64 Chilcompton Road

At the last inspection in April 2016 the service was rated Good overall. 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. Key questions continued to be rated Good and one had improved its rating to Outstanding. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

The people who stayed at Base House and used the service were provided with high quality, safe and caring support which was exceptionally responsive. People received highly personalised care and support specific to their needs and preferences. There was an excellent understanding of seeing each person as an individual, with their own social needs. People came to stay at Base House for respite on a regular basis. During the inspection there was only one person staying at the service but we based our judgements on the support and care provided to them and others who received regular support.

Base House focussed on wellbeing and ensuring people had a sense of purpose. The aim of the service was to provide respite but also to help people further develop their independent living skills with a view towards moving on to supported living. People had been asked about their individual aspirations, such as moving into their own flat, learning to cook more Italian meals or getting a paid job. Staff then worked with people to create plans of action in order to work towards each aspiration. One person spoke to us about and others wrote about their achievements and relatives commented how much their loved one had learnt during their time at the service.

Staff demonstrated to us they cared strongly about people’s wellbeing in every aspect of their lives and worked towards improving each person’s happiness and wellbeing. Staff promoted people’s equality, diversity and ensured their human rights were upheld. Staff spoke confidently to us about how they fought for people’s rights and gave us examples which demonstrated they put people’s individuality and personal wishes before all else.

People were encouraged to socialise, pursue their interests and hobbies and try new things in a wide variety of innovative ways. For example, the service had recently been awarded money, following the delivery of a presentation by people and staff to a local ‘Dragon’s Den’, in order to put on a ball. People were very excited about this taking place.

There was evidence of quality monitoring leading to continuous improvement and people were actively involved in the running of the service. People had given their feedback about the service during a South West Action For Learning and Living Our Way Limited (SWALLOW) evaluation day. Some of the top feedback was that people were “treated like adults”, the service “met people’s individual needs”, that staff were “kind, caring and thoughtful” and that staff “made people feel valued.”

The care service has been developed and designed in line with the values that underpin “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.

People were protected from risks relating to their physical health, their mental health and possible abuse. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Staff knew how to recognise possible signs of abuse.

Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Where this was needed, staff supported people to take their medicines safely and staffs’ knowledge relating to the administration of medicines was regularly checked. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the service. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the service were sufficient to meet people’s needs. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal.

There were systems in place to assess, monitor and improve the quality and safety of the care and support being delivered. The service was person-led and empowered people to discuss their views. One person discussed their role in the organisation’s management committee and told a member of staff; “I am your boss! You’ve got to listen to what I say!”

Further information is in the detailed findings below

64 Chilcompton Road provides a respite service and an opportunity for people with learning disabilities to learn and develop their independent living and personal skills in a safe environment. The service opens each afternoon and includes the option of overnight stays for up to three people at a time.

The service has a registered manager. 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 staff had received training regarding how to keep people safe. They were aware of the service safeguarding and whistle-blowing policy and procedures.

Staffing was arranged in a flexible way to respond to people’s individual needs.

There were suitable arrangements in place for the safe storage, receipt and administration of people’s medicines.

Each person was supported to access and attend a range of working, educational and social activities. People were supported by the staff to use the local community facilities and had been supported to develop skills which promoted their independence.

People’s needs were regularly assessed and resulting support plans provided guidance to staff on how people were to be supported. Support in planning people’s care, treatment and support was personalised to reflect people’s preferences and personalities.

The staff had a clear knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support individuals to meet their needs.

Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their support needs.

The service maintained daily records of how peoples support needs were met

Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way responding to their needs.

There was a complaints procedure for people, families and friends to use and compliments could also be recorded.

We saw that the service took time to work with and understand people’s individual way of communicating in order that the service staff could respond appropriately to people.

The provider had quality monitoring systems in place which were used to bring about improvements to the service.

We saw that support plans had been developed with each individual and their families. They documented each person's wishes regarding how their support was provided. One person told us "it's good here because I get to do things I want, like making pies".

During our visit, we saw that people in the service were spoken to in a respectful way. We saw staff were approachable and helpful at all times. We saw that staff interacted well with people. We saw staff maintained people's dignity, privacy and independence. For example, we saw how they checked on how people wanted to be supported.

We saw that activities were suited to individual needs. One person told us: 'I usually go out on an evening because that's what I like to do" and added they were 'learning loads of things here'.

We spoke to two staff and viewed training records. The records showed that people in the service were protected from abuse as far as possible, as they were supported by a staff team who had received regular safeguarding training. Staff also told us that safeguarding and whistleblowing were part of their regular supervisions and annual appraisals. We saw that the provider had an effective system for monitoring and assessing the quality of the service that regularly took into account the views of people and their families.