Walsingham Support - Griffin Close

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.

The home had 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.

Walsingham Support - Lindisfarne provides residential care for up to six people with a learning disability. The property is in a residential area of Frizington and is near to all the amenities of the area. The building is a purpose built bungalow with six single bedrooms and suitable shared areas. The home has its own transport.

People who lived in the home were unable to verbalise their views on how safe they felt but we judged that they were relaxed in their environment and that they had good relationships with members of the staff team. Staff were suitably trained in safeguarding and there had been no incidents of concern reported. Accidents and incidents were reported and managed appropriately.

Staff were suitably recruited, inducted and trained so that they could develop in their role. Staff received suitable training to undertake the work they did. Staffing levels met the needs of people in the home. The organisation had disciplinary processes in place and there had been no staff issues in Lindisfarne.

Medicines were managed well with good audits of the medicines held for people. The staff team did not rely on sedative medicines and every person in the home had their medicines reviewed regularly.

Infection control measures were in place and the home was clean and orderly on the day of the visit.

The staff team understood their responsibilities in relation to supporting people who lacked capacity. The manager made sure that she worked within the Mental Capacity Act 2005. Staff worked with people to ascertain their wishes and to gain consent.

The people in the house were encouraged to eat healthily and the staff team make meals from fresh ingredients. Good nutritional planning was in place.

We observed a caring team of staff who focussed on people's strengths. Staff were trained in the values of the organisation and they displayed these in the way they worked. The staff we spoke to had a good understanding of concepts like dignity, respect, equality and diversity.

People in the home had an advocate and the staff team supported people to be as independent as possible. The staff were careful about confidentiality and privacy. People were encouraged to make choices where possible. The service had a suitable complaints procedure and there had been no complaints received for some time.

Assessment and care planning were of a good standard. 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 activities in the home. They also went out to local clubs and events. Two people went to church every week. Some people went to a day centre and everyone went out of the house on a regular basis. There was a range of activities that people joined in with. These included sports and outdoor activities. People also went out shopping and for meals.

The organisation had a detailed quality monitoring system in place. The registered manager had also introduced supplementary monitoring that helped with quality in the service. There were improvement plans in place so that any issues could be dealt with swiftly.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

The staff in this service were observed working patiently and sensitively with the people who lived in the home. Staff had received training on person centred thinking, safeguarding, restraint and the management of behaviours that might challenge.

Staff received suitable training and new members of staff had the appropriate checks before they had access to people in the service.

We had evidence to show that this service made appropriate safeguarding referrals. The management team were aware of their responsibilities.

Medication management was under constant review. We had evidence to show that people were not given unnecessary medication.

Is the service effective?

We observed staff delivering care and services appropriately. We learned that staff completed mandatory training. Staff had received specialised training to understand the needs of the people living in the home.

The people who lived in the home had been assessed in terms of their mental capacity. There were detailed care plans in place. These plans included, where appropriate, guidance on managing behaviours that might challenge.

We observed people being given options and choices. For example we saw people being offered choices in what they wanted to eat and drink. We also saw good nutritional planning in place for people who found this problematic.

There were suitable arrangements in place for people to see health care professionals. This included visits from psychiatrists, GPs, community nurses and healthcare specialists.

Is the service caring?

We observed kind, patient and sensitive care delivery on the day of our inspection. We saw that people who lived in the home responded positively to the staff on duty. Staff understood people's needs and were aware of their life story.

The people in the service had access to advocacy services, care plans were in an "easy read" format. Social workers, health care professionals and family members were involved in the planning of care. Care plans, risk assessments and risk management plans were in place. People were supported so that their privacy and dignity was maintained.

Is the service responsive?

During our inspection we had evidence to show that people who lived in Lindisfarne were supported and encouraged to be part of the wider community.

Care plans were detailed and person centred. When people lacked capacity to make decisions multi-disciplinary meetings were held with professionals and other relevant parties. Relatives and friends were encouraged to visit and people in the home went to stay with relatives.

Is the service well-led?

The registered manager for the service had suitable experience and training. She ensured that the quality monitoring systems in the home ran efficiently. The senior officers of the organisation visited the home and were aware of how the service was operating.

Staff in the home told us they worked well as a team under the leadership of the manager. Staff involved people in the home in day-to day decisions.

People in the service received suitable levels of personal and health care and were involved in a range of interesting and appropriate activities.

We checked on the food provided in the home and had plenty of evidence to show that people got healthy meals and were helped and supported to get enough to eat and drink.

On the day of the visit the home was clean, warm, tidy and homely. There was good evidence to show that the environment was safe and appropriate for the people who lived there.

There were good systems in place to make sure that people got the quality of care and services they needed. Representatives of the company visited to make checks on quality issues.

There had been no complaints about the home but there were suitable arrangements in place to support anyone who wished to complain.