Background to this inspection
Updated
27 November 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 unannounced inspection was carried out by a single inspector and took place on 22 October 2018. Before the inspection we reviewed the Provider Information Return (PIR). This is information providers are asked to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the other information we have about the home such as notifications. A notification is information about important events the provider is required to send to us by law.
During the inspection we spoke with three people using the service and a relative, three staff members the registered manager the intervention manager and area manager. Some people using the service could not express their views verbally about the support they received, so we spent time observing the care and support provided and tracked that this matched with guidance in their care plan.
We looked at three care plans, four staff records and other records related to the running of the service such as environmental checks, minutes of meetings and audits. After the inspection we spoke with five other relatives by phone. We also contacted health and social care professionals and local authority commissioners for their views.
Updated
27 November 2018
This unannounced inspection took place on 22 October 2018. At our last inspection on 7 and 8 April 2016 we rated the service 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.
Cabrini 1 is one of three small separate care homes run by the provider in the same road that provides accommodation care and support to seven people with learning difficulties and some physical disability or health needs. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were six people living at the home.
The 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. So that people with learning disabilities and autism using the service can live as ordinary a life as any citizen
The service had 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. They were aware of their responsibilities' and had submitted notifications as required. They were aware of their legal requirement to display their current CQC rating which we saw was on display at the home and on the provider’s website.
At this inspection we found there were systems to monitor the quality of the service although the provider did not carry out their own separate recorded quality checks but relied on the managers own audits. The provider was in the process of reviewing their quality assurance systems at the time of the inspection.
We have made a recommendation that the provider seeks appropriate guidance on the implementation of new quality monitoring systems. We will check on the progress with this at the next inspection.
There were effective safeguarding procedures in place to protect people from the risk of abuse. Staff understood the different types of abuse and knew who to contact to report any concerns. There were processes in place to learn from accidents and incidents. Individual risks to people were assessed and detailed guidance provided to staff to reduce risk. Medicines were safely managed.
There were sufficient numbers of staff at the service. The environment had been adapted to meet people’s needs. The service was clean and staff understood how to reduce the risk of infections.
Staff received sufficient training supervision and support to fulfil their roles and responsibilities. New staff completed an induction when they started work and staff received regular training and supervision that helped them support people’s individual needs.
Prior to joining the service people's needs were carefully assessed in partnership with people, their families and health and social care professionals where relevant.
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 support this practice.
People were supported to meet their dietary and nutritional needs safely and provide them with sufficient choice. The service worked with health and social care services and professionals to maintain the good health of people they supported. The service supported people when they moved between services through effective communication to ensure their care and support were coordinated well.
People and relatives told us staff treated people with kindness and consideration. Staff respected people’s individuality and promoted their independence. People were involved as far as possible in decisions about their care.
People’s care and support was responsive and personalised to their needs. The service used positive behaviour support (PBS) where appropriate. This is a person-centred approach to supporting people who display or are at risk of displaying behaviours which may require a response with the aim of improving their quality of life. The service promoted equality and people’s diverse needs were respected and supported. Information was available in a range of formats.
People were supported to engage in the community and in activities that they enjoyed. People were supported to socialise, learn new skills, and maintain relationships. People and their relatives knew how to complain about the service should they need to. Information was available in a range of formats.
Relatives, staff and professionals gave positive feedback about the management of the service and said their views were listened to. We saw there were areas where the service worked to keep up to date with best practice and share learning in the team. There was a clear ethos of providing good quality person centred care at the service.