Trabel

Trabel is a residential care home providing accommodation and personal care for up to 12 people. The service provides support to people with learning disabilities or autistic spectrum disorder. At the time of our inspection there were 12 people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People received the care and support they needed to be safe. People had a choice about their living environment and were able to personalise their rooms. Staff communicated with people in a way that met their needs. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome.

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 supported people to access health and social care support in the community.

Right Care:

Staff understood how to protect people from poor care and abuse. Care was provided in line with people’s preferences and choices. Staff had training on how to recognise and report abuse. People's care and support plans reflected their needs. Care records contained risk assessments with clear guidance for staff to follow. The service worked together with healthcare professionals to ensure people's needs could be met.

Right Culture:

The registered manager promoted a person-centred environment and people experienced good outcomes. People received compassionate and empowering care that was tailored to their needs. Staff understood people's needs. People and those important to them were involved in planning their care. staff had completed relevant training required for their role.

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

Rating at last inspection

At the last inspection we rated this service as good (published on 1 November 2017).

At our last inspection we recommended that appropriate records were maintained in relation to the Mental Capacity Act. At this inspection we found the provider had acted on the recommendation and had made improvements.

Why we inspected

We inspected due to the length of time since the last inspection.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well Led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Trabel on our website at www.cqc.org.uk.

Follow up

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

Trabel is a care home for twelve people with learning disabilities and behaviour that may challenge others. The home is arranged over three floors and includes two independently staffed flats with one bedroom and two bedrooms. One person is supported in a self-contained bungalow in the grounds. The home is located just outside Huddersfield Town centre.

There was a registered manager in post who had been registered since October 2010. 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 had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Safe recruitment and selection processes were in place and medicines were managed in a safe way for people.

There were enough staff to provide a good level of interaction. Staff had received an induction, supervision, appraisal and role specific training. This ensured they had the knowledge and skills to support the people who lived there.

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, although some best interest processes had not been evidenced. We recommend the registered provider consult best practice in this area to ensure mental capacity assessments and best interest processes are always recorded when decisions need to be made on behalf of people who may lack capacity.

People were supported to eat a balanced diet and meals were planned around their tastes and preferences.

Positive relationships between staff and people who lived at Trabel were evident. Staff were caring and supported people in a way that maintained their dignity, privacy and diverse needs.

People were involved in arranging their support and staff facilitated this on a daily basis. People were supported to be as independent as possible throughout their daily lives.

Care records contained detailed information on how to support people and included measures to protect them from social isolation. People engaged in social activities which were person centred.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

People told us the service was well led. The registered manager and deputy manager were visible in the service and knew people’s needs.

People who used the service, their representatives and staff were asked for their views about the service and they were acted on.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard.

Trabel House is a care home for 12 people with learning disabilities and associated challenging behaviours. There were 12 people living in the home at the time of this inspection.

The service 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe from harm. Staff were aware of the different types of abuse people might experience and of their responsibility for recognising and reporting signs of abuse. Possible risks to the health and safety of people using the service were assessed and appropriate actions were taken to minimise any risks identified.

Robust staff recruitment processes were in place to ensure applicants were properly assessed as to their suitability for working with vulnerable people. There were sufficient staff to safely meet people’s needs and staffing was well organised to ensure people received appropriate levels of support.

We found some of the systems in place to ensure people received their medication safely were not effective and could have put people at risk. We recommended the service review its medication audit to ensure it was robust enough to identify any issues in relation to the safe administration of medication.

Staff had been provided with ongoing training and support to assist them in performing their role. Although we found supervisions were not always undertaken in line with the provider’s policy, staff we spoke with told us they felt well supported and had the necessary skills needed to care for people effectively.

The service worked within the principles of the Mental Capacity Act 2005 (MCA) to uphold people’s rights. Detailed information was held about how to communicate effectively with people in order to maximise their ability to provide their consent to care and treatment wherever possible.

People using the service were supported to meet their nutritional needs and to maintain good health through access to appropriate healthcare services.

Staff demonstrated a sensitive and caring manner in their interactions with people using the service. They were knowledgeable about people’s needs and how best to support people to be as independent as possible.

People and their relatives were involved in care planning and were actively encouraged to share their views and opinions of the service. People’s privacy and dignity was maintained.

Care plans were reviewed and updated on a regular basis to reflect changes in people’s needs. Input was sought from healthcare professionals to ensure people were receiving care and treatment which was appropriate for their needs. Care records were person-centred and provided staff with information about how to care for people in line with their individual preferences. People’s wishes and aspirations were clearly identified and they were supported to achieve these.

The service had appropriate systems in place for recording and responding to complaints and records showed complaints were taken seriously and thoroughly investigated.

Information was provided to people and their relatives about who to contact should they have any concerns. Staff we spoke with felt supported by the registered manager and were able to easily access support when they required it. The provider had a range of systems in place for monitoring and reviewing the service and action was taken to address areas for improvement.

We saw that interaction between staff and the people who used the service was respectful and often humorous. The staff we spoke with told us that that people enjoyed having a laugh. The home was welcoming and the people who used the service were very friendly and approachable.

We spoke with three members of staff and they all told us they enjoyed working at the home. They told us that the people who lived there were treated very well. One staff member told us 'It's like a little family here, we know people very well because they have lived here a long time'.

We looked at four care plans of people who used the service. We saw that they were comprehensive and reflected the needs of the individual. In addition to the care plans, we saw that there were risk assessment in place and these too had been reviewed and updated to reflect the changing needs of the individual.

We saw that staff received regular training which ensured they were kept up to date with their skills and knowledge. Staff told us they received regular supervision and had annual appraisals.

"I like baking"

"I can choose what I want to do"

"I'm happy"