Apple House

Updated 13 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 January 2019 and was unannounced and carried out by one inspector and an inspection manager.

Before the inspection, we reviewed information the provider sent us in the provider information return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information that we held about the service such as statutory notifications that had been sent to us by the provider. These detail events which happened at the service, which providers are required to tell us about.

We contacted commissioners to seek their views about care and support people received at the service. Commissioners are people who work to find appropriate care and support services for people.

We made general observations of how people using the service were supported by staff. We spoke with three people using the service, three care staff, two deputy managers and the registered manager / provider.

We reviewed the support plans and associated care records for three people using the service to ensure they were reflective of their needs. We looked at the recruitment files of three staff, and other documentation in relation to staff training and staff supervision and the overall management of the service.

Updated 13 February 2019

This inspection took place on 17 January 2019 and was the first comprehensive inspection of the service since registering under a new provider in May 2017.

Apple House is a small residential care home that provides care and support for up to eight people with learning disabilities. At the time of our inspection, the provider confirmed they were providing care and support for eight people.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The home is based in a residential area and is 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 using the service can live as ordinary a life as any citizen.

The registered provider was also the registered manager for the service. 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.

The ethos at Apple House was based on providing a family type setting for all adults, whilst supporting their needs through structured education and living.

People received individualised care and support that was responsive to their individual needs. The ethos of the service ensured that all people were fully involved in their care.

Staff had an excellent understanding of all the people using the service. They worked as a close team and were driven in providing person centred support to enable people to achieve as much independence as possible.

The registered manager / provider was very involved in the care of people using the service. The provider and staff were committed to promoting human rights to enable people with learning disabilities to be empowered to live the life they choose.

The staff were extremely dedicated to helping people to achieve their potential. Every opportunity was sought to enhance people's life experience. The service had established strong links with resource centres for people with a learning disability and proactive in building relationships with the local and wider community.

People's support plans were person centred and fully reflected their individuality, people were supported to set goals and targets that were achievable. An equality, diversity and human rights approach to supporting people's privacy and dignity and treating them as individuals was embedded in the staff practice.

Systems were in place to ensure that no discrimination took place, and that people's cultural and life choices were promoted and protected. The support plans gave information on how people wanted their care and support to be delivered, and included information on their hopes and aspirations, their social, cultural and spiritual beliefs and physical and emotional needs.

People received kind and compassionate care and had maximum control over their lives. Staff were very passionate and enthusiastic about ensuring the care they provided was personalised and individualised.

People received care from staff that had the knowledge and skills to provide their care and support. Staff induction training and mentoring was comprehensive and on-going training was provided to ensure staff followed current good practice guidance.

Staff had regular team meetings and individual one to one supervision meetings. These gave staff opportunities to discuss any issues or concerns, their personal development and any further support required. The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Correct staffing levels were in place.

People were supported to live health lifestyles and have access to the services of other health and social care professionals. the care and welfare of people using the service, and progress and strategies for promoting healthy lifestyle choices, eating a healthy diet, getting fresh air and exercise. Staff followed a consistent approach, and people felt valued, resulting in an increased sense of well-being, and reduced incidents of anxiety and challenging behaviour.

Information on how to make a complaint was available in easy read formats. People knew how to make a complaint if needed, and they were confident that their concerns would be listened to and acted upon as required.

No people using the service were receiving end of life care, and no advanced end of life care plans were in place. We have made a recommendation the provider seeks guidance on how to support people with learning disabilities with end of life care planning.

The staff worked in line with the Mental Capacity Act code of practice. People's consent was gained before any care was provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.