We carried out a review of the data available to us about L and S Care Homes Limited - 3 York Terrace on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about L and S Care Homes Limited - 3 York Terrace, you can give feedback on this service.
We found the following examples of good practice.
Staff maintained social distance from each other and people, when they were not providing personal care. People were supported to maintain a social distance with each other.
Separate staff teams worked with people who were Covid positive and other people to reduce the risk of spreading the virus.
Staff completed extra cleaning of high touch points and shared facilities, such as the bathroom and kitchen.
The service felt homely despite the additional infection prevention and control measures put in place to protect people and staff.
L and S Care Homes Limited - 3 York Terrace is a residential home providing personal care for up to three people. At the time of the inspection there were three people living at the service. People living at 3 York Terrace were younger adults with learning disabilities, who had lived at the home for several years.
3 York Terrace is a terraced house in a residential area and is split across three floors. Two bedrooms, a bathroom and an office were on the first floor whilst the ground floor had communal areas including a kitchen. There was a self-contained flat in the basement which opened out onto a small rear garden.
The service had 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 that 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.
People’s experience of using the service and what we found
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service had not always supported best practice. People required one to one support and were not able to leave the home alone so when out were under constant supervision. If people cannot consent to constant supervision a Deprivation of Liberty Safeguard application may be required. The registered manager had not considered that people may need a Deprivation of Liberty Safeguard authorisation. New staff went through an induction period. People’s nutritional and hydration needs were met and people received support from health and social care professionals.
The registered manager told us that no staff training had taken place for the past 18 months. This was confirmed by staff. We were shown a supervision policy document that recorded that supervision meetings should take place every two months. No supervision meetings had taken place during the ten months prior to this inspection. Nevertheless, staff and professionals spoke well of the registered manager and people interacted with her in a positive way. Audit processes were in place. Feedback was sought from staff through handover meetings.
People were not able to tell us directly they felt safe however we observed staff interacting with people and we spoke to staff about their understanding of safety issues. Staff understood safeguarding and were aware of the whistleblowing policy. Maintenance checks were up to date and people received medicines safely. Risk assessments were individualised and up to date. Staff were recruited safely and there were enough staff working each shift to ensure people’s care and support needs were met.
Staff were caring and people’s privacy, dignity and independence were respected and promoted. People were encouraged to be involved in their care plan reviews and to contribute where possible. People’s differences under the Equalities Act 2000 were considered as part of care planning and respected.
People were supported in a person-centred way which focussed on peoples’ needs. Relatives told us they were involved in care planning and reviews. People had a programme of activities both inside and outside of the home which they were supported with. Routine was very important to people and this was understood by staff. Links to the local community had been established and a robust complaints policy was in place.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and the potential drivers for improvement.
As part of this thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The home did not use any restraint measures.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 30 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
L and S Care Homes Limited - 3 York Terrace provides accommodation for up to three people who need support with their personal care. The service provides support for people with learning disabilities or autistic spectrum disorders. The service is a small, converted domestic property. Accommodation is arranged over three floors, including a self-contained one bedroom flat on the lower ground floor. The service has two single bedrooms on the first floor. Three people were using the service at the time of our inspection.
Rating at last inspection
At the last inspection, the service was rated Good.
Rating at this inspection
At this inspection we found the service remained Good.
Why the service is rated Good
The registered manager was leading the service and was supported by a deputy manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were relaxed in the company of staff and each other. Staff treated them with dignity and respect at all times.
Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. Concerns were investigated and responded to.
People had enough to do during the day, and were supported to take part in activities they enjoyed such as swimming and going out to local cafes. Staff supported people to maintain relationships with their friends and family and be part of their community.
Assessments of risks to people had been completed and care had been planned with people and their representatives to meet their needs and preferences, and support them to develop independent living skills.
Changes in people’s health and behaviour were identified quickly and staff contacted people’s health care professionals for support. People were supported to plan and cook a balanced diet of food they liked. Processes were in place to support people to take any medicines safely, however, no one was taking medicines at the time of our inspection.
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 support this practice.
There were enough staff to provide the care and support people needed when they wanted it. Staff were recruited safely and Disclosure and Barring Service (DBS) criminal records checks had been completed. Staff were supported to meet people’s needs and had completed the training they needed to fulfil their role. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.
