training in safeguarding and understood how to report any concerns about people’s safety and wellbeing. Risks to people were understood, assessed and appropriately monitored. There were enough staff available to meet people’s needs. People were supported to take their medicines safely. Infection prevention and control was well managed. When things went wrong, lessons were learnt, and steps taken to prevent reoccurrence.

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. People’s needs and choices were assessed and planned for. Staff were supported with induction, training and supervision to ensure they had the right skills to support people. People were supported to eat a health balanced diet. Staff worked with other agencies to ensure that people lead healthier lives.

People were treated with kindness and care. People made choices about their day to day support and were encouraged to express their views. People’s privacy and dignity was respected. People were encouraged to maintain and develop their independence.

People received personalised care from staff who knew them well. People’s communication needs were understood and supported. People took part in a range of activities and were supported to maintain relationships that were important to them. People and their families felt confident to complain if needed.

Staff were proud to work for the service and felt well supported by the registered manager. People, their relatives and staff’s views had been sought and used to further develop the service. Quality assurance checks supported the service to continuously learn and improve. Staff worked in partnership with other professionals.

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 Requires Improvement (published 22 January 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

Care at Stennings is registered to provide accommodation for persons who require nursing or personal care, for a maximum of eight people. At the time of the inspection eight people with a learning disability were living at Care at Stennings. Accommodation is provided in eight single bedrooms within two houses which are linked together by a conservatory. Each house has a shared kitchen, dining room and lounge. The gardens at the front and rear are secluded and accessible to the people living at the home.

Care at Stennings is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service was built and registered before the publication of the Registering the Right Support best practice guidance. However, it is 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 at the time of the inspection. One of the providers was also registered as a registered manager at Care at Stennings. 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 provider had not ensured that we were notified of all safeguarding incidents, which they are required by law to do.

People were supported to have choice and control in most aspects of their lives and staff them in the least restrictive way possible; the policies and systems in the service had not always supported this practice. However, this was addressed by the registered manager following the inspection.

Quality assurance systems and the actions taken were variable. Areas highlighted for improvement, had not always been acted on. However, other quality assurance completed had been used to improve the service.

People told us that they felt safe at Care at Stennings. Risks to people and about the environment were considered and managed. Risks around infection control were mitigated.

There was a positive and person-centred culture. People were treated with kindness, compassion and respect. One person’s relative told us, “He loves going back there.” People’s privacy and dignity was protected. People knew how to make complaints and felt confident to talk to staff or the registered manager if they needed to.

People’s health, social, physical and emotional needs were assessed for each person and their support planned for. People were involved in reviewing their support and setting goals to achieve or maintain. People were encouraged to be independent where possible and take part in household tasks.

People were supported to access regular healthcare support as needed. Medicines were managed safely.

People took part in activities which matched their interests. One person told us, “I go out on the bus, to the cinema and shopping.” Some people attended colleges and day centres. Some people took part in voluntary work.

Staff were recruited using safe recruitment practices. New staff were supported with an induction training programme. Staff received regular training and supervision to ensure they had the right skills to support people. One person told us, “I like them, I get on well with staff.” Staff worked well together and in partnership with other professionals and agencies.

People, their relatives and staff’s views of the service provided were sought. The provider regularly visited the service.

During this inspection we found a breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of this report.

The service has 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 2008 and associated Regulations about how the service is run. People, relatives and staff spoke highly of the registered manager.

Some key principles of the Mental Capacity Act 2005 (MCA) were not being consistently applied. Staff were not always clear about how to ensure that proper consideration was given to matters of consent to empower people to make their own decisions in line with the MCA. Staff had received training and demonstrated a good understanding of the principles of the MCA however there were some inconsistencies in their practice regarding assessing people’s capacity in relation to managing some or all of their medicines. In other areas of practice staff were working within the principles of the MCA and Deprivation of Liberty Safeguards (DoLS).

People told us they felt safe living at Stennings, one person said, “I feel safe because they don’t just let strangers come in.” Staff had a clear understanding of their responsibilities in regard to keeping people safe from harm and abuse, and risks were identified and managed appropriately. A relative told us, “I’m really happy with the care, we know (person’s name) is safe and well cared for and that’s such a relief.” Staff had been recruited through a safe and robust process with appropriate checks made to ensure they were safe to work with people. There were sufficient staff to ensure people were safe and had their needs met. Staff were knowledgeable and well supported. Training opportunities were good; one staff member said “The manager is always offering and suggesting training for us.” Staff were knowledgeable about the needs of people with learning disabilities.

Medicines were stored and managed safely and people were supported with their health care and dietary needs. People were supported to be as independent as possible in choosing and preparing their meals. One person told us, “I usually decide myself when to eat, I sometimes need a bit of help from staff but I can do quite a lot on my own,” There were regular opportunities for people to eat out and they told us they looked forward to these occasions.

People were supported by staff who were caring and compassionate. People’s relatives spoke highly of the caring nature of the staff. One relative told us, “I feel blessed that (person’s name) is able to live there, the staff do so much, I can’t fault the care.” Staff spoke about their roles with enthusiasm and commitment, one commented, “I love helping the service users, if you don’t feel that way you wouldn’t work here.” Throughout the inspection we saw positive interactions between people and the staff with numerous examples of staff listening to people and consistently responding in a positive way. People told us they liked the staff and appeared happy and relaxed in their presence.

Staff were clearly focussed on providing personalised care and had a good understanding of people’s needs and how to support them. A system was in place to inform staff of any changes to peoples care needs. People were supported to engage with the community through a wide range of activities according to their preferences and interests. Care records were detailed and personalised and gave a strong sense of the individual and what was important to them. People had full and busy lives, one relative said, “I’m really happy with the care, there is so much going on, you have to ring because they are never in.”

There was a complaints system in place and people and their relatives told us they felt comfortable raising any concerns. The culture of the service was positive and person centred. There was a clear vision that people should be involved with their community and this was understood and embedded in practice within the service. The registered manager was well regarded by people, relatives and staff who were well supported. There were systems in place to monitor the quality of the service and this information was used in addition to feedback from service users, relatives and staff to drive service improvements where needed.

People we spoke with told us that they were happy at the home and said; 'staff are very supportive', 'my keyworker help me a lot', 'I make my own decision', 'I go home at weekend'. One person said, 'I enjoyed my holiday at Disneyworld Paris'.

We found that there were an array of meaningful activities both in house and outside on offer to the people living at the home. We observed the enthusiasm of individual getting ready to go the gym in the morning and same for swimming in the afternoon.

We found that there was a robust recruitment process in place and staff were well supported by management. The manager said that the selection process for staff recruitment was to reflect the needs of the young adult who used the service.

We found that there were appropriate arrangements for making sure that medicines were stored, administered and recorded properly. There were evidence that staff had training in the administration of medication.

There were effective systems in place in term of records management at Stennings. All records were securely locked and accessible to designated members of staff only.

The provider told us people were pre-assessed prior to admission to the home. To support people to make the move to living at the home overnight visits were provided to ensure people experienced a smooth transmission to their new environment.

During the visit we observed staff engaged with people in a warm and supportive manner. We noted information was displayed in different forms to meet the needs of the people living in the home. For example we noted information was displayed in pictures and other visual aids.

We found people were protected from the risk of abuse as staff were trained in safeguarding. We found the staff were knowledgeable and knew how to raise a safeguarding alert if there were concerns about people safety.

Staff told us they were supported to deliver care and treatment to people at an appropriate standard. We reviewed records and saw staff were regularly supervised and they were appraised annually.

The provider had a system in place to monitor and assess the quality of the service they delivered.