Caradon

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People had received a range of assessments and support around their needs. For example, one person was taken weekly to the speech therapist. We were assured staff understood people well and were able to communicate effectively. Need to know information was readily available in people’s folder in the kitchen but this should be in their bedrooms to protect their confidentiality. We observed staff communicating well with each other and working as a team. We asked for assurances around monitoring of health and bowels and were assured systems were in place and people were supported. Good oversight of peoples needs meant any changes could be identified and responded to. People at the service were subject to deprivation of liberty safeguards (DOLs) and these had all been applied for, three had so far been granted. Mental capacity assessments were in place for decisions and showed what had been assessed, who was involved and what the outcome was. These were dynamic documents which were kept under review.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff showed understanding of the needs of the people supported and had received the right training. Support was organised for people to access services and staff knew what they were doing on any given day. A healthcare professional told us "I have found the few different staff members I've met very friendly and approachable, and they all appear to have the patient's best interests at heart. They all appear to have an excellent understanding of the patient's strengths and needs. When I hand over any recommendations or feedback about the session, they appear to listen, and share relevant information regarding the patient's communication at home and with others".

We were assured staff understood people well and were able to communicate effectively. Staff had time to read peoples support plans and were able to tell us about peoples needs including dietary requirement, allergies, and health care needs. Staff worked along side people and adapted routines accordingly. Individual and shared support had been agreed and there was some built in flexibility according to peoples wishes. Peoples wishes were discussed in the regular resident meeting and individual review to establish if people were happy and what they wanted to do.

Need to know information was readily available in people’s folder in the kitchen, though this should ideally be in their bedrooms to protect their confidentiality. Most records were electronic which staff could access using handheld phones. Staff checked in with people and supported them with a range of different activities according to their needs and wishes. Care plans were reviewed regularly in consultation with people that used the service. Needs led assessments had been completed, and were subject to an annual review. Care plans were reviewed regularly in consultation with people that used the service. Needs led assessments had been completed and were subject to an annual review.

Peoples's needs had been assessed and support plans provided clear guidance on how to support people safely. People's health was reviewed during a ward round each week by the named GP and we saw evidence of people accessing other health services. One person was supported to attend a speech therapy session each week. The home had initiated a well being walk, each day for residents and staff, down a quiet back country lane and people looked forward to that.

Staff showed understanding of the needs of the people supported and had received the right training. Support was organised for people to access services and staff knew what they were doing on any given day. A healthcare professional told us "I have found the few different staff members I've met very friendly and approachable, and they all appear to have the patient's best interests at heart. They all appear to have an excellent understanding of the patient's strengths and needs. When I hand over any recommendations or feedback about the session, they appear to listen, and share relevant information regarding the patient's communication at home and with others".

The manager and deputy had a good understanding of the health needs of people and we saw evidence of future planning for appointments and evidence of this being known to the staff team. There was effective communication and a good handover process to ensure information was distributed in a timely fashion and issues dealt with promptly.

People had key workers who worked closely with people and parents for information and advice. People had weekly key worker meetings recorded in accessible format. People were supported to plan their day, and the provider was in the process of purchasing more vehicles to give people opportunities to attend activities of their choice .

Staff told us there was a fixed rota which took into account peoples needs. Staff told us there were always enough staff, flexibility and great support and teamwork. We observed staff communicating well with each other and working as a team. Staff were well recruited and all brought something different into the team with a mix of ages, gender, and culture. Staff spoken with all had previous, relevant experience.

Feedback from external professionals was positive. One health professional told us "After a few initial hiccups when they first opened this has been working well. The staff know the residents well and are able to ask for help appropriately on the ward round or by requesting on the day care. The residents seem to be doing well in their care and as far as I can tell have settled well. I have no concerns about the service".

Rotas and staff allocation boards were in place showing how people got their shared and individual hours. Staff holidays were planned in advance. The service worked well with the local GP surgery and the named GP phoned the home every Friday to get an update on people and review any issues pending. We saw evidence that recommendations from the Quality Management Officer had been implemented and were being embedded.

People were supported to eat healthy food and have a balanced diet. Food and fluids were monitored. We asked for assurances around monitoring of health and bowels and were assured systems were in place and people were supported. People were encouraged to walk and have exercise. The service had started a daily well being walk which was well received by both people and staff. We observed people being offered food and drink. There was a good stock of healthy food in the fridge and access to fruit and vegetables. People received their medicines at the time they needed them.

Staff told us they were well supported with regular contact with a named GP who was getting to know people well. A range of professionals including the learning disability team and mental health team helped ensure people had the medicines they needed and access to services. No one had any long-term conditions with the exception of epilepsy which was well controlled. Allergies and specialist diets were known and accommodated.

Good oversight of peoples needs meant any changes could be identified and responded to. Staff told us people were usually able to consent to care and treatment and any change to health was responded to.

People had a range of activities planned and were free to decide on what to do. Assistive technology was in place to support those that required them. We saw evidence that people had frequent reviews and their support plans were dynamic and modified as the staff got to know them better. We saw people taking part in a well being walk during our second visit, and spending time in the garden. A person was supported by staff to clean the chicken enclosure and feed them.

We saw evidence that the service and management team worked collaboratively with external agencies to improve outcomes for the people supported. There had been several multidisciplinary team approaches to specific issues around people. Six people had moved into the service within a short space of time and the transition had been well managed. A healthcare professional we spoke to told us "When there have been difficulties, the management team have reached out for advice and support, identifying the need for a communication assessment to be able to better support this young man when he is having behaviours that are challenging".

Care plans and risk assessments had captured the needs of the people supported. We were shown a digital system for raising issues by staff, which immediately notified the manager and deputy. There was involvement in Caradon from the wider organisation and we saw evidence of nominated individual audits.

People at the service were subject to deprivation of liberty safeguards (DOLs) and these had all been applied for, three had so far been granted. People were involved in decision making and staff recorded that involvement and how decisions had been reached. Everyone we observed were able to make simple decision such as what to wear, choices of meals and to give consent to see the GP. More complex decisions would be made involving other professionals. Staff told us one person became upset then visiting the GP because of the environment which had resulted in the GP arranging home visits which had reduced their anxiety.

Staff had received training in DOLs and there was information around the service. Staff were familiar with people’s communication styles and conversed with people in a way that was appropriate such as signs or using objects as a frame of reference, i.e. asking people to chose between one thing or another. Staff talked about least restrictive practice and gave the example of sensor alarms in two peoples bedrooms which recorded movement to support people with epilepsy. This was less restrictive than regular physical checks and more effective.

Mental capacity assessments were in place for decisions and showed what had been assessed, who was involved and what the outcome was. These were dynamic documents which were kept under review. Activities where appropriate were risk assessed and consent had been sought from people around all aspects of their care such as sharing information, photography, and medicines. On our second visit, some staff had just completed Proact Scipr training, and they told us that it empowered them to support people safely.