The registered manager had oversight of the service. Staff felt supported and were motivated by them. Staff shared the registered manager’s vision of a good quality service and told us they would be happy for their relatives to receive a service from L and S Care Homes Limited - 3 York Terrace. Records in respect of each person were accurate and complete.
This inspection was carried out on 17 and 18 June 2015. 24 hours’ notice of the inspection was given because the service is small and the people are often out and we needed to be sure that they would be in at some time during the inspection, so we could meet them.
L and S Care Homes Limited - 3 York Terrace provides accommodation for up to 3 people who need support with their personal care. The service provides support for people with learning disabilities or autistic spectrum disorders. The service is a small, converted domestic property. Accommodation is arranged over three floors, including a self-contained one bedroom flat on the lower ground floor. The service has two single bedrooms on the first floor.
A registered manager was working at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The registered manager provided strong leadership to the staff and had oversight, with the provider, of all areas of the service. Staff were motivated and felt supported by the registered manager. The staff team had a clear vision of the aims of the service and made sure these were delivered. Staff told us the registered manager was approachable and they were confident to raise concerns they had with her. Processes were in place to learn from incidents and accidents and continually improve the service.
There were enough staff, who knew people well, to meet peoples’ needs at all times. The needs of people had been considered when deciding how many staff were required on each shift. Staff worked one to one with people and had the time and skills to provide the care and support people needed. Staff were clear about their roles and responsibilities and were accountable for their actions.
Staff recruitment systems were in place and information about staff had been obtained to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
Staff were supported to provide good quality care and support. The registered manager had a training plan in place to keep staff skills and knowledge up to date. Some staff held recognised qualifications in care; other staff were working towards achieving qualifications. Staff met regularly with the registered manager to discuss their role and practice and any concerns they had.
Staff knew the possible signs of abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team. Emergency plans were in place and staff knew how to keep people safe in an emergency.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager was clear about their responsibilities under Deprivation of Liberty Safeguards (DoLS). Arrangements in place to check if people were at risk of being deprived of their liberty and apply for DoLS authorisations. Systems were in operation to obtain consent from people and to make sure decisions were made in people’s best interests. Staff supported people to make decisions and choices in all areas of their lives every day.
People’s needs had been assessed and reviewed to identify changes in the support they required. Care and support was planned and reviewed to keep people safe and support them to be as independent as possible. People, their relatives and professionals who knew people well were involved in planning and reviewing their care.
People were supported to take part in domestic activities, such as cooking and cleaning. Possible risks to people had been identified and were managed to keep people as safe as possible while they learned and practiced independent living skills.
People got the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care and treatment they needed to keep them as safe and well as possible.
People were involved in choosing and preparing their own food and drinks and they were supported to have a balanced diet. Choices were offered to people in ways they understood. Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained.
People were supported to participate in hobbies and activities they enjoyed, at the service and in their local community.
People’s relatives were confident to raise concerns and complaints about the service. These were logged and investigated and people had received a satisfactory response.
The registered manager completed regular checks of the quality of the service provided. When shortfalls were found action was taken quickly to address these and prevent them from occurring again. People, their relatives and staff were asked about their experiences of the care. These were used to improve and develop the service.
The environment was safe, clean and homely. Maintenance and refurbishment plans were in place and the flat had recently been redecorated.
Accurate records were kept about the care and support people received and about the day to day running of the service and provided staff with the information they needed to provide safe and consistent support to people.
We saw good interactions between the people living there and the staff. People looked settled and relaxed and smiled in response to staff.
The people living at York Terrace were not able to talk to us so we observed interactions, staff spoke politely and clearly explaining what they were doing and offering people choices.
We saw staff trying different approaches to gain an understanding of what people wanted and changing their plans to suit the people's needs at that time.
We saw that the physical health and diet of the people who lived there were a high priority to staff. Medication was managed safely and risks were considered when planning care.
We saw that the capacity of the people who live here was considered and they were involved as much as possible in their care and supported to be as independent as possible. We found that care records were fit for purpose.
We spoke with relatives of people who lived there who said they were" very happy" and that the "care is good"
Staff offered people choices and they responded by smiling or moving towards the activity or task.
Staff spoke to people politely and clearly explaining what they were doing and giving people time to respond before providing any care.
We saw people looking calm and relaxed in the home.
We saw good interactions between the people living in the home and the staff. People smiled in response to the staff.
Staff were able to gain a response from the people in the home when they were supporting them. We saw staff trying different approaches to gain an understanding of what the person wanted.