Archived: East View Housing Management Limited - 6 High Beech Close

We found the following examples of good practice.

The home was clean and tidy. Regular cleaning took place throughout the day. Staff completed a COVID-19 clean four times a day, this included disinfecting frequently touched areas. Signs had been put up around the home to remind people and staff to wash their hands. Staff had received training in infection prevention and control.

When there were restrictions on people going out, staff formed links with the local community to arrange safe visits out for people. For example, people at the home enjoyed doing their own shopping. The registered manager arranged with a local clothing store to have a time for people from the home to access the shop whilst closed to the public to do their shopping. Staff had supported people to buy an outfit for a meal out. The registered manager had contacted a local restaurant and arranged for people to have a meal in the restaurant before it opened to the public.

Staff engaged people in what was going on in relation to changes in government guidance and the government messages that were being given to the public. Staff and people watched the information announcements on TV together and then discussed what they had heard to ensure everyone understood what was happening.

When external activities had to be stopped, staff thought of inventive ways to keep people engaged and active. Staff supported people to keep in contact with people in the provider's other homes through zoom calls involving quizzes and dances.

There were clear plans in place for how to support people in the event of an outbreak of COVID-19. The registered manager had made up packs of information and signs to be used around the home in the event of an outbreak. Thought had been given to how they would support people to isolate in their bedrooms if needed.

Staff were wearing personal protective equipment (PPE) in line with government guidance. Staff had worked with people to help them to understand the need to wear face masks. At the beginning of the pandemic, people had struggled to understand staff's expressions behind their face masks. During this time, staff had worn badges on their tops with pictures of their smiling faces to reassure people. Staff had carried out meetings with people to help them to understand the expressions of others wearing masks.

People were able to show us how they had been taught by staff to wash their hands correctly and showed us staff had been wearing masks. People told us that staff had done an excellent job of keeping them safe and had worked hard throughout the pandemic. Staff had supported people to learn how to do their own testing for COVID-19. Staff had demonstrated with people how to do this safely and stayed with people while they did their own tests.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

There were enough staff who had been appropriately recruited, to meet people’s needs. People told us they felt safe. Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. Staff understood what they needed to do to protect people from the risk of abuse. Incidents and accidents were well managed. People’s medicines were managed safely.

People’s needs were effectively met because staff attended regular training to update their knowledge and skills. Staff attended regular supervision meetings and told us they were very well supported by the management of the home. People were encouraged to make decisions and choices. The registered manager and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. They also ensured people were not having their freedom restricted or deprived unnecessarily.

People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to attend health appointments, such as the GP or dentist. People had enough to eat and drink and menus were varied and well balanced. People’s meals were served in a way that respected their specific needs.

Staff had a very good understanding of people as individuals, their needs and interests. People were supported to take part in a range of activities to meet their individual needs and wishes. All attended day centres for varying numbers of days each week and one person had a work placement. Activities were also arranged at home, for example arts and crafts and pamper sessions. People told us they enjoyed having meals out, theatre trips and holidays. People also told us they enjoyed visiting their friends and inviting friends and their family members to their house.

The environment was clean and well maintained. The provider had ensured safety checks had been carried out and all equipment had been serviced. Fire safety checks were all up to date.

The provider had good systems to monitor the management and quality of the home. Through regular internal monitoring the registered manager ensured a range of audits were carried out to monitor the care and support provided. Where shortfalls had been identified they were addressed in a timely manner. Feedback was regularly sought from people, relatives and staff. People were encouraged to share their views on a daily basis. People and relatives were given information on how to make a complaint and said they would be comfortable raising a concern or complaint if they needed to.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary describes what people using the service and staff told us, our observations during the inspection and the records we looked at. At this inspection, we spoke with all of the people who lived at the service, two care staff, the deputy manager and the manager as well as the maintenance staff and one of the owners of the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that care plans were sufficiently detailed to allow staff to deliver safe and effective care that reflected the support required for people's assessed needs. One person commented 'It's fantastic living here, I love it'.

People lived in safe, maintained accommodation which presented a comfortable environment.

People were protected from bullying, harassment, avoidable harm, abuse and breaches of their human rights. Staff we spoke with knew about safeguarding of vulnerable adults and what action to take if they needed to. Records showed that all staff had received training about this. People who lived at the service said that they felt safe. One person told us, 'I'm very happy, I feel very safe".

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted, we found that suitable policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

We asked people if they were happy with the support they received. People told us that they were and felt that their support needs had been met. One person commented 'I couldn't be happier, the support I get really suits me'.

Our observations and discussions with staff showed that they had a good understanding of people's care and support needs and that they knew them well. This was reflected by the clear guidance in people's care plans and the support staff provided.

Is the service caring?

We asked people who used the service if staff were kind and gentle when they supported them. People told us that they were. One person said 'All of the staff are great, they care about us all'. Care records contained personalised information which helped staff to know the people they supported and how to meet their needs.

We saw that staff showed patience, compassion and understood how to support people as individuals. Our observations found that staff knew how to communicate effectively with people. We saw that staff sometimes used hand signs and picture reference cards to help them do this. One person communicated with the help of a tablet computer.

Is the service responsive?

People's needs had been assessed before they moved to 6 High Beech Close. This meant the manager could be certain that the service had the skills and facilities to meet the identified needs of the people who lived there. People told us that they met with their key workers at least once a month to talk about the things that were important to them. People had access to activities that were important to them and had been supported to maintain relationships with friends and relatives where possible. Records confirmed that people had access to other health care professionals. This meant that there was access to specialist help when needed.

Is the service well-led?

Staff had a good understanding of their role within the service and felt supported by the manager. The manager showed a good knowledge and oversight of the running of the service. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service had been given opportunities to express their views about how it was run.

Throughout the inspection, the manager and staff demonstrated that they placed the needs of the people who lived at 6 High Beech Close at the heart of the service. Discussion with staff found that they had a good understanding of their responsibilities and of the values of the service.

The provider had given assurances that all relevant records would be updated by the end of August 2013. Our visit was to assess whether sufficient progress had been made to achieve compliance in regard to record keeping and security of records.

The people living in this house were younger and had developed a range of independence skills. They led an active lifestyle and took part in activities on week days. However, most people had a home day during the week. We chose to visit on a day we knew some people had previously been home. However, on this occasion everyone was out. We were however, able to speak with two staff members that supported the people in the house at various times, we also spoke with the manager on the telephone.

We were able to review records we had seen at the previous inspection and found that these had been updated and that the provider had taken the necessary steps to address outstanding shortfalls.

People told us about the activities they attended during the week, evenings and at weekends. They also told us they had some home time when they could do things they wanted to do. They felt that they were always consulted about matters that related to them, and said they informed staff when they wanted to do things, or needed things. One person told us they had recently consented to some medical treatment.

Staff spoken with demonstrated knowledge and understanding of the people they supported. They had access to detailed information about people's needs but acknowledged this was not always kept updated. Staff told us they felt well supported and that staffing levels were appropriate to meet the needs of the people in the house.