We carried out a review of the data available to us about Stoke House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Stoke House, you can give feedback on this service.
We found the following examples of good practice.
• There were clear infection control protocols for all people entering the home, such as health screening, access to hand sanitiser, hand washing facilities and personal protective equipment (PPE). Staff provided visitors with directions about what they should do to ensure safety. There was clear signage to remind people about social distancing.
• The registered manager communicated updates about COVID-19 guidance and home protocols to people’s relatives, to ensure compliance with infection prevention control.
• Thorough cleaning regimes were followed by staff including checklists for all high touch points.
• Staff supported people to maintain social contact with friends and relatives through video and phone call. The registered manager told us this had become an opportunity for some people to develop their technology and communication skills. The home had visiting facilities in the communal garden or through meeting at a closed window. There was a separate indoor room which could be used for visits. The registered manager was in the process of reviewing visiting protocols for people's relatives in response to recent governmental guidance.
• Staff used social stories with some people to provide information and reassurance about changes to their routines and additional infection control measures. At the beginning of the pandemic one person expressed distressed about staff wearing face masks; to reassure the person staff showed their face briefly whilst maintaining social distancing and wearing a visor before placing the mask on their face.
• Records showed the service considered a person's wishes and emotional wellbeing when reviewing their shielding status. A best interest decision was made to enable the person to access the community and their college setting, supported by staff to follow specific safe measures to reduce risk.
• The registered manager kept up-to-date with government guidance and advice from their local health protection team. They attended regular provider forums held by the local authority and knew who to contact for advice.
Stoke House is a residential care home providing accommodation and personal care to five adults at the time of the inspection. The service can support up to six people. There were 15 staff employed by the provider.
Stoke House supports people living with a learning disability or autism. The service is owned and operated by a family. The building is adjacent to Bridge House, a care home for children with learning disabilities and registered with Ofsted. The same family own and operate the children’s care home. Children who reach adulthood at Bridge House are offered the opportunity to move next door to Stoke House. This provided good continuity in their care and support pathway.
The care home accommodates people across three floors, each of which has separate adapted facilities. There is a communal kitchen, sensory room, lounge room and dining room on the ground floor. Some bedrooms had ensuites, otherwise there were enough communal bathrooms for people to share. There was a large backyard at the rear of the care home.
The service has been developed and designed 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.
There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were protected from abuse, neglect and discrimination. Risk assessments were carried out in a timely manner for people's personal care. The risk assessments were thorough and up-to-date and contained relevant information to ensure risks were mitigated as far as possible. Premises risks were assessed and managed, however a Legionella risk assessment and scheme of control was required. This was completed shortly after the site visit. We are satisfied people were not unduly placed at risk due to the missing risk assessment. There were enough staff deployed. The house was clean and tidy. Medicines were safely managed.
People's likes, preferences and dislikes were considered and used in their everyday care. Staff had a good knowledge of people's needs. People received enough food and drinks to prevent malnutrition and dehydration. People's care was joined up with local and community-based health and social care professionals. The service is compliant with the Mental Capacity Act 2005 (and associated provisions), including lawfully depriving people of their liberty. There had been recent refurbishment of the property and this was on a continuous basis. Staff had the necessary knowledge, skills and experience to support people who lived at Stoke House.
The service was caring and the staff kind and compassionate. People's rights were respected, and their dignity and privacy was maintained. Where possible, people's independence was maintained and promoted. People and parents or relatives were involved in their care planning and reviews. There was positive feedback on file about the care provided. We received numerous positive testimonials from health and social care professionals who worked with people at the care home.
Support plans were person-centred, detailed and contemporaneous. The daily notes were very good and contained information about people's behaviour and emotional status. The service ensured that information was provided in a way that people could understand it. This included the use of symbols, pictures and words, a 'choices' board and 'now, next, then' process. There was a satisfactory complaints mechanism. The outcomes book was a positive tool to celebrate the successes of care that people experienced with the support they received from staff.
There was a good underlying set of principles about the care provided to people of Stoke House. Staff were happy at the service and there was a positive workplace environment. There was an appropriate series of audits and other quality assurance processes to gauge, monitor and report on the quality and safety of care. Appropriate actions were taken when issues were identified. The registered manager and team leader were knowledgeable, skilled and experienced and able to lead the service well. There was good linked up working within the organisation and local community. The transition of people from children to adults' care was a very positive one. Management and team meetings were used to share lessons learned, knowledge and updates within the organisation.
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.
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 Good (published 9 June 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.
The registered manager has been in post since January 2016. 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 and associated Regulations about how the service is run.
Relatives provided feedback about the caring nature of staff. Comments included, “I think they (Staff) are exceptionally caring” and “They (Staff) always look after [Name of family member] as if they’re looking after their own family.”
We observed staff used enabling positive language in their interactions with people. People were listened to, given time and supported using their preferred communication methods. Staff promoted people’s independence and supported them to exercise choice. Relatives were involved in planning and making decisions about their family member’s care.
Relatives felt their family members were safe from abuse and harm. Staff were trained and understood their responsibilities in regards to safeguarding and safe recruitment processes and checks were in place. The service had sufficient numbers of staff to keep people safe and meet their care needs. Risk assessments were in place to minimise identified risks and medicines were safely administered and managed.
Relatives felt staff were experienced and skilled to provide care and support to their family members. Comments included, “Staff are skilled, sometimes my daughter needs medicine for her epilepsy and staff are trained to give it” and “I think they are very competent.” Staff received appropriate induction, supervision and training.
We found the service acted in accordance with the Mental Capacity Act 2005. Consent was sought from people or their family members who had legal authority to give it. People were effectively supported at meal times. Care records contained information about each persons; dietary needs and preferences. Health action plans ensured people’s health needs were met.
Relatives felt the care and support delivered was personalised. We heard comments such as, “They (Staff) look at [Name of person] to see what she likes. The care is very personalised for example, staff will say, ‘This is what [Name of person] likes and this is what [Name of person] prefers.”
Care records captured people’s preferences, interests, aspirations and diverse needs. People were engaged in meaningful activities that enhanced their social well-being. Care plans and risk assessments were regularly reviewed and kept up to date and relatives said they knew how to make a complaint but had no need to do this.
Relatives felt the service was well-managed. Comments included, “It is well-managed, and they (management) know the young adults very well. The service is managed to a very good standard” and “It is managed extremely well from financial to caring. Their (staff) dedication is without question.”
Staff described the culture of the service as open and spoke positively about management. Quality assurance systems were in place to improve the quality and safety of people who used the service. We have made a recommendation in regards to the completion of the staff training matrix. The service actively encouraged feedback from people and their family members about the quality of care delivered.