The Big House

Updated 13 April 2022

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.

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 12, Safe care and treatment and Regulation 17, Good governance, and also the requirement notice for Regulation 13, Safeguarding service users from abuse and improper treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One inspector carried out the inspection.

Service and service type

The Big House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who had started in January 2022. They had begun the process to be registered with CQC. 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.

Notice of inspection

We gave the provider a short of period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be available to support the inspection and there would be people at home to speak with us.

What we did before inspection

We reviewed information we had received about the service and the action plan from the last inspection. We sought feedback from the local authority and commissioners. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We communicated with the person who lived at the service. They were unable to talk with us and used different ways of communicating including actions and gestures. We spent time observing interactions between staff and the person living at the service to help us understand their experience of receiving care.

We spoke with a relative about their experience of the care provided. We spoke with four members of staff including the manager, service manager and two support workers. We reviewed a range of records. This included the person’s care record and medicines record. We looked at two staff files in relation to recruitment. We looked at some records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We sought feedback from two professionals who regularly visit the service.

Updated 13 April 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

The Big House is a residential care home providing personal care to one person at the time of the inspection. The service can support up to three people.

People’s experience of using this service and what we found

Right Support

Staff supported the person to have the maximum possible choice, control and independence and they had control over their own lives. Staff communicated with the person in ways that met their needs. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.

Staff focused on the person’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

The service gave the person care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. The person was able to personalise their room and benefitted from the interactive and stimulating environment.

Staff supported the person with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported the person to play an active role in maintaining their own health and wellbeing.

Right Care

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well.

The service had enough skilled staff to meet the person’s needs and keep them safe. The manager assured us staff training was being monitored to ensure all staff had completed the essential training needed to provide good quality care and meet people’s needs and wishes.

People’s care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Risks to the person had been assessed and staff followed the support plan guidance to protect the person from avoidable harm. Staff encouraged and enabled the person to take positive risks.

People had individual ways of communicating; using body language, sounds, pictures and symbols so they could interact comfortably with staff and others involved in their care and support. Staff had the necessary skills to understand them.

Right culture

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. The service had enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted.

Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Leicester, Leicestershire and Rutland. To understand the experience of social care providers and people who use social care services, we asked a range of questions in relation to accessing urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this inspection to assess whether sufficient improvements had been made to meet the regulations and check the service is applying the principles of Right support Right care Right culture.

Follow up

We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.