Ferriby Lane

Ferriby Lane is a large semi detached property with gardens to the front and rear. It is set on a residential street and is close to local shops, amenities and public transport. Ferriby Lane is registered to provide care and accommodation for up to 9 adults with learning disabilities, autism and associated complex needs. At the time of our inspection 4 people were living there. A self-contained flat is also provided within the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Everyone we spoke with was positive about Ferriby Lane. We observed there was a homely atmosphere and people and staff had developed good and caring relationships built on trust and mutual respect. The good outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; people's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The provider had systems in place to safeguard people from abuse. Staff understood how to keep people safe. They recognised and reported any safeguarding concerns. Required risk assessments were in place and medicines were managed safely. Accidents and incidents were monitored to identify and address any patterns or trends to mitigate risks.

Staff were recruited safely and had the appropriate skills and knowledge to deliver care and support to people in a person-centred way.

Care plans contained relevant information about how to meet people's needs and were regularly reviewed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems supported this practice. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

The environment was warm, welcoming, clean and free from malodours. People’s rooms were personalised.

There was a wide range of opportunities for people to engage in activities, attend college courses and follow hobbies and interests. Visitors were welcomed.

People were positive about the staff and told us their privacy and dignity were promoted. Preferences and choices were considered and reflected within records.

People had access to a varied and balanced diet. Where required, staff monitored people’s weights and worked with healthcare professionals to make sure people received medical attention when needed.

People and staff spoke positively about the registered manager. They felt able to raise concerns and were confident these would be addressed. Staff told us they were well supported by the registered manager and management team.

Checks of safety and quality were carried out to ensure people were protected from harm. Work took place to support the continuous improvement of the service and the registered manager was keen to make changes that would impact positively on people's lives.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 6 July 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Ferriby Lane 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. Ferriby Lane accommodates people in a semi-detached house with four bedrooms. In addition, there is another self-contained flat next to the property with one bedroom. At the time of the inspection, the service was providing support to five adults with a learning disability and/ or autism.

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 was a registered manager at the service. 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.

This was a comprehensive inspection that looked at whether the service was safe, effective, caring, responsive and well-led.

At our last inspection, we rated the service as Good. At this inspection we found the service Requires Improvement.

People were supported in a clean and accessible environment that was suitable for people’s needs, although there were some repairs that were required to maintain the property. We discussed these with the registered manager who was putting a plan in place to address these. The service identified and responded to risks in the environment, however not all risks had been identified. We found that only one fire extinguisher had a protective case put on following an incident. This was addressed by the registered manager following the inspection, so all fire extinguishers had a protective case.

The service’s electrical safety certificate had urgent recommendations which could have been potentially dangerous, these had not been addressed. Following the inspection the registered manager informed the electrics were planned to be retested and work carried out week commencing 9 July 2018. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this full version report.

People were supported to receive their medicines as prescribed. Staff were recruited safely and supported in their roles. People were supported by well trained and knowledgeable staff. They knew the people living at the service well and were skilled in delivering effective care and support. Staff were knowledgeable about safeguarding and how to respond to any concerns to keep people safe. Staff worked closely with professionals to ensure they met people's health and well-being needs.

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 make their own decisions where possible and consent was gained before care or support was provided. For those that lacked capacity to make particular decisions, staff followed the principles of the Mental Capacity Act 2005 and acted in people’s best interest.

People who lack mental capacity to consent to arrangements for necessary care or treatment can only be deprived of their liberty when this is in their best interests and legally authorised under the MCA. The procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of the responsibility to apply for DoLS for people living at the service and they had made relevant applications.

Staff were caring and understood the importance of confidentiality and respected people’s privacy. People were supported to be independent and were treated with dignity and respect. Staff supported people to challenge discrimination and promoted equality and diversity.

Staff were responsive to people’s needs. Care plans were detailed and person-centred so information was available to staff. People were supported to maintain relationships with their family and develop new and existing relationships. They were supported to pursue their hobbies and interests and to access social and leisure activities within the community. Support was also available to people to gain skills through volunteering and employment.

A complaints policy was in place and people told us they knew how to make a complaint if needed. There was an open culture and communication was good between staff and management, as well as people using the service. Ongoing feedback was gained from people using the service informally, daily. The registered manager was approachable and staff felt supported in their role.

Systems were in place to assess and monitor the quality of the service and help drive improvements. Audits were completed by the registered manager, which helped to identify any errors and supported learning and development within the service. However, systems were not always effective in identifying and addressing shortfalls in the maintenance of the building to address any safety issues, in timely manner.

Further information is in the detailed findings below.

The service is registered to provide accommodation and personal care for up to four people with a learning disability and autistic spectrum disorder. There were four people living at the service on the day of our inspection.

