Crownwise Limited - Streatham Common South

Crownwise Limited - Streatham Common South is a care home that provides care and support for up to 7 people. At the time of our inspection there were 6 people using the service including older people, and those with a physical disability or mental health challenges. The care home accommodates people in one building.

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

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.

People, and staff thought that Crownwise Limited - Streatham Common South was a safe place for them to live and work. Risks to people were regularly assessed, reviewed and this meant people could take acceptable risks, enjoy their lives and live safely. Accidents, incidents, and safeguarding concerns were reported, investigated and recorded. There were enough suitably recruited staff to meet people’s needs. Staff safely administered medicines and prompted people to take them. If required staff used Personal Protection Equipment (PPE) effectively, safely, and the infection prevention and control policy was up to date.

People and their relatives, and healthcare professionals told us effective care was given, people were not subject to discrimination and their equality and diversity needs were met. Staff were well trained, and supervised. People and their relatives thought the care staff provided was good and met people’s needs. Staff encouraged people to discuss their health needs, any changes to them, and concerns were passed on to the management and appropriate health care professionals. This included any possible change to services if people’s needs changed. People were protected by staff from nutrition and hydration risks and they were encouraged to choose healthy food options, and balanced diets whilst meeting their likes, dislikes and preferences.

People received care and support from staff in a friendly way and attention was paid to small details that made all the difference. People felt respected and staff acknowledged their privacy, dignity, and confidentiality. They were encouraged and supported to be independent and do things for themselves. This improved their quality of life by promoting their self-worth. Staff cared about people, and were compassionate, and passionate about the service they provided.

The provider was responsive to people’s support needs which were assessed, reviewed, and care plans were in place that included any communication needs. People were provided by staff with person-centred care, and they had choices, and were encouraged to follow their routines, interests and maintain contact with relatives, and friends. They were also supported to interact with others living at the home so that social isolation was minimal. People and their relatives were given appropriate, easy to understand information about the home to make their own decisions regarding whether they wished to live there. Complaints were recorded and investigated.

The home had management and leadership that was visible with an open, positive, and honest culture. The provider’s vision and values were clearly set out, understood by staff and they followed them. Areas of responsibility and accountability were identified for management, and staff and a good service was maintained and regularly reviewed. There were thorough audits, and records were kept up to date. Wherever possible community links and working partnerships were established and maintained to further minimise social isolation. The provider met Care Quality Commission (CQC) registration requirements. Healthcare professionals told us the service was well managed and met people’s needs in a professional, open and friendly way.

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

Rating at the last inspection

The last rating for this service was Good (published 16 February 2018).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

The overall rating for the service has remained Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Crownwise Limited - Streatham Common South on our website at www.cqc.org.uk.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Crownwise Limited - Streatham Common South is a residential care home providing personal care to up to 6 people. The service provides support to people with mental health conditions. At the time of our inspection there were 6 people using the service.

Care Homes

Crownwise Limited - Streatham Common South accommodates 6 people in one adapted building.

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

People were safe at the home. One person told us, “I am happy here.” Staff knew how to protect people from the risk of harm. Risks to people were assessed, reviewed regularly and managed. Staff understood their responsibilities and the provider’s safeguarding procedures in relation to raising concerns about people’s well-being.

Staff understood people's health conditions and how these posed risks to their day to day living. The registered manager worked closely with other health and social care professionals to discuss concerns and managing risks to each person using the service. Staff received additional training and support to ensure they supported people to live safely.

The registered manager undertook quality assurance checks on the standard of care provided. Shortfalls were identified and resolved in a timely manner. Staff were encouraged to learn from incidents and to improve their practice.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

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.

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

Rating at last inspection

The last rating for this service was good date last report (published 17/02/2018).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service had been missing from the service. The information shared with CQC about the incident indicated potential concerns about the management of risk of self-neglect. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the well-led section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Crownwise Limited - Streatham Common South on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the time of inspection there were four people living at the service which is located on the ground and basement floors of a detached house.

We found the following examples of good practice.

