Fredrick's House

Updated 6 July 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 6 June 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides a supportive living service for younger adults who are often out during the day. We needed to be sure that they would be in.

The visit was carried out by one inspector; this was because the service only provided support to a small number of people and it was decided that additional inspection staff would be intrusive to people’s daily routines.

Before the inspection we reviewed the information about the service the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

We looked at four people's care plans, associated risk assessments and medicines records. We looked at management records including recruitment files, training and support records, staff meeting minutes, audits and quality assurance.

We observed people spending time with staff. We spoke with the registered manager, the deputy manager, three support staff. We spent time and communicated with five people who use the service. We received information from a visiting professional and spoke with them after the inspection. We also contacted and spoke with two relatives by telephone.

Updated 6 July 2018

Care service description

This service provides care and support to people living in two ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC)does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the inspection the service provided support for five people, living in two shared houses which were situated next door to each other. Each person had their own room and shared the communal areas and garden. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities. People living in the houses shared kitchens and lounges. There was an office on site and sleep in arrangements were available for staff.

Not everyone living in the two houses received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. When they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Rating at last inspection

At our last inspection fully comprehensive inspection in October 2015 we rated the service good overall but there was a breach in one of the regulations. We returned to the service in February 2017 to make sure the registered person had taken action. They had taken the necessary action and the breach in the regulation was met and the rating for the service remained Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People felt safe in the service. Staff understood how to protect people from the risk of abuse and knew the action they needed to take to report any concerns in order to keep people safe. People were encouraged to raise any concerns they had and felt that they would be dealt with appropriately. The management responded appropriately when concerns or complaints were made.

Staff were aware of how to reduce risks to people to try and keep them safe. When people were at risk of falling the falls risk assessment needed further guidance on the action staff should take if a person did fall. Staff were able explain clearly what they would do to make sure the person was safe. Staff were only recruited after the necessary pre-employment checks had been completed. There were enough staff working in the service to meet people's needs.

The management and staff carried out regular health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements as a result. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Fire safety checks were carried out regularly. People were protected from the risk of infection.

On the whole staff received the training and support they required to carry out their roles effectively. Some staff had not completed epilepsy training and there were people at the service living with this condition. The registered manager said they would address this shortfall. Staff we spoke with knew what action to take if a person have a seizure and there was clear guidance in their care plans. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received the support they needed to ensure they had adequate food and drink that they enjoyed. People were encouraged and supported to lead a healthy active life. People were referred to the relevant healthcare professionals whenever this was needed. People’s medicines were managed safely.

People were included in all aspects of their daily lives. If needed people were supported to make their own decisions about their care. Staff supported people in a kind and caring manner which promoted their dignity and privacy. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice

People were assessed before they came to live at the service. Care plans contained the detail needed to show how all aspects of people’s care was being provided in the way they preferred. People were supported to take part in a variety of activities that promoted their emotional, social and physical wellbeing. People and their relatives had not yet been asked about their end of life care preferences. The registered manager had identified this as a shortfall and there were plans in place to address the issue.

People, staff, relatives and visiting professionals told us that the service was well led and that the management team were supportive and approachable and that there was a culture of openness within the service. The registered manager was experienced and skilled in supporting people with complex health needs. Staff said they could go to the registered manager at any time and they would be listened to. Staff understood their roles and responsibilities as well as the values of the service.

The registered manager worked with other professionals and outside agencies to ensure people had the support they needed. There were links with the local community. There was an effective quality assurance system in place to identify any areas for improvement. Staff, relatives, stakeholders and people who used the service were encouraged to be involved in the running of the service and give their views on any improvements needed.

Further information is in the detailed findings below