Disabilities Trust - 9 Twyford Lane

Updated 22 November 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by one inspector.

Service and service type:

Disabilities Trust - 9 Twyford Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to nine people in three adapted buildings.

The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection:

The provider was sent a provider information return to complete. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us.

During the inspection:

We spoke with three people who used the service and had discussions with four members of staff that included the registered manager, the assistant manager and two rehabilitation support workers. We reviewed a range of records. This included two people’s care and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection:

We carried out telephone interviews with two relatives of people using the service to gain their views about the service.

Updated 22 November 2019

About the service:

Disabilities Trust - 9 Twyford Lane is a residential care home which provides care and support to people with an acquired brain injury. It is registered to provide care for up to nine people. People were supported to live as independently as possible and the service was split into three individual houses all on one complex. Each house occupied up to three people. At the time of our inspection there were nine people living at the home.

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:

The staff and the management team were passionate about providing people with support that was based on their individual needs, goals and aspirations. As a result, their care was tailored to meet their exact needs.

The staff at 9 Twyford Lane were committed to making sure people lived fulfilling lives and were highly motivated with a 'can do' approach which meant they were able to achieve positive outcomes for people. Without exception, people spoke positively about their experience of the service and the successes they had been supported to achieve.

It was clear the culture within the service valued the uniqueness of all individuals who lived there. The service used person centred and innovative ways to provide people with the support they needed, based on best practice. People were fully supported to follow their interests and take part in social activities to achieve their aspirations and dreams.

The service took a key role in the local community and was actively involved in building further links. For example, people were supported to volunteer at a local food bank and one person volunteered at a dog rescue centre.

The complaints procedure which was accessible to people using the service and was easy to use. This was available in easy read and a pictorial version.

Systems were in place to make sure the service was safe, with very good staffing levels and highly skilled staff to deliver good quality care.

Risks to people were fully assessed and well managed. People were supported to take positive risks, to make sure they had greater choice and control of their lives. The positive risk-taking approach showed that staff respected people's rights for independence and to take risks.

People were fully involved and supported to safely recruit staff to work at the service. This ensured that successful applicants had the right values and skills to match the values that were at the heart of the service.

Staff were trained in infection controls and the safe administration of medicines. Robust arrangements were in place to make sure action was taken, and lessons learned when things went wrong, to improve safety across the service.

People's needs, and choices were assessed, and their care was provided in line with their preferences. Staff received an induction process when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people.

People were supported to be independent in shopping, preparing and cooking their own meals. Staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their 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. The principles of the Mental Capacity Act (MCA) were followed.

Staff provided care and support in a very caring and meaningful way. They knew the people who used the service very well and had built up kind and compassionate relationships with them. People and relatives, where appropriate, were involved in the planning of their care and support. People's privacy and dignity was

maintained at all times.

The service continued to be well managed. The provider had systems in place to monitor the quality of the service. Actions were taken, and improvements were made when required. Staff felt well supported and said the registered manager was open and approachable. The service worked in partnership with outside agencies.

Rating at last inspection.

The last rating for this service was Good (published 3 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 9 Twyford Lane 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 re-inspection programme. If we receive any concerning information we may inspect sooner.