Walsingham Support - Griffin Close

Updated 23 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 January 2018 and was unannounced. We returned on 22 January as an announced visit so that we could meet all five people in the home and to give feedback. The inspection was conducted by an adult social care inspector.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service, such as statutory notifications we had received from the registered provider. A statutory notification is information about important events which the service is required to send us by law. We also gained information from social workers, health care practitioners and commissioners of care at a regular meeting we have with them. We planned the inspection using this information. We used a planning tool to collate all this evidence prior to visiting the home.

Over two days we met all five people who lived in Lindisfarne. We observed them in their own home and we engaged with them by spending time with them and by talking to them. People in the service were living with profound learning disabilities and not everyone used speech as their main form of communication. Everyone was still able to make their wishes known and most people responded to questions. After the visits we spoke with two relatives who visit the home on a regular basis.

We read all five care files. These included risk assessments, care and support plans, hospital passports, moving and handling plans and nutritional planning. We looked at daily notes and communication records related to care delivery. We looked at records of food taken, nutritional planning and other charts that help staff record care delivery. We checked on the management of medicines.

Over the two days we met with the registered manager, her deputy, five support workers and the housekeeper. We read four staff files. These included information about recruitment, induction, training and development. We received information related to training delivered and to future training plans

We saw rosters, records relating to maintenance and to health and safety. We checked on food and fire safety records and we looked at some of the registered provider's policies and procedures. We saw records related to quality monitoring.

We walked around all areas of the home and checked on infection control measures, health and safety, catering and housekeeping arrangements.

Updated 23 February 2018

This was an unannounced inspection that took place on 19 January 2018 and we returned on 22 January to see two people who had not been in the home on 19 January 2018 and to give feedback. The service was rated as good at the last inspection in November 2015 and was not in breach of legislation.

Lindisfarne is a six bedroom bungalow situated in a residential area in the village of Frizington. It is within easy walking distance to village amenities. It can accommodate up to 6 people with a learning disability in single rooms. The home has suitable shared areas and an enclosed garden. People benefit from the home having its own transport. The home is operated by Walsingham who have other care homes in the area and throughout England.

Lindisfarne 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 home accommodates 6 people in one specially designed and 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.

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

The home had a suitably experienced and qualified 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. The registered manager was aware of current good practice and deployed and managed staff and resources to the satisfaction of the registered provider.

People in the home were protected from potential harm and abuse because staff understood their responsibilities and had received suitable training in safeguarding matters. The house was safe and secure and the registered manager had ensured that maintenance and improvement were on-going and that there was a suitable emergency plan in place.

Everyone in the home had a risk assessment that covered their care needs and risks around activities. There were suitable risk assessments in place regarding the building and the grounds. Accidents and incidents were minimal and suitable risk management was in place to lessen or prevent any accidents.

Staffing levels met the assessed needs of people in the service. The registered manager kept people's care and support needs reviewed and changed staffing levels when necessary.

Staff were appropriately recruited and Walsingham had suitable human resources policies and procedures in place. The organisation had grievance procedures and a confidential 'whistleblowing' line that staff could use if necessary.

Medicines were suitably managed with staff receiving training and checks on competence. People had regular reviews of medication so that they received optimum medicines support.

Staff were trained in prevention of infection. They understood how to use personal protective equipment. Improvements had been made to the environment which would help prevent cross infection. The house was warm, comfortable, clean and fresh on both days we inspected. We noted that improvements had been made to bathrooms and toilets and that decoration and replacement of furniture and fittings was on-going.

Staff received good levels of support through supervision, appraisal and checks on their competence. We saw that new staff had a thorough induction and then received both formal and informal supervision. The registered manager and the deputy manager worked with staff and helped them to deliver good levels of care and support. Records showed that the staff team discussed best practice issues in supervision and in team meetings as well as informally during their shifts.

The registered manager had a good understanding of the Mental Capacity Act 2005 and staff had received training on these matters. We saw good evidence that appropriate steps were taken to help people who found decision making problematic. There had been no incidents where restraint had been used but staff had received suitable training on behaviours that challenge and how to manage them.

People received good quality food that was home cooked in the service. People also went out for meals. Staff were able to support people who had difficulties managing a normal diet and could contact dieticians and other health care professionals if necessary. Regular checks were done to ensure people were well hydrated.

Staff gave people support and guidance; pre-empted the needs of people and helped people to feel calm and relaxed in the house. This was done with patience, humour and sensitivity and at the pace people needed.

Each person in the home had a care plan and a health care plan. These were of a high standard with suitable details in place for staff to deliver all aspects of care and support. They had all been rewritten in a simple format that was easy to use and were accessible for people. Easy read formats were also in use.

We saw that these plans had helped people to meet some of their personal goals and that this meant that people went out and were involved in the community. We also saw that one person had been supported to develop their speech by using some new technology and by staff working with them. We also learned of a person who had been supported to manage their own personal care. We saw that health care needs had been addressed through care planning and 'best interest' reviews. We also noted that the team were aware of people's changing levels of needs and dependency and that plans were in place to support people as they grew older.

Staff encouraged people to be part of the day to day life of the house and, where possible, people were involved in shopping and cooking, tidying and cleaning the house. People went out to village clubs, church and events. They also went further afield in the house (or their own) transport. People went on holiday and followed their own activities and hobbies.

We saw that in care planning and in the planning of activities the staff had thought deeply about the needs of people. This in itself posed challenges due to the complex needs that people were facing in their day to day life. We saw a number of examples where people had been supported to make considerable achievements. We also saw that the staff had wanted people to have experiences that they had never had before. We saw evidence of how much people had enjoyed the 'summer ball' and that this special event was to be repeated. Together these things we judged the service to be outstanding in responsive.

There had been no concerns or complaints about the service and people or their families had the right level of support and information to raise these if necessary.

We had evidence to show that good planning was in place if people had to go into hospital, were at end-of-life or if they had to move to a different service.

The registered provider had a suitable quality monitoring system and we saw evidence to show that this was in place. Senior officers of the organisation visited regularly to ensure that good standards were being met. We saw that improvements had been made due to the results of audits and questionnaires.