Cavendish House

Updated 13 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 31 October 2018 and was announced. We gave the service 2 days’ notice of the inspection site visit because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available to support the inspection process. The inspection was undertaken by one adult social care inspector.

Before our inspection we reviewed information that we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. The manager submitted a provider information return (PIR) the day following the inspection site visit. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.

Inspection activity started on 31 October 2018 and ended on 06 November 2018. We visited the office location on 31 October 2018 to meet the manager and provider and to review care records and policies and procedures. The young people who used the service at the time of this inspection were not able to tell us about the service they received. However, on 05 and 06 November 2018 we spoke with relatives of three young people to gather their views about the support provided.

We received feedback from representatives of the local authority health and community services.

We reviewed care records relating to two people who used the service and other documents central to people's health and well-being. These included staff training records, medication records and quality audits.

Updated 13 November 2018

The inspection took place on 31 October 2018 and was announced. This is the first inspection of this service since it registered with the Care Quality Commission (CQC) in October 2017.

Cavendish House is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It is registered to provide a service to children, younger adults and older people living with learning disabilities, mental health issues and physical and sensory impairments. There were five young men using the service at the time of this inspection.

Not everyone using Cavendish House receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

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 provider had a manager in post who had submitted their application to register with CQC.

Staff had been trained in how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. People were supported to take risks to help retain their independence and freedom. Enough safely recruited staff were available to meet people’s needs. People's medicines were safely managed. Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them. The management and staff team used incidents as a learning tool to help further ensure people’s safety and wellbeing.

Staff received training and supervision to enable them to meet people’s care and support needs. The service worked within the principles of the Mental Capacity Act 2005 (MCA). The staff and management team liaised with social care commissioners and appointed next-of-kin where people were not able to give consent. Staff did not cook meals for the young people they supported, however they did advise a healthy eating regime and people’s weights were recorded if a risk had been identified in this area. The staff and management team worked in partnership with external professionals and families to help ensure the individuals needs were identified and met.

People had a small team of staff who supported them which helped to ensure continuity and enabled people to form bonds with the staff. Each person was treated as an individual and their needs and wants were managed on an individual basis. Staff had developed positive and caring relationships with people they clearly knew well. Staff understood the importance of promoting people’s independence and support plans supported this to allow people to live as independently as possible. People's care records were stored securely to help maintain their dignity and confidentiality. The approach of the service meant that the staff and management team worked with individuals in a way that promoted their dignity and independence and empowered people.

People and their relatives had been involved in developing support plans that addressed all areas of people’s lives including social networks, employment and education, health needs and individual identity. Support staff were matched as far as possible with the people they supported in terms of gender, interests and skills. Staff accompanied people into the community to undertake activities of their choice. Concerns and complaints raised by people who used the service or their relatives were appropriately investigated and resolved.

The manager demonstrated an in-depth knowledge of the staff they employed and people who used the service. Staff meetings took place monthly to enable the team to reflect and discuss practice, review complaints, incidents, and safeguarding matters. The management team met monthly to review strategic and operational needs, incidents, accidents, complaints and for general strategic and operational oversight of the service and priorities for the organisation. There was a range of routine checks undertaken by the management team to confirm the support provided was safe. The provider had informed the CQC of significant events in a timely way which meant we could check that appropriate action had been taken.