Walsingham Support - 21 Budge Lane

Walsingham Support - 21 Budge Lane is a residential care home providing accommodation and personal care to up to 6 people with learning and physical disabilities in 1 adapted, single storey, wheelchair-accessible building. At the time of our inspection there were 5 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Right support

People’s needs were assessed, and plans were in place to ensure they were met in a person-centred way. Risks to people’s safety were identified and reduced. The purpose-built premises enabled people’s mobility needs to be safely supported. People received their medicines as prescribed from trained and supervised staff.

Right care

People were active and chose the activities they engaged in. 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 made timely referrals to health and social care professionals to ensure people’s needs were effectively met.

Right Culture

The service promoted an open and inclusive culture and focused on people’s unique needs and individual preferences. The provider regularly checked the quality of care and support people received and used action plans to drive on-going improvements.

Rating at last inspection

The last rating for this service was Good (published 10 May 2018 ).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walsingham Support - 21 Budge Lane on our website at www.cqc.org.uk.

We found the following examples of good practice.

People were supported to receive visitors safely. Relatives and healthcare professionals undertook COVID 19 tests and temperature checks prior to entering the care home. This protected people from the risk of COVID 19 being brought into the service by visitors.

Staff followed published guidance to protect people from the spread of COVID 19 within the care home. Staff wore personal protective equipment (PPE) including face masks, visors, gloves and aprons. This meant people’s care and support was provided in line with best practice.

The provider ensured that staff had sufficient quantities of PPE available to them at all times. Staff received training in the correct procedures for safely putting on and taking off PPE items. The home was well ventilated, and the registered manager oversaw the implementation of an enhanced cleaning programme throughout the service. Where people were anxious by staff wearing PPE, they were provided with reassurance.

People were supported to receive vaccinations against COVID 19. The majority of staff had also been vaccinated. Where staff had not received vaccinations, risk assessments were place. In cases of high vulnerability the provider enabled staff to shield at home and not enter the care home.

The service continued to work in partnership with other organisations. For example, the registered manager and staff liaised with other providers to enable people to move into the care home. They ensured that timely and appropriate referrals were made to health and social care professionals. This meant people’s needs continued to be assessed and safely met.

Walsingham Support - 21 Budge Lane is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Walsingham Support - 21 Budge Lane accommodates up to six people with a learning disability in one adapted building. The care service has been developed and designed 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 were two people living in the service at the time of our inspection.

Since our last inspection the provider had employed a new manager who was now the 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 continued to be safe and received support from staff trained to keep them safe. Staff assessed and managed people’s risks. Staff understood the signs to be aware of that might indicate people were at risk of improper treatment and knew what actions to take if they observed it. There were enough staff available to support people safely and robust recruitment practices were used to ensure all staff were suitable to deliver care. People’s medicines were stored, administered and recorded appropriately and good hygiene practices were in place.

People had their needs assessed and staff were trained to meet people’s assessed needs. Staff were supervised and their performances were appraised by the registered manager. People continued to be treated in line with the principles of the Mental Capacity Act 2005. People had access to healthcare services and were supported to eat well and drink plenty.

People and staff shared positive relationships which had lasted for many years. People were supported with kindness and compassion when other residents passed away. Staff treated people with dignity and respect and supported them to maintain relationships.

Staff delivered personalised care and support. People engaged in a wide range of meaningful activities and their communication needs were supported. A complaints procedure was available in an easy to read format and the registered manager responded to complaints in a timely manner.

The service was well-led. People and staff felt supported by the registered manager and the wider provider organisation. There was an open culture and supportive atmosphere at the service. The quality of the service people received was subject to on-going checks and audits and the manager involved other agencies when required to ensure people’s needs were met.

Budge Lane is a six bedded residential care home for adults with learning disabilities, autism and poor mobility. At the time of our inspection, there were five people living at the home. The service had a manager who had been in place for three weeks at the time of this inspection. He told us he was in the process of registering with the Care Quality Commission (CQC). We saw written evidence of his application. 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 and their relatives told us that they felt safe living in the home and when they received care and support from staff. Staff were knowledgeable in recognising signs of potential abuse and understood the relevant reporting procedures. Assessments were completed to assess any risks to people and to the staff who supported them. Appropriate guidance was in place for staff to follow to help keep people safe. There were other systems in place to protect people from the risk of possible harm. There were risk assessments in place to do with the environment and equipment to provide guidance to staff on how risks could be managed and minimised where possible.

People’s needs had been assessed and care plans included detailed information relating to their individual needs. Care plans were personalised and demonstrated people’s preferences, and choices. People’s care and support packages were amended as necessary to meet their changing needs.

There were sufficient numbers of staff available to meet people’s individual support and care needs. There were safe staff recruitment practices in place and appropriate recruitment checks were conducted before staff started work ensuring people were supported by staff that were suitable for their role.

Medicines were managed, stored and administered safely and people were appropriately supported to take their medicines.

There were processes in place to ensure new staff were inducted into the home appropriately and we saw staff received regular training, supervision and annual appraisals. Staff were aware of the importance of gaining consent for the support they offered people. The manager and staff were able to demonstrate their understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation.

People were supported to maintain good health and had access to a range of health and social care professionals when required. People’s nutritional needs and preferences were met.

Staff demonstrated a good understanding of the needs of the people they supported and could describe peoples’ preferences as to how they liked to be supported. We observed staff speaking to, and treating people in a respectful and caring manner and interactions between people, their relatives and staff were relaxed and friendly.

People received care and treatment in accordance with their identified needs and wishes. Care plans contained information about people’s history, choices and preferences, preferred activities and people’s ability to communicate. Staff respected people’s privacy and dignity. People and their relatives told us they were made welcome in the home and they enjoyed the social events they were invited to attend.

Assessment and care planning were of a good standard. Where ever possible people were involved in planning their care and where this was not possible people’s relatives were engaged in this process. Care files were up to date and person centred. Care was reviewed by the staff team and by other professionals.

People in the house were encouraged and supported to join in with a range of activities in the home and in the community. People went to local clubs where events such as “tea dances” were held. Others went swimming and one person went to church every week.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the complaints policy.

Walsingham had a detailed quality monitoring system in place. There was also other appropriate auditing monitoring systems in place that helped with quality in the service. The manager and the staff were approachable and fully engaged with providing good quality care for people who used the service.

We found that people received effective and safe care and support from staff that were familiar with people's individual needs and preferences. People were provided with a choice of suitable food and drinks. Plans and health protocols were in place, where required, for those people who needed support to maintain adequate nutrition and hydration levels. The service worked closely and effectively with a wide range of other agencies and professionals.

We saw evidence that regular checks were made of equipment at the service and the staff we spoke with said that there was no shortage of equipment.

There were sufficient staff to meet the needs of people at the service. We learned that three of the people at the service had been supported by staff to have a holiday recently. We saw that there were procedures to deal with complaints and an easy read guide displayed in the office.

For the people that we were not able to talk to we observed staff interaction. We saw that everyone had high levels of well being. There was a lot of interaction with staff, and a warm and friendliness between staff and people who use the service. Staff knew people who use the service well and could anticipate needs whilst giving options whenever they could.

Most of the communal areas had recently been redecorated making the rooms more comfortable and homely.