The Mews

Updated 4 February 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 18 January 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 4 February 2022

This was an unannounced inspection which took place on 06 and 07 March 2018. This was the first comprehensive rated inspection of the service since it changed ownership in 2017. A previous inspection in April 2016 under the previous ownership identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations (2014) in that some equipment and parts of the premises were not adequately maintained or suitable for their required purpose, and staff did not always receive mandatory training and supervision in line with the provider’s policies and procedures. At this inspection we found improvements had been made and the service is no longer in breach of the regulations.

The Mews is a service which provides accommodation, personal care and nursing care and provides care and support to young people with disabilities. It comprises of three units situated over four floors. It is built on the side of a hill and terraced, which means all floors have direct access to outside areas. Nursing care is provided by qualified nurses who are supported by care assistants. The service has 50 single bedrooms and at the time of our inspection there were 48 people living in the service.

There was a culture of openness and transparency at the service. Although the service supported people with a variety of extremely complex needs the environment was more homely than clinical. Imaginative furniture arrangements minimised the risk of accidental injury, and the non-clinical environment did not detract from the high quality of care and support provided. Care was provided in a calm and relaxed environment. There was a real sense of community throughout the service; people who used the service were stimulated with a wide range of activities, their needs were addressed and they appeared content. They told us that they got on well with staff and were well supported. They had made friends and enjoyed living at the Mews. The staff we spoke with enjoyed working at The Mews and told us they felt a sense of fulfilment. Most of the people working there had done so for a long time, with very little staff turnover.

People felt they had a stake in the service and a say in how the service was managed. Staff were extremely positive ¿about the people they supported and management and leadership inspired them to deliver a high quality service.

People were safe. There were few allegations of abuse, and those that were raised were taken seriously and fully investigated. Accidents and incidents were recorded and analysed for trends, with a view to preventing repeat occurrences.

The service took a proactive approach to risk and risk taking. Staff worked collaboratively and with mutual respect for other professionals and agencies so that people's social, emotional and physical needs were met. This helped them to lead an exceptionally high quality of life. People’s care and support was planned proactively with them and whilst areas of potential risk had been continually assessed lifestyle choices were respected. Whilst recognising their rights to live their lives the way they chose, staff worked closely with people to consider ways of reducing the risk their choices might incur.

Privacy and dignity were respected, and people were supported by very kind, caring and compassionate staff who routinely went above and beyond what was expected of them to ¿provide people with excellent, high quality care.

People told us that they were well cared for in a welcoming and inclusive environment. Nothing seemed to be too much trouble for the staff.

We saw that there were enough staff to meet people’s needs across all three units of The Mews. Recruitment systems in place ensured staff shared a similar value base and reflected the local population. We saw staff had access to good face to face training and a programme of ongoing learning and development.

People told us that they enjoyed the food on offer and we saw mealtimes were a merry and social occasion. Attention was paid to people’s dietary needs, and the menu reflected people’s tastes and preferences. People who used the service told us that they had had a hand in planning the menus at The Mews.

There was good communication between staff which allowed continuity of care, and the service had developed impressive relationships with external health and social care organisations.

The service was extremely person centred, and people had choice in all aspects of their care. People had a real say not only in how their own care was to be delivered but also in how the service was run. Good care records reflected delivery of person centred care in all interventions, and people were encouraged to maintain their independence and autonomy. There was a clear understanding that people were not defined by their disability, and were encouraged to maintain their own lifestyle. Disability was secondary to the person.

The service demonstrated an innovative approach to providing stimulation and activity to all the people who used the service. Three full time activity co-ordinators ensured that people had access to activities either on a one to one basis or in groups, and people were supported to maintain their hobbies and interests. Nothing was considered to be off limits.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This person was respected by the staff and people who used the service. He was supported by the new owners, who had shown a willingness to invest in the service. The registered manager was equally supported by a strong staff team who shared his values and worked to promote the needs of the people who lived at The Mews. We saw that the registered manager consistently sought to make the lives of the people who used the service better; auditing systems identified areas for improvement, and he sought criticism as a way of learning how to enhance the quality of the service.

The registered manager, and unit managers were always visible and available to listen to people and their relatives to ¿offer them choice and make them feel that they mattered.

People were at the heart of everything the provider did and were consulted and involved in everything.