42a Haddon

We found the following examples of good practice.

¿ Learning sessions with people who used the service took place when lockdown was introduced to support people’s understanding and reduce anxiety. For example, people learned about social distancing and alternative greetings such as ‘elbow dabs’.

¿ When any cases of Covid 19 were suspected or confirmed, the flat where the person lived was completely locked down. Two members of staff worked exclusively in that flat on alternating shifts until the person recovered or the period of isolation ended.

¿ When lockdown commenced the service supported staff who relied on public transport get to and from work by sharing lifts with colleagues. This reduced the risks of infection to staff, and people using the service.

¿ The service managed to maintain a stock of PPE throughout the pandemic and purchased extra supplies in preparation for any second spike.

¿ During the lock down period the on site coffee shop took responsibility for sourcing, purchasing and preparing all meals. This meant people and carers were not going to supermarkets and this reduced risk.

¿ Rotas and shifts were planned so staff worked in as few flats as possible. This included overtime shifts which was a change to usual practice.

¿ All staff completed risk assessments which considered their individual circumstances. These were used to make adjustments as necessary to keep staff and the people they supported safe.

¿ All visits by relatives to the service after lockdown eased were individually planned and risk assessed. Risk assessments were shared with relatives prior to the visit. All visits took place in a separate building which reduced the risks of cross infection.

¿ Staff were seen to be wearing appropriate PPE during the inspection visit.

Further information is in the detailed findings below.

42a Haddon is a residential care home that is registered to provide personal care for up to 40 adults with learning disabilities and autism.

People’s experience of using this service:

• People received safe care and were protected against avoidable harm, neglect and discrimination.

• Risks to people’s safety were assessed and strategies were put in place to reduce the risks.

• The recruitment practices ensured suitable staff were employed to work at the service and staff were employed in sufficient numbers to meet people’s needs.

• People's medicines were safely managed.

• Systems were in place to control and prevent the spread of infection.

• People’s needs were assessed to ensure the service could meet their needs.

• Staff received an induction and ongoing training that enabled them to have the skills and knowledge to provide effective care.

• People were supported to maintain good nutrition and hydration.

• Staff supported people to live healthier lives and have access to healthcare services.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• Staff treated people with kindness, compassion and respect.

• People were supported to express their views and be involved in making decisions about their care.

• People were involved in planning their care and in on-going reviews of their care.

• Systems were in place to continuously monitor the quality of the service.

• The service worked in partnership with outside agencies.

Rating at last inspection:

Good (report published 2 August 2016)

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

The inspection was carried out by one inspector.

42a Haddon is a service that provides accommodation and personal care support for adults with learning disabilities. Accommodation is provided in self-contained flats within a complex. On the day of our inspection 40 people were using the service.

There was a registered manger in post. 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 felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and knew how to report any concerns. People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service. People received their medicines safely when they needed them.

Staff received a comprehensive induction process and on-going training. They were well supported by the registered manager and had regular one to one time for supervisions. Staff had attended a variety of training to ensure they were able to provide care and support based on current practice when supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to prepare and cook their own meals. People were encouraged to eat a healthy balanced diet.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People, and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests, join in activities of their choice and encouraged to develop relationships with people.

A complaints procedure was in place and accessible to all. People knew how to complain. Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service had risk assessments in place to enable them to be as independent as possible.

Deprivation of Liberty Safeguards (DoLS) assessments had been arranged for people whose needs required them.

Is the service effective?

People were involved in the planning and review of their care and signed to consent to this.

Documentation was available in a pictorial format to aid understanding.

Is the service caring?

People were supported by staff that were knowledgeable of, and responsive to, their needs.

We observed positive interactions between staff and people who used the service.

Is the service responsive?

Peoples care plans were reviewed regularly to include any changes in their needs.

A robust complaints system was in place, and we found that complaints had been responded to in a timely manner.

Is the service well led?

The service had a registered manager, who was supernumerary to the staff rota. They were supported by a management team, who were available 'on call' to offer guidance and support if and when required.

The quality assurance system was robust and included monthly visits from the area manager. Staff and people who used the service were asked for their opinions, and feedback was acted upon.

For those people who were not able to talk to us, we looked in their care records and saw that their needs had been assessed and that care was being provided in a way that ensured their safety and welfare.

We spoke with relatives who told us that the staff at 42a Haddon 'have given people the life they should have'. Another person told us that their relative was very happy there and 'they always seem to be busy'.

We spoke with members of staff that were knowledgeable about the needs of the people they supported. We heard staff speak with people with dignity and respect. We found that 42a Haddon was well managed.