Melvyn & Jan John

Updated 11 February 2020

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

The inspection was carried out by one inspector.

Service and service type

Melvyn and Jan John is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 had a manager registered with the Care Quality Commission. 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. The registered manager was one of the two providers.

Notice of inspection

We gave a short period notice of the inspection because it is a small service and we needed to be sure that the provider or registered manager would be in available to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with the providers and observed the support they provided. We reviewed a range of records. This included one person’s care plan and associated risk management records.

After the inspection

We received feedback from one person’s advocate and from a representative from a local university.

Updated 11 February 2020

About the service

Melvyn and Jan John is a residential care home providing personal and nursing care to one person living with severe learning disabilities and Autism. People live together as a family in a two bedroomed terraced house in Ripple.

The service was registered prior to the guidance ‘Registering the Right Support’. However, the service has been developed 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

People lived in a service which supported them to stay safe and protected from discrimination, abuse and avoidable harm. The providers were knowledgeable about how best to minimise risks and were aware of possible triggers and risk factors. People were encouraged and supported to take positive risks and their rights to freedom were promoted. Restrictions were kept to a minimum and people felt safe and secure living with the providers as part of a family. The providers regularly reflected on changes in people’s behaviour to help identify possible triggers and reduce the risk of reoccurrences.

People were supported by the two providers who were both trained and experienced learning disability nurses. They had lived together as a family for many years. People had a circle of support, a group of family, friends and health care professionals, who gave support and friendship to people.

People’s care and support was planned, monitored and reviewed in line with evidence-based guidance, such as the British Institute of Learning Disabilities. The providers kept their knowledge up to date and were registered with the Nursing and Midwifery Council.

People continued to be supported to eat healthily and meal times were social, family occasions. People were involved in cooking and shopping for the service. The providers worked closely with health care professionals to make sure people remained as healthy as possible. People had a communication passport to make sure important information about their needs and preferences could be shared with other health care professionals when required.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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.

People were treated with kindness and compassion and had clearly built trusting relationships with the providers who knew them well. The providers noticed small changes in people’s behaviour which may indicate a decline in their health or be a sign of distress. People were constantly reassured and appeared very settled. People’s privacy and dignity were respected, and their independence was promoted.

People’s care and support needs were planned and reviewed with their circle of support to ensure their needs and preferences were met. People were supported and encouraged to maintain relationships with those who were important to them. People continued to stay as active as possible with many holidays and regular trips out, for example to wildlife parks. People were offered choices and given information in the way that suited them best, such as using picture cards.

People were supported in a positive, open and inclusive environment where they were valued for their individuality. The providers constantly researched ways to improve people’s lives. They demonstrated compassion and enthusiasm to provide the best support they could and welcomed feedback from people’s circle of support.

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 Outstanding (Report published 28 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.