This was an unannounced inspection which took place on 8 January 2018. 10 Spennithorne Road is a care home without nursing which is registered to provide a service for up to four people with profound learning disabilities, all of whom have physical needs. There were four people living in the service on the day of the visit. The accommodation is single storey and is light and spacious. All of the bedrooms are single and each has a sink. There is a communal kitchen and sitting area and a shared bathroom.
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 using the service were supported to live as ordinary a life as any citizen.
At the last inspection in 26 August 2015 the service was rated Good. At this inspection we found the service remained Good.
The service had 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.
Staff responded to people's needs and went 'over and above' to ensure these needs were met. Behaviour management plans were detailed and included least restrictive interventions. All staff were enthusiastic about their role and the quality of care they provided. This meant that people who had previously challenged other services were being successfully supported by an outstanding responsive approach to their individual needs.
Staff lived the values of the provider and put people at the heart of everything they did. Staff were all clear that they worked as a team and for the benefit of the people living at 10 Spennithorne Road.
People were actively encouraged to be involved in all aspects of their care. Systems had been implemented to ensure people understood information relating to their care and that enabled people to be actively involved in reviewing their care plans with staff. Care plans were drawn up in an accessible format in line with the Accessible Information Standard.
The management team had control measures in place to maintain people's environmental safety. This included a variety of risk assessments and tools to safeguard them from potential hazards. Staff demonstrated a good awareness of how to protect people from potential harm or abuse.
The service remained safe. People's safety was contributed to by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and who to alert if they had any concerns. General risks and risks related to the needs of individual people were identified and appropriate action was taken to reduce them.
Staffing levels were sufficient to meet people's needs. We found staff were recruited in a safe way; all checks were in place before they started work and they received an in-depth comprehensive induction. Staff were kind and caring and they knew about people's needs and preferences. We observed staff treated people with dignity and respect and it was clear they knew people well and their preferences for how they wished to be supported. This ensured people were fully involved in all decisions and were enabled to take control of their lives; staff gained consent before undertaking any support tasks.
There were positive and caring interactions between the staff and people. People were comfortable and at ease with the staff. Staff had a clear understanding of people's individual needs, preferences and routines. People were involved as fully as possible in decisions about the care and support they received. When people could not communicate verbally staff anticipated or interpreted what they wanted and responded quickly.
Medicines were stored securely and managed safely by staff assessed as competent to do so. Staff supported people to maintain their health and to access healthcare services when needed.
People's wide range of dietary needs and preferences were supported by the service.
Staff understood their responsibilities in relation to the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. 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 supported this practice.
People were involved in activities which they enjoyed. Planned activities took place regularly and there was guidance for staff on how best to encourage and support people to develop their interests, skills and hobbies. Staff supported people to achieve their personal goals.
Accidents and incidents were recorded and analysed for themes and patterns, and appropriate action was taken to reduce risks. Lessons had been learnt when things went wrong.
The service had a strong leadership presence with a registered manager who had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. The home and the registered manager had significant support and guidance from the provider. Thorough and frequent quality assurance processes and audits ensured that all care and support was delivered in the safest and most effective way possible.
We found an open management culture, which enabled staff to raise concerns, discuss ideas and contribute to the development of the service. The provider had a clear strategic direction and was committed to providing a quality service to meet people's individual needs and minimise risks to health and safety. Quality assurance systems were used effectively to highlight areas requiring development and to drive continuous improvement in the service. The senior staff demonstrated strong values and a desire to learn about and implement best practice throughout the service.