Archived: Disabilities Trust - 128 Beech Hill

We found the following examples of good practice.

The environment had been adapted to encourage social distancing. Communal areas were arranged to enable appropriate spacing between people.

The home was clean and tidy. Cleanliness and good infection control was maintained through the home. This included regular cleaning of areas which were frequently touched, for example door handles.

Staff were seen to be wearing appropriate personal protective equipment (PPE), and there was a plentiful supply evident throughout the home.

The provider had policies and procedures for infection prevention and control, which were understood and followed by staff. All staff had received additional training in infection prevention and control and had completed regular competency checks.

Staff and people took part in a COVID-19 testing regime. The test results were clearly displayed in a folder which was checked regularly by staff to ensure the frequency of tests and results were monitored and correct.

This inspection took place on the 15th May 2017 and was announced. This was because the service is a small service and we needed to make sure people would be in when we arrived. It was also so that the provider had time to arrange for sufficient numbers of staff to be deployed on the day to facilitate the inspection without disrupting people's daily routines.

At the last inspection on 5 May 2015 the service was rated Good.

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.

The service had an extremely positive culture that was exceptionally person-centred, open, inclusive and empowering. Staff went the extra mile to share information with people and provide explanations in a way that empowered them to make informed decisions and become more independent. One person told us “I make my own choices, I decide what I do”. There was a strong emphasis on team work and communication sharing. The registered manager and staff had a ‘can do’ attitude and were solution focussed. One relative told us “Staff are brilliant, they have good ideas, useful one’s, they have a lot of empathy and get things done. I’ve no concerns”.

The service was exceptionally well led. Staff were enthusiastic and happy in their work. They felt supported within their roles and held the management team in high regard, describing a management approach, where managers were always available to discuss suggestions and address problems or concerns. A social care professional told us “It’s very, very well organised. They are excellent and go beyond what they’re supposed to do”. A staff member told us “I love working here. I’ve learnt a lot and developed my career. (Line manager’s name) is very approachable the management is good”.

Staff had a common aim and purpose to achieve positive outcomes for people. They excelled at providing consistency which had a positive impact on people’s wellbeing, reduced their anxiety levels and provided stability. A relative told us “Consistency is the key and they do that well”. A staff member told us “We work well as a team, it works like clockwork. We provide consistent support; this is a very settled house”. Another staff member commented “I love it here, really good continuity of care and a rewarding job and great support”.

People mattered and the care was exceptionally personalised. Each person had a trusted member of staff, known as a keyworker, who took a lead role in each person's care and wellbeing. They continuously looked for ways to ensure people had positive experiences and led fulfilling lives. Staff knew about people's lives, their interests and talents and encouraged them to become more independent and try new things.

Information was shared and explanations given to people to help them form their own opinions and make their own choices and decisions. People were fully involved in every aspect of the day to day running of the service from cooking and cleaning to decorating and completing safety checks.

The management team were approachable and flexible and embraced staff ideas and suggestions. Relatives and staff told us they were happy to raise any concerns and that management and staff worked well together.

People and their relatives were involved in the planning and reviewing of their care and discussed and shaped the activities they wished to take part in. One person told us “I make my own choices, I decide”. People were supported to take part in a wide range of activities that were meaningful to them and which they enjoyed. A relative told us “It’s great they’ve got (person’s name) making things, it’s an excellent achievement”. People had been supported to create scrap books to document their achievements, holidays and trips out.

The staff we spoke with were aware of their role in safeguarding people from abuse and neglect and had received appropriate training. We saw risk assessments had been devised to help minimise and monitor risk, while encouraging people to be as independent as possible. Staff were very aware of the particular risks associated with each person’s individual needs and behaviour.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

Recruitment practices were robust and new staff received and induction to the service which included shadowing experienced staff before working unsupervised. Staff received the training and support they needed to undertake their role.

The registered manager was aware of their legal responsibilities and kept up to date with good practice. They had formed links with the local community such as schools and colleges where they had given presentations to raise awareness of supporting people with autism. Accident and incidents had been recorded and monitored to identify trends and themes. Records had been audited and were gaps had been identified action had been taken to rectify this.

Each person had a set of individual plans detailing their care, support, healthcare needs and any risks that staff needed to be aware of. The service had a robust medication protocol in place at the service and this ensured that the people using the service were having their medication at time they needed in a safe way. People using the service told us that they enjoyed preparing the evening meal and look forward to their take away meal on Sunday's. We saw evidence of mandatory checks that had been carried out and maintenance schedule in place to ensure a safe environment for people using the service. There was a good level of hygiene around the home and we were told by staff that most of the people would clean their own room as part of their daily activity.

We looked at the training program in place and found that in addition to mandatory training, staff had to attend specialist training. They were training on Mental Capacity Act, Deprivation of Liberty Safeguards, autism, epilepsy and makaton. This ensured that people using the service were safe and their health and welfare needs were met by competent staff.

There were four people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and four members of staff. People living at the home said they liked the home and felt safe.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and one person told us how they had chosen the colour of paint used to decorate their room. Rooms we looked at were personalised.

We saw people being addressed in a respectful manner. We looked at peoples individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded. We saw that monthly audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service.