Accommodation is provided in a detached two storey building with four large bedrooms, a spacious lounge, a central kitchen dining room, laundry, two offices and self-contained annexe. Three bathrooms are available in the house and the annexe has a bathroom for sole use of the person living there. The service has a large garden with a summer house and some designated off street parking to the front of the building.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. There was a manager registered with the Care Quality Commission (CQC); they had been registered since May 2011.

We undertook this unannounced inspection took place on 15 and 18 January 2016. At the last inspection in January 2014 the registered provider was compliant in all areas assessed.

The people who used the service had complex needs and were not all able to tell us fully their experiences. We used a Short Observational Framework for Inspection (SOFI) to help us understand the experiences of the people who used the service. SOFI is a way of observing care to help us understand people who were unable to speak with us. We observed people being treated with dignity and respect and enjoying the interaction with staff. Staff knew how to communicate with people and involve them in how they were supported and cared for.

We found the service required improvements to one of the five key areas we inspected. We noted some areas that required attention to ensure effective maintenance of the building and these were mentioned to the registered provider, the registered manager and acting manager to address.

Relatives felt every opportunity was provided to safely maximise people’s independence. They also told us communication with the service was very good.

The service developed and maintained strong links with external organisations and within the local community. There was a strong emphasis on key principles of care such as compassion, inclusion, respect, dignity and enablement.

The safety of people who used the service was taken very seriously and managers and staff were well aware of their responsibility to protect people’s health and wellbeing. People we spoke with told us they felt safe living in the home.

We found people’s care plans were written in a way that clearly described their care, treatment and support needs. These were regularly evaluated, reviewed and updated. The care plan format was easy for people to understand by the use of pictures and symbols. We saw evidence to demonstrate that people and their relatives were involved in their care planning.

The staff understood the procedures they needed to follow to ensure people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We found staff were recruited safely and there was sufficient staff to support people. Staff received training in how to safeguard people from the risk of harm and abuse. They knew what to do if they had concerns. There were policies and procedures available to guide them.

People who used the service had assessments of their needs undertaken which identified any potential risks to their safety. Staff had read risk assessments and they were aware of their responsibilities and how to support people in order to minimise risk.

We found staff had a caring and professional approach and found ways to promote people’s independence, privacy and dignity. Staff provided information to people and included them in decisions about their support and care.

People’s nutritional needs were met and people were supported to shop for food supplies and were assisted to prepare meals. We saw staff monitored people’s health and responded quickly to any concerns. People received their medicines as prescribed and had access to a range of professionals for advice, treatment and support.

People participated in a range of vocational, educational and personal development programmes at the organisation’s college facility. They also accessed a range of community facilities and completed activities with the service. They were encouraged to follow and develop social interests and be active and healthy and to go on holiday. Staff also supported people to maintain relationships with their families and friends.

Staff had received training in legislation such as the Mental Capacity Act 2005, Deprivation of Liberty Safeguards and the Mental Health Act 1983. They were aware of the need to gain consent when delivering care and support and what to do if people lacked capacity to agree to it. When people were assessed by staff as not having the capacity to make their own decisions, meetings were held with relevant others to discuss options and make decisions in the person’s best interest.

Staff had access to induction, training, supervision and appraisal which supported them to feel skilled and confident when providing care to people. This included training considered essential by the registered provider and also specific training to meet the needs of people they supported.

There was a complaints process and information provided to people who used the service and staff in how to raise concerns directly with senior managers.

Medicines were ordered, stored, administered and disposed of safely. Training records showed staff had received training in the safe handling and administration of medicines.

We spoke with two people who were able to communicate with us. They told us they were happy with the service and their views were sought by staff. They also knew how to make a complaint, if they had one.

We saw the complaints procedure was available to people who used and visited the service. Staff told us how they would support people to raise concerns if they could not do so themselves.

People were happy with the care they received and told us they saw a range of health professionals for advice and treatment. We found that staff helped to make sure health and social care was well coordinated and provided by a range of professionals.

We found that the numbers of staff provided was based on people's individual need and regularly reviewed to ensure that there was adequate support available to meet the needs of the people who used the service.

We found people were able to express their views about the service via daily activities of living, surveys and meetings. Audits and checks were completed to monitor quality and where further action was required, this was put in place in order to improve services.

During the inspection we spoke to six members of staff, a relative and one person that used the service.

People told us they were happy with the care and support that they received. People's comments included: "I do like it here.' and 'They do listen to me."

One person told us about the weekly meetings in place to decide menus, leisure activities and allocation of tasks which promoted independent living skills: "We talk about what we want to do and if anything is upsetting us, so they can help to sort it out.'

Relatives spoke positively about their care and support, comments included: "We are very happy with everything, we are in touch regularly and aware of what is going on. We also have the opportunity to ring and discuss any issues when they are at home and their key worker is always happy to offer advice.'