Archived: Favor House

Favor House is a residential care home providing personal care to up to seven younger people who may live with learning disabilities and autism, or mental health needs. At the time of the inspection there were five people living at the home.

The service has 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

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

The provider had not ensured they had displayed their most recent Care Quality Commission (CQC) rating on every website maintained by them, or on their behalf, as they are required to do by law, to inform the public of their most recent rating.

Other Improvements required to the providers governance systems had now been driven through. Incidents which affected the health, safety and welfare of the people who used the service were notified to the Care Quality Commission. The provider had informed us of changes relating to the management of the service, and a new manager had been registered with the Care Quality Commission. The registered manager had been supported by the provider to address breaches identified during the previous inspection. These related to the management of fire risks, the currency of people’s risk assessments and the effectiveness of medication audits. Checks had also been improved to ensure staff had developed appropriate skills and were supported to provide good care.

People liked living at Favor House and relatives were complimentary about the way the home was led. Staff were positive about working at the home and told us their views were listened to. The registered manager had developed links with other health and social care organisations, to further develop the care available to people.

People were supported by staff who understood what action to take if they had any concerns for people’s safety and well-being. Staff understood people’s safety needs and people’s care plans and risk assessments now provided staff with the information they needed to assist them to reduce risks to people’s safety. Systems were in place to reduce the chance of infections and there were enough staff to care for people. People were supported to have the medicines they needed to remain well, and medicines were administered by staff who had been trained to do this, and whose competency was checked. Staff were supported to administer people’s medicines safely through guidance such as medication protocols and checks undertaken by the registered manager.

People’s needs were assessed, and staff reviewed their assessments as people’s needs changed, so staff could be assured people were provided with the care they wanted. Staff had been supported to undertake training linked to the needs of the people they assisted, and to develop the skills they needed to care for people. People were supported to see other health and social care professionals. Where staff had sought advice from other health and social care professionals, the advice was followed. This helped to ensure people enjoyed good health and well-being outcomes.

Staff understood what action to take to reduce the risks to people when they ate or drank, and staff ensured people were supported to have the right amount to eat and drink, so their health would be maintained. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People liked the staff who cared for them, and relatives told us this helped their family members to feel happy and settled. Staff involved people in day to day decisions about their care, and understood and supported people’s rights to dignity, independence and privacy.

People’s decisions, preferences and needs were taken into account when their care was planned. The views of relatives, staff and other health and social care professionals were considered when people’s care was planned, and their risks were assessed. Staff supported people to understand how to raise any concern or complaints, and systems were in place to take any learning from these. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.

Staff gave us examples of how they had worked together as a team, and with people, their relatives and other health and social care professionals, so people would have the care they needed at the end of their lives. The registered manager planned further work with people, their relatives and staff to identify and respond to people’s wishes at the end of their lives and in the event of their sudden death.

Rating at last inspection an update

The last comprehensive rating for this service was Requires Improvement (published 4 July 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations identified at the last comprehensive inspection.

At this inspection we have found evidence that the provider needs to make further improvement. Please see the Well-Led section of this full report. The rating for this location therefore remains Requires Improvement.

Why we inspected

This was a planned inspection based on the previous rating. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We have identified a breach of Regulations, as the provider had not ensured they had displayed their most recent Care Quality Commission rating on every website maintained by them, or on their behalf, as they are

required to do by law.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

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

Favor House is a care home that provides personal care for up to 7 people with learning disabilities within one adapted building over two floors. At the time of our inspection, 6 people were living at the home.

People's experience of using this service:

• Appropriate fire safety measures were not in place to protect people in the event of a fire. This included a failure to ensure all fire doors were fitted with self-closing devices and kept closed.

• People’s risk assessments and risk management plans had not been reviewed and updated on a regular basis, to respond to any changes in risk.

• Improvements were needed in the handling and administration of people’s medicines, to ensure this reflected good practice guidelines.

• Not all staff had received training on how to protect people from abuse, and abuse concerns had not always been reported to the relevant external agencies.

• Although pre-employment checks were in place, staff member’s Disclosure and Barring Service (DBS) checks had not always been renewed in line with the provider’s procedures.

• Staff training needs and their need for formal supervisions and appraisals had not been consistently addressed.

• The provider’s quality assurance systems and processes had not been fully integrated into the service. The quality audits and checks completed by staff to date were not effective.

• The provider had not notified us about a change in management arrangements at the service or all required incidents affecting people’s health, safety and welfare.

• Appropriate standards of hygiene and cleanliness were maintained throughout the home.

• People were supported to make choices about what they ate and drank and enjoyed the food and drink provided. However, complex needs or risks associated with people’s eating and drinking were not always accurately recorded.

• People were supported to access community healthcare services, to ensure their health needs were monitored and met. However, their ‘health action plans’ had not been kept under regular review.

• The design of the home enabled people to eat and relax in comfort, socialise with others or spend time alone.

• Staff recognised the need to respect and support people’s day-to-day decision-making.

• Staff treated people with kindness in their day-to-day care and support.

• People felt able to voice their opinions to staff and felt listened to.

• People were treated with dignity and respect and steps were taken to protect their personal information.

• People’s care files were bulky and disorganised, and their care plans and needs assessments had not been reviewed and updated on a regular basis.

• People had support to participate in a range of social and recreational activities in the local community.

• The people and their relatives were clear how to raise concerns and complaints about the service provided, and felt comfortable doing so.

• Staff worked well as a team and were satisfied with the management support available to them.

• Staff and management sought to work effectively with community health and social care professionals to achieve positive outcomes for people.

We found the service met the requirements for 'Requires Improvement' in four areas and ‘Inadequate’ in the one remaining area. The overall rating of the service was ‘Requires Improvement’. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Why we inspected: The provider registered with the Care Quality Commission (CQC) in February 2018. This was the first inspection of the service under this provider and therefore their first rating.

Enforcement / Improvement action we have told the provide to take: Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any information of concern is received, we may inspect sooner.