Archived: The Old Bakery

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.

Rating at last inspection

At our last inspection on 6 March 2016, we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People were supported by caring and compassionate staff. They supported and involved people to express their views, and acted on them. People were treated with dignity and respect and care was organised around people's individual needs. Staff supported people to be as independent as possible, and upheld their rights to privacy, dignity and a family life.

People were protected because staff knew how to recognise signs of potential abuse and how to report suspected abuse. People's risks were assessed and actions taken to reduce them as much as possible.

People received care and support at a time convenient for them because staffing levels were sufficient. Staff had been safely recruited to meet people's needs.

People received effective care from skilled and experienced staff, who had regular training and supervision.

People received personalised care from staff who knew what mattered to them. They were encouraged to socialise and pursue their interests and hobbies. There was a complaints process, although no complaints had been received.

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

People were supported to lead a healthy lifestyle and have access to healthcare services. Staff recognised any deterioration in people's health, sought professional advice appropriately and followed it. People received their medicines on time and in a safe way.

The service was well led by the provider and registered manager. The culture was open and promoted person centred values. People, relatives and staff views were sought and taken into account in how the service was run. The provider had systems in place to monitor the quality of care provided. They made continuous changes and improvements in response to their findings.

Further information is in the detailed findings below.

The Old Bakery is registered to provide accommodation with personal care for up to four people with learning disabilities. Three people lived at the service when we visited.

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.

Staff were discreet when supporting people with personal care, respected people’s choices and

acted in accordance with each person’s wishes and preferences.

Staff supported people to improve their independence and lead busy and fulfilling lives. This included increasing their skills and confidence through supporting people to be involved in their local community.

People had their needs met by staff who had an in-depth knowledge of their communication, care and health needs. The service had a regular training programme to ensure staff had the right knowledge and skills.

People’s care records were detailed, easy to read and understand about how to support each person. Care plans had been developed with the person, where possible, and those close to them . Staff used a variety of methods to support people to communicate and provide each person the information they needed to make choices. For example, using pictures and symbols in an easy read format.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, relatives and health and social care professionals were consulted and involved in decision making about people in their 'best interest’.

People were supported to improve their health through good nutrition. Staff encouraged people to

eat a well-balanced diet and make healthy eating choices. People had become more active, two people had been supported to lose some weight. This had improved their wellbeing and helped them to maintain their mobility. Staff worked closely with local healthcare professionals such as the GP, community nurse and members of the local learning disability team. Health professionals said staff were proactive and sought advice appropriately about people’s health needs and followed that advice.

Staff had completed safeguarding training. They demonstrated a good awareness of the signs of potential abuse and knew how to report concerns. Detailed risk assessments were in place for each person with clear actions identified to reduce risks as much as possible. People received their medicines safely and on time. Accidents and incidents were reported and included measures to reduce risks for people.

The provider had a written complaints policy and procedure, although no complaints were received. Information about how to raise concerns or complaints was provided in a suitable format for people. People and a relative said they wouldn’t hesitate to speak to the registered manager about any problems.

The culture at the service was open, and promoted person-centred values. Staff worked proactively with other professionals for the benefit of the people they supported. The provider had a range of quality monitoring arrangements in place. These included audits of care records and medicines management and regular health and safety checks. They made continuous improvements in response to their findings.

Three people were living at the home when we visited. We did not seek people's views about the safety and suitability of the premises. We spoke with the registered manager and a senior care worker and looked at documents related to the premises. We saw that environmental risk assessments had been updated and regular health and safety checks were carried out. These improvements meant people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

At the inspection, we also identified that the registered manager was no longer in day to day charge of the home and had delegated that role to a senior care worker. We spoke with the provider and advised them of the need to register a new manager.

We saw that people were able to make day to day choices about how they spent their day and about what activities they wished to undertake. Where people lacked capacity, we saw that families and health and social care professionals were consulted about decisions in their 'best interest'.

One person said 'I am very happy here'. Another person's relative said, 'we think it's quite impressive, x has been very well and seems happy'. The health care professional we spoke with told they thought people were being well supported and had their care needs met. They also commented about how recently, people at the home had more opportunities to go out in the community which they enjoyed.

Staff were very caring and compassionate and interacted well with people. Staff were knowledgeable about people's care needs how to support people. Care records also included detailed information about people needs and how to manage any risks. The home was kept clean and was adequately maintained. However, we identified some improvements were needed in relation to undertaking regular health and safety checks, including fire safety.

The provider was compliant with four of the five outcomes we inspected.