We inspected this service on 7 November 2017 and the inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived. At our previous inspection in December 2015, the service was meeting the regulations that we checked and received an overall rating of Good. Horninglow Bungalows provides personal care for up to 16 adults with a learning disability and associated conditions. People were supported within three bungalows which were situated next door to each other. The Bungalows were owned and maintained by another provider and people that lived in these bungalows had a tenancy agreement with this provider. There were 12 people using the service at the time of the inspection.
There was a registered manager in post. 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. The registered manager oversaw the running of the full service and was supported by senior care manager, care managers and senior support workers.
People were supported to understand how to keep safe and staff were clear on their role on protecting people from the risk of harm. Staff understood their responsibilities to raise concerns and record safety incidents. These were reviewed and analysed to ensure actions could be taken to reduce risks and promote a safe environment. Individual risks to people were identified and people were supported to take reasonable risks to promote independent living. Environmental risks within people’s homes were also undertaken and people were supported to raise any concerns regarding improvements with their landlord, to ensure they were protected by the prevention and control of infection.
People were protected against the risk of abuse, as checks were made to confirm staff were of good character. People told us and we saw there were sufficient staff available to support them. The skill mix of staff ensured people’s needs were met. Medicines were managed safely and people were supported as needed to take their medicine as prescribed.
People were consulted regarding their preferences and interests and these were incorporated into their support plan to ensure they were supported to lead the life they wanted to. People were supported to be as independent as they could be and assistive technology was in place to support people in achieving this. The staff team knew people well and were provided with the right training and support to enable them to promote people’s independence and autonomy.
People were supported with their dietary needs and to access healthcare services to maintain good health. A period of transition was provided to support people when they moved to or from the service. This was done with other organisations to ensure the person received coordinated support that met their needs and preferences.
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 importance of gaining people’s consent to the support they received was understood by the staff team. Staff knew about people’s individual capacity to make decisions and supported them to make their own decisions. Where people were unable to make certain decisions the staff ensured that best interest decisions were made in accordance with legislation. Where people needed support to manage their behaviours and keep safe; this was provided in a proportionate way and monitored with the support of healthcare professionals.
People were supported develop and maintain interests and be part of the local community to promote equality and integration. The registered manager actively sought and included people and their representatives in the planning of care. Assistive technology was in place where people did not receive 24 hour support; to enable them to seek assistance when needed. There were processes in place for people to raise any complaints and express their views and opinions about the service provided. People were supported to express their emotions and grieve following the death of a loved one.
A positive culture was in place that promoted good outcomes for people. People who used the service, their relatives and the staff team were all involved in developing the service; which promoted an open and inclusive culture. Staff had a clear understanding of their roles and responsibilities and this was guided by the registered manager who empowered them to take responsibility and develop their skills. The registered manager and provider understood their legal responsibilities and kept up to date with relevant changes. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.