The provider had appropriate arrangements in place to reduce the risk of infection. A safe visiting procedure was in place. People were tested for COVID-19 before their admission and after their arrival to reduce risk of infection. People who use the service and staff and residents were tested regularly for COVID-19. The home was clean and hygienic throughout. Staff followed enhanced cleaning schedules to ensure specific areas identified as high risk of transmission of the virus, such as light switches and other touch points, were cleaned several times per day. There was enough Personal Protective Equipment (PPE) available at the home. We observed staff using and disposing of PPE safely and in line with national guidance. Staff had received appropriate infection prevention and control training to manage Covid-19. This included donning and doffing (putting on and taking off) of PPE. Staff worked closely with people who use the service to understand the impact of Covid-19 and how to keep themselves safe. The registered manager told us they received good support from the provider organisation, the local authority and the Clinical Commissioning Group. Staff told us they had received emotional and practical support to assist them through the difficulties of the COVID-19 outbreak. The home’s infection prevention and control policy and risk assessments had been updated relating to COVID-19. The provider had assessed and mitigated infection risks to staff working at the care home, including staff in high risk groups.

Further information is in the detailed findings below.

Crownwise Limited - Streatham Common South 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.

Crownwise Limited - Streatham Common South is a care home for six people with mental health needs. At the time of inspection there were five people living at the service which is located on the ground and basement floors of a detached house.

At the last inspection the service was rated Good, at this inspection we found the service remained Good.

The service had a registered manager in place. 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 followed adult safeguarding procedures to support people from potential harm and abuse. Fire safety instructions and equipment were available for staff to use in the event of fire. There were enough staff to support people with their care needs. People received their medicines in line with good practice. Staff made appropriate records to monitor the incidents and accidents occurring. Infection control procedures were in place and followed by staff to prevent infections. However, we found the communal bathrooms requiring cleansing.

Staff supported people to manage risks around their daily living. However, some risk assessments were not in place to ensure that people were safe to take part in activities of their choice. We made a recommendation about this.

Staff followed the service’s policies and procedures to ensure people’s wellbeing. Staff regularly attended training courses to support them in their roles and responsibilities. People’s nutritional needs were assessed and people made choices about what and where they wanted to eat. Staff supported people access health care professionals who monitored and maintained their health needs. People lived in the premises that met their care and support needs. Person centred assessments were carried out when people were first referred to the service. 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.

Staff were aware of what was important to people. People’s views were listened to and people made choices about the activities and social events they wanted to take part in. Staff were respectful towards people’s care and support needs. People were treated with dignity and staff encouraged people’s privacy. Staff monitored people’s progress in learning new skills to increase their independence.

Staff followed people’s care plans to meet their individual needs. People were involved in planning their care and support needs. Regular group and one to one meetings were facilitated to gather people’s views and make decisions on the care they wanted to receive. People and their relatives were provided with opportunities to share their experiences and to provide feedback about the service.

People and their relatives told us the management team was approachable and available to speak to when needed. Staff received support from the registered manager to carry out their duties as required. They were involved in the running of the service and were well informed about the service’s activities. Staff were encouraged to learn new skills in their role. People’s care records were suitably maintained and audited as necessary. The service worked in partnership with other agencies to provide people with person centred care.

People had a staff member allocated as their key worker who regularly reviewed their care to ensure it met their needs. Staff told us that people were supported to make their own decisions and they worked with people on implementing their care plans, for example, encouraging them to engage in activities.

Appropriate arrangements were in place for the cleaning of the home environment and weekly health and safety audits which included a cleaning check, were carried out by staff. People told us they were supported in doing their washing and cleaning their rooms. There was an infection control policy in place.

The provider had an effective staff recruitment and selection process in place and we found that staff had the appropriate qualifications and experience to meet the needs of people in the home.

The provider had an effective recording system in place. People's records were accurate and fit for purpose and stored securely. Staff records were well maintained and stored in a locked cabinet.

We found that people had been involved in the planning of their care and the running of the service.

We found that people had been supported to maintain their physical and mental health and to develop their independent living skills and opportunities for community involvement.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were enough qualified, skilled and experienced staff to meet people's needs.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.