We carried out a review of the data available to us about Robinson House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Robinson House, you can give feedback on this service.
We found the following examples of good practice.
On arrival at the home visitors had their temperature taken, completed a health questionnaire and declaration, were required to wash their hands and were given personal protective equipment (PPE) to put on. The home had an ample supply of PPE. All staff had received training in the correct use of PPE, and how to take it off and put it on safely. Testing was carried out for both people living in the home and staff on a regular basis. If anyone had symptoms of COVID-19 they were tested immediately and isolated until the results were received.
People were supported to have regular contact with their families and friends via video calling. People were supported to take part in activities that they enjoyed with staff including trips out of the home. Risk assessments had been completed for any activities outside of the home to ensure risks were minimised.
Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection. There were ample supplies of cleaning equipment. Staff had been made aware of the correct cleaning fluids to use to prevent the spread of infection.
Robinson House is a care home providing accommodation and personal care for up to ten people with a learning disability.
The service is delivered 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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. Ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.
People’s experience of using this service and what we found
People liked the staff that cared for them People received kind and compassionate care and staff respected people’s privacy, dignity and independence. People were involved in all decisions about their care.
People felt safe, and relatives felt reassured and confident that their loved ones were in a safe and caring environment. Staff knew how to keep people safe from avoidable harm and abuse; they gave people their medicines safely and followed good infection prevention and control procedures.
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 had undertaken training and received support from the registered manager to ensure they could do the job well.
Systems to monitor how well the service was running were carried out. Concerns were followed up to make sure action was taken to rectify the issue. People and their relatives were asked their view of the service and changes were made to any areas they were not happy with.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 (published 8 March 2017).
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.
This inspection was undertaken by one inspector and an expert by experience of people living with a learning disability. At the last inspection on 08 July 2014 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.
A registered manager was in post at the time of the inspection. 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.
Systems were in place to manage risks to people using the service and to keep them safe. This included safeguarding matters, behaviours that were challenging to others and medicines.
There was sufficient staff on duty to keep people safe. A thorough recruitment and selection process was in place, which ensured staff recruited were suitable to work with people who used the service.
The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s needs were assessed, so that their care was planned and delivered in a consistent way. The registered manager and staff talked passionately about the people they supported and knew their care needs well. Different communication methods had been used to support people to understand information about their care. Staff offered people choices, for example, how they spent their day and what they wanted to eat. These choices were respected.
People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported to carry on with their usual routines, shopping and accessing places of interest in the community.
People were provided with sufficient to eat and drink to stay healthy and maintain a balanced diet. People had access to health care professionals, when they needed them.
There was a strong emphasis on promoting good practice in the service. Staff were clear about the vision and values of the service in relation to providing compassionate care, with dignity and respect. Staff knew what was expected of them and we observed staff putting these values into practice during our inspection.
The provider had a range of systems in place to assess, monitor and improve the service. Significant improvements had been made to the interior décor since our last inspection. People had been consulted on the improvements made to the premises and their choices had been respected. People, their relatives and staff were regularly asked for their feedback about the quality of the service provided. Feedback was used to recognise good practice and to drive improvements where shortfalls were identified.
Further information is in the detailed findings below.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was unannounced, which meant the provider did not know that we were coming. Our last inspection took place in October 2013, at that inspection there were no breaches in the regulations.
Robinson House provides a service for up to 10 people who have a learning and or physical disability. There were 10 people living at the home when we visited. There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were proper policies and procedures in relation to the MCA and DoLS to ensure that people who could make decisions for themselves were protected. We saw from the records we looked at, where people lacked the capacity to make decisions, that best interest meetings were held. This was for finances, medicines and other things which affected a person’s safety.
We found that people’s health care needs were assessed, so that care was planned and delivered in a consistent way. From the three people’s plans of care we looked at, we found that the information and guidance provided to staff was detailed and clear, and in an appropriate format. During our observations throughout the day we saw that staff clearly knew how to support people in a way that the person wanted to be supported. We also saw that people at risk of malnutrition or dehydration were effectively supported to have sufficient quantities to eat and drink.
We saw that staff respected people’s privacy and dignity. This was by always knocking on the person’s door or asking for permission before providing any personal care to people. We saw staff using curtains or blinds and offering space for people to talk in private.
Records we looked through and people we spoke with demonstrated to us that the social and daily activities that were provided had been decided upon by each person. People could change their minds if they did not want to do their routine activities. Staff we spoke with confirmed these alternative arrangements to ensure that people who remained at the home were supported to improve their daily living and social skills. One person we spoke with said, “I have been home for the weekend and I am now tired. Tomorrow I am going out for a pizza.”
Other records we looked at such as, easy read documents showed us that people were supported to complain or raise any concerns if they needed to. There had not been any complaints since our previous inspection in 2013. We were provided with positive comments about the service from healthcare professionals. The complaints procedure was available to people in an appropriate format and if required, people could be supported by a social worker or an advocate. Our observations confirmed to us that staff responded appropriately if people were not happy, or communicated that they were anxious about something.
The provider had a robust recruitment process in place. Records we looked at confirmed that staff were only employed within the home after all essential safety checks had been satisfactorily completed. Staff we spoke with told us that they had not been offered employment until these checks had been carried out. Records viewed confirmed this to be the case.
The provider used a variety of ways to assess the quality of service that it provided. This was by involving families, advocates, social workers, health care professionals and others on a regular basis. Records were kept wherever this occurred to evidence the reasoning behind any changes to people’s care.
Medication storage and records were well maintained.
We found that consent had been recorded within people's care plans and that people's care and support needs were well documented.
We found that people were given appropriate choices in food and drink. They were given support to prepare and serve the meals.
We found that appropriate numbers of trained staff were available to support people in meeting their care and support needs.
We found there were systems in place to ensure continued improvement in the service provided.
One person said that they liked having a wheelchair as this helped them to get around and about inside and out of the home.
People living in the home were able to direct and influence how they received their care and were able to self determine routines such as when they wanted to have their medication and where they wanted to have their meals.
The people living in the home have opportunities to influence how the home is run, to include changes within the menus.