Futures

Updated 10 May 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 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 6 February2018. We gave the service 24hours notice of the inspection visit as we needed to be sure that staff would be available to speak with us. The inspection team consisted of two inspectors, a specialist advisor and an expert by experience. The specialist advisor had experience of working with people who had complex needs, similar to the people living at Futures. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we reviewed information we held about the service including any notifications, (a notification is information about important events which the service is required to send to us by law) and any complaints that we had received. The provider had submitted a Provider Information Return (PIR) before the inspection. A PIR asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. This enabled us to ensure that we were addressing any potential areas of concern at the inspection.

We spoke with four people who use the service and three relatives by telephone. Not everyone communicated verbally but some people were able to respond to our questions using gestures or eye movements. We observed the support that people received. We interviewed nine members of staff and spoke with the registered manager and the Head of Residential Operations. We looked at a range of documents including policies and procedures, care records for six people and other documents such as safeguarding, incident and accident records, medication records and quality assurance information. We reviewed staff information including recruitment, supervision and training information as well as team meeting minutes and we looked at the provider’s information systems.

The last inspection of 3 February 2015 identified no concerns.

Updated 10 May 2018

This inspection took place on 6 February 2018. Futures is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Futures consists of three bungalows which are located on the site of Chailey Heritage Foundation. The provider, Chailey Heritage Foundation, is a registered charity supporting children and young people who have complex physical and learning disabilities and health needs. Futures provides care for up to 21 young adults between the ages of 16 and 25. It is a transitional service that supports young people with the development of life skills in preparation for adulthood. At the time of the inspection there were 19 young people living at the home. Some people were not living at the home permanently but had regular periods of planned respite care.

The home had a registered manager and they were present throughout the inspection. 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.

At the last inspection, on 3 February 2015, the home was rated as Good overall. At this inspection the rating remained Good overall, however we did find some areas of practice that needed to improve.

Staff demonstrated a firm understanding of their responsibilities with regard to safeguarding people. Incidents were recorded and addressed promptly. However, consideration had not always been given to ensuring the proper external scrutiny in line with the provider’s own policy. This was identified as an area of practice that needed to improve.

Incidents and accidents were being recorded however not all recording was complete. This meant that the registered manager could not be assured that all incidents and minor injuries were being investigated thoroughly. Maintaining complete and accurate records to show what actions have been taken for each recorded incident is an area of practice that needs to improve.

People and their relatives told us that they felt people were safe living at the home. Medicines were stored, managed and administered safely. Staff had a good understanding of how to identify and manage risks. There were enough staff to care for people safely. The provider had robust procedures for recruitment.

Staff told us they received the training and support they needed. People and relatives felt that staff were knowledgeable about people’s needs. One relative told us, “All the staff are skilled across the board.”

People were supported to have enough to eat and drink. They were able to choose the food they wanted, and nutritional risks and needs were managed effectively. A staff member explained, “The young people have meetings every week and decide what meals they would like to have.”

Staff supported people to access the health care services they needed. The provider had partnership arrangements with a health care provider based on the Chailey Heritage Site. This meant that people could access a range of specialist clinicians, nurses and therapists.

People’s needs were assessed in a holistic way. Care records were comprehensive and included people’s choices and preferences.

Staff worked effectively with each other and with health care professionals to support people. Staff demonstrated a firm understanding of their responsibilities with regard to the Mental Capacity Act. 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 and their relatives spoke highly of the staff. A relative told us, “All the staff are very caring.” Staff knew people well and understood how to support people with their communication needs. People were actively involved in making decisions about their care. Staff were respectful and actively promoted people’s dignity and independence.

People were receiving care that was personalised and responsive to their needs. One relation told us, “The staff know my relation very well, so they act more quickly when some thing’s wrong.” People were living full and busy lives. They were supported to pursue their interests and to maintain relationships that were important to them.

There was a complaints system in place and people and their relatives were confident that any concerns would be responded to effectively.

People, their relatives and staff spoke highly of the management of the home. There was clear leadership and staff understood their roles and responsibilities. Quality monitoring systems were used to drive improvements. People and staff were involved in development plans and they told us their ideas were welcomed. Staff had developed effective working relationships with partner agencies.