Background to this inspection
Updated
16 October 2019
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.
Inspection team
The team consisted of one inspector.
Service and service type
Cabrini House (2) is a ‘care home’. People in care homes receive accommodation and nursing or 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and sought feedback from the local authority who commission from the service. We also reviewed the information the provider sent us in the provider information return. This is information providers are required to send us 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 spoke with five people who used the service, three members of care staff, a senior coordinator, the registered manager and the intervention manager. Some people were not able to express all their views about the care and support they received and so we observed the care provided in the communal areas.
We reviewed two care plans and a range of records related to the management of the service such as medicines records, staff training records and minutes of meetings. We spoke with five relatives of people using the service by phone following the inspection and communicated with one relative by email.
Updated
16 October 2019
About the service
Cabrini House 2 is a ‘care home' providing accommodation and support for up to seven people with learning difficulties and or autism. There were seven people living there at the time of the inspection. Cabrini House 2 is one of three similar small homes owned by the provider in the same residential road.
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. The building design fitted into the residential area with domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
People’s experience of using this service and what we found
We found 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.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Relatives said they thought the home was well managed; although communication about some things did not always work smoothly. We found this had not impacted on people’s care. The registered manager told us they were working to improve communication. They understood their role and responsibilities. Staff spoke positively about the support they received from the provider and registered manager. They told us they worked well as a team and were well supported by the registered manager.
The provider had systems in place for monitoring the quality and safety of the service. People’s and their relative's feedback was sought informally and through an annual survey. The most recent survey showed that people felt supported and happy with the care they received
People told us they felt safe. Staff understood their roles in safeguarding people from harm. Risks to people had been assessed and staff knew how to manage these risks safely. Staff worked with people to support them to understand possible risks. There was a process to identify learning from accidents, incidents and safeguarding concerns.
There were safe recruitment practices that followed legal requirements. Medicines were safely administered and managed. Staff worked in ways to reduce infection risk.
People’s needs were assessed before they started using the service. Staff asked for people’s consent before they provided care or support. Staff received training and support to meet people’s needs effectively.
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. People’s nutritional needs were assessed and met. Health professionals said that staff worked proactively to meet people’s health needs.
People and their relatives said staff treated people with care and kindness. People were consulted about the support they received. Relatives told us they were consulted and listened to. Staff treated people with dignity, respected their privacy and encouraged their independence, in line with registering the right support. People’s needs in respect of their protected characteristics were assessed and supported.
People had a personalised plan for their care. These were up to date and reflected their needs. People were involved in a range of activities that they enjoyed at the service and within the community, in line with the principles of registering the right support. The provider had introduced new techniques to try and develop people’s skills and confidence. People’s wishes relating to their end of life care needs had been discussed with them or their relatives, where appropriate.
There were systems to monitor the quality and safety of the service. Staff worked in partnership with relatives, health and social are professionals and voluntary organisations.
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 (report published March 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.