Archived: Fell Close

Updated 18 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

This inspection was carried out by one inspector.

Service and service type

Fell Close 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.

The service had a manager registered with the Care Quality Commission. This means 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

This inspection was unannounced on the first day and announced on the second day.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used 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. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We also spoke with three staff, the registered manager for the service, and the area manager who was supporting with the inspection.

We reviewed a range of documents. This included two people’s care plans and risk assessments. Medicine records and management information. We looked at three staff files including training and supervision, and a variety of records relating to the management of the service, including policies and procedures.

After the inspection

Following the inspection we received feedback from two relative’s and two health professionals.

Updated 18 October 2019

About the service

Fell Close is registered to provide care and accommodation for up to 4 people with learning disabilities, autism and/or physical disabilities. At the time of our inspection 4 people were living at this service.

The service had 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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

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 did not use restrictive intervention practices. Care plans were in place to guide staff, in a person-centred way, in line with positive behaviour support principles should interventions be needed in the future. Where interventions were used the registered manager knew to record where lessons could be learnt to reduce the likelihood an incident would occur again.

Staff had awareness of peoples likes, dislikes and interests and supported people to maintain relations with friends and family members.

People were not always supported to have maximum choice and control of their lives in terms accessing activities in line with their interests and hobbies. Staff supported them in the least restrictive way possible; policies and systems supported this practice. People were provided with information in a way they could understand, and staff encouraged involvement in their care when they had the time available. Staff knew the importance of gaining peoples consent before delivering care and support for people.

Staff knew people well and cared about the people they supported. The service demonstrated positive outcomes for people to reflect the principles and values of Registering the Right Support. People were supported to make their own decisions, staff told us it was difficult due to staff dynamics to enable people to choose when they would like to go out or participate in activities to maintain their independence. Staff and relatives felt that people’s quality of life could be improved upon in this area. Staff sought the right support from health professionals when needed to support people’s emotional, physical and mental well-being.

We made a recommendation that the provider work with the local authority to improve choice of activities and events people could attend.

Care plans contained detailed and relevant information about how to meet people's needs. Staff communicated well between themselves to ensure handovers included relevant information.

Systems were in place to safeguard people from abuse or harm, which included safe recruitment processes. Detailed risk assessments were in place and overall medicines were managed safely. Accidents and incidents were recorded. The registered manager told us they would ensure these were analysed and preventative measures taken to prevent future repeat incidents.

Staff received an induction and annual refresher training to ensure they maintained their skills and knowledge. The registered manager was sourcing additional training specific to one person’s health condition and to support staff with managing behaviours.

Staff supported people to eat and drink when needed. People had input into menu planning and the registered manager advised that people were given healthy option choices.

Staff spoke positively about the registered manager. The service had been in the process of a management restructure and a new area manager was now in place to support the service.

Audits and quality checks were in place to ensure the service maintained good standards of care and continually looked to develop the service to ensure positive outcomes for people.

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

Rating at last inspection and update

The last rating for this service was Good (published 8 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. We will work with the local authority to monitor progress.