All inspections: 4 Cottage Walk - Care Quality Commission

At the last inspection in February 2015, the service was rated as ‘Good’. At this inspection in January 2018 we found the service remains ‘Good’. The inspection was unannounced.

4 Cottage Walk provides accommodation and personal care for up to six people including younger adults. It is a service for people with a physical disability, learning disability and/or on the autistic spectrum and mental ill health. At the time of our inspection, six people were receiving care and support at the service.

The care 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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.

Some people who used the service were unable to verbally tell us about what it was like living at 4 Cottage Walk. We therefore used observation to help us understand people’s experiences.

Procedures were in place to safeguarded people who used the service from the potential risk of abuse. Risks to people’s health and wellbeing were managed well whilst maintaining their independence. These were reviewed to ensure people’s needs were met effectively and safely.

There were sufficient numbers of staff to support people and safe recruitment practices were followed. The administration of medicines were managed safely to keep people well. Staff knew how to report any concerns and incidents were investigated.

People’s needs and choices were assessed in line with current guidance. Appropriate induction, training, supervision and appraisals were in place to enable staff to provide appropriate care to people. Staff had a range of skills, knowledge and experience to care for people effectively.

People were supported to eat and drink enough to meet their needs and to make informed choices about what meals they had. People received regular and on-going health checks and support to attend appointments. Professionals worked together to support people with their mental and physical health and wellbeing.

Staff had an understanding of the principles of the Mental Capacity Act (MCA) 2005. Capacity to make specific decisions was recorded in people's care plans. People had maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff interacted with people in a caring and friendly way and treated them with dignity and respect. People’s individual communication needs were recorded in their care files and information was provided in accessible formats. The premises were designed, adapted and accessible to meet people’s needs.

Care plans contained information about people's wishes and preferences. They were involved in reviews of their care arrangements where possible but this was not always recorded. People were encouraged to pursue their interests and to maintain links within the community. There was an effective complaints procedure in place and people and their relatives knew how to make a complaint should they need to.

There was a management structure in place which provided clear lines of responsibility and accountability. Staff were committed and supported. Quality assurance checks were carried out to ensure people received a high quality service which met their needs and protected their rights.

The inspection took place on 26 February 2015 and was unannounced. 4 Cottage Walk provides accommodation and personal care and support for up to five people, some who may have a mental health need. At the time of our inspection there were five people who lived in the service.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Health and social care professionals we spoke with were all positive in their comments about the support provided to people at 4 Cottage Walk.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The service had appropriate systems in place to keep people safe. We saw that staff followed these guidelines when they supported people. Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.

There was a process in place which ensured people’s health care needs were assessed appropriately and that care was planned and delivered to meet people’s needs safely and effectively. People were provided with sufficient quantities to eat and drink and their nutritional needs were met. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people’s healthcare needs were well managed. Staff interacted with people in a caring, respectful and professional manner. Where people were not always able to express their needs verbally we saw that staff were skilled at responding to people’s non-verbal requests promptly and had a detailed understanding of people’s individual care and support needs.

People were offered a variety of chosen social activities and supported to follow their interests and hobbies. People were encouraged to take part in activities that interested them and were supported to maintain contacts with the local community so that they could enjoy social activities outside the service. There were systems in place to manage concerns and complaints. There was an open culture and the manager and staff provided people with opportunities to express their concerns and did what they were able to reduce people’s anxiety. People understood how to raise a concern and were confident that actions would be taken to address their concerns.

The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits completed by the provider and registered manager and subsequent actions had resulted in improvements in the service. Systems were in place to gain the views of people, their relatives and health or social care professionals. This feedback was used to make improvements and develop the service.

We spent time with four of the people using the service and spoke in more detail with one person to find out what it was like to live in 4 Cottage Walk. People told us that they felt safe, well cared for and happy living at the service.

We spoke with three staff who told us that there was always sufficient staff on duty to meet the needs of the people using the service. They told us that they had a good staff team who were committed to working together to ensure that the people using the service were able to lead fulfilling lives.

We saw that people received care and support according to their assessed needs. We found that records relating to people who used the service provided an accurate reflection of their needs. Where people did not have capacity to consent to their care and support and where they required treatment the provider acted in accordance with the legal requirements and principles of Mental Capacity Act (MCA).

We found that people were protected from the risks of inadequate nutrition and hydration and unsafe use and management of medicines. Staff had received training and spoke knowledgably about the people they provided care and support to.

People who use the service were given appropriate information and support regarding their care or treatment.

We observed that staff members were polite and attentive towards people using the service, in particular those people with no or limited verbal communication. We saw that staff made good eye contact with people that were unable to communicate and used touch, such as holding people's hands or stroking their upper arm to reassure them when they reached out to staff.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. Where people were unable to provide a verbal response or tell us verbally their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at 4 Cottage Walk to be positive.

One person who used the service told us they could not remember being consulted

about or involved in developing their care plan or having been consulted when it was

reviewed and updated. They also told us that they were able to make choices

about some aspects of their care. For example, they could choose when they went out and they were also able to make a decision as to whether or not they participate in social activities.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People told us they were satisfied with the level of care and support they received

at 4 Cottage Walk and that they feel well looked after by the staff. One person told us "I like living here, the staff are very good, they look after me well and know when to leave you alone."

People told us they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests if they preferred.

People told us that they felt comfortable talking with the staff about any issues that they had and that the manager was also always available for them to talk to.

Archived: 4 Cottage Walk

All Inspections

11 January 2018

During a routine inspection

26th February 2015

During a routine inspection

6 October 2013

During a routine inspection

31 May 2012

During a routine inspection