River Cottage

River Cottage is a residential care home providing personal care to 3 young people with learning disabilities and autism at the time of the inspection. The service can support up to 3 people.

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

We received extremely positive feedback from people, they told us they were very happy living at River Cottage and really enjoyed the learning opportunities, activities and the local community they engaged in. Relatives spoke very highly of the staff team improvements their support had made to their relative’s communication and wellbeing as a result.

The service had been fully developed and without doubt designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people 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 received exceedingly well planned and co-ordinated person-centred support, appropriate and inclusive for them.

Peoples health, well-being and communication were drastically improved as a direct impact from the level of personalised support they received from the staff team who continually supported people to develop, try new things, learn new skills to help achieve personal goals.

Peoples communication was massively improved from the innovative use of accessible information. This was used creatively and appropriately and was readily available for people throughout the home. This was done inclusively and made use of various formats to suit individuals.

The registered manager and staff supported people to make valuable connections to help tackle social isolation and to support each other. People were able to access a superb range of activities in the home and outside which promoted, education, improved wellbeing and community citizenship. This included the highly regarded Princes Trust and Duke of Edinburgh awards.

The registered manager developed bespoke training by using external resources to their advantage and this was used across the providers other services as a benchmark. Their expertise regarding creating person centred culture, a modern, homely environment and positive behaviour support was shared by the provider.

There were excellent systems in place for communicating with people, their relatives and staff to ensure they were fully included by one to one key worker meetings, handovers, team meetings, phone calls and emails.

People were supported emotionally and confidentially to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and leadership in the service ensured this practice was the norm. People were supported to build and maintain important personal relationships that mattered to them; with peers, friends and relatives.

People were empowered to have their say and to exercise their rights. Access to an advocacy service was available and taken up when needed. Support was provided in a way which put the people and their preferences first. Healthcare professionals were regularly involved with people and the home.

The environment was very clean, modern and homely and maintained to a very high standard with personalised features throughout. Audits and monitoring systems were used effectively to manage the service and to make improvements when required.

There were enough staff to support people. Staff received support and a variety of appropriate and personalised training to meet people’s needs. Medicines were managed well, safely administered and recorded accurately. Individualised risk assessments were in place. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure 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 Outstanding (28 May 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 service provides accommodation and support for young adults who have behavioural needs and learning disabilities.

There was a very high level of confidence in the leadership and management of the service expressed by relatives, staff and other professionals. The registered manager demonstrated passion and commitment to people, strong values and a desire to learn about and implement best practice throughout the service. Staff were motivated and proud of the work they did and spoke passionately and positively about people and their achievements. The service had developed and sustained effective links with organisations that helped people living at River Cottage to gain a level of independence and confidence that people’s families and social workers did not think possible.

The registered manager and staff team demonstrated passion and commitment to providing the best possible care and opportunities for people and we were told of the excellent progress people had made since living at River Cottage. One social worker told us, “It’s great to see my client back in education and to see they are becoming more responsible and independent in the home and the community.”

The service provided amazing care and support to people to enable them to live fulfilled and meaningful lives. Staff were skilled at ensuring people were safe whilst encouraging them to stretch their potential and achieve as much independence as possible. We saw that the service had developed its own education opportunities through the Duke of Edinburgh (DoE) award scheme so trained staff could enable people not only to learn new skills both individually and as a team but also to gain a nationally recognised award. The focus the service had developed through the DoE scheme and through the relationships it had developed with further education services showed that young people previously excluded from education were enabled to access and achieve their potential.

The service placed a strong emphasis on person centred care. Support plans ensured staff had all the guidance and information they needed to enable them to provide individualised care and support. People and their family members were consulted and involved in assessments and reviews. People's individual communication needs were understood and all information was provided in a format appropriate for them, which meant they could participate fully in the running of the service. One social worker told us, “The staff really understand people’s needs and are very focused on providing a person centred approach.”

The registered manager used effective systems to continually monitor the quality of the service and had ongoing plans for improving the service people received. The registered provider gathered information about the quality of their service from a variety of sources including people who used the service, their family and friends and external agencies. This was used to enable the registered provider to identify where improvement was needed and to implement and sustain continuous improvement in the service. Thorough investigations had been carried out in response to safeguarding incidents and these had also been appropriately reported to CQC by the provider. Comprehensive audits were carried out by the management team to ensure the appropriate improvements took place within the home.

People were kept safe and free from harm. They were encouraged to become more aware of safety issues and to learn strategies to protect themselves, for example the service worked to support people with peer pressure and internet safety. Comprehensive risk assessments identified individual risks to people's health and safety and there was information in each person's support plan showing how they should be supported to manage these risks. Risk assessments also supported people to take positive risks. There was enough staff to meet people’s needs and to ensure they were able to access activities and be part of their local community. The registered provider operated safe and robust recruitment and selection procedures.

Staff protected people’s privacy and dignity. All interactions between staff and people were caring and respectful, with staff being consistently patient, kind and compassionate. Staff demonstrated affection and warmth in their contact with people, which was clearly reciprocated.

Records and conversation with the registered manager and relatives showed that people were listened to and complaints or concerns were taken seriously and responded to appropriately. There was a clear complaints procedure which was available in pictorial form.

The registered manager ensured that staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Each member of staff had a personal development plan to enable them to think creatively about the support they provided to people. Staff were able to access additional training to ensure they understood and could support people effectively. Staff were clear about their roles and responsibilities and received excellent support from the registered provider and registered manager to provide care and support for people.

Staff had received training in Mental Capacity Act 2005 (MCA) to make sure they understood how to protect people’s rights. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager, registered provider and staff ensured that people were supported in ways that did not restrict their freedom and were looked after appropriately.