Archived: Applegarth

Applegarth is a care home that provides support for up to six people who have a sensory impairment and a learning disability or autistic spectrum. At the time of our 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.

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

The staff at Applegarth were exceptionally kind and caring and had great empathy with the people they supported. They understood the challenges people faced each day and ran the home to ensure they led full and active lives. Staff knew people well and used a range of communication methods, some of which were unique, to ensure people were involved in decisions about their care and support.

People grew in independence and confidence at the home. They were outgoing, enjoying a range of activities and community life. Relatives said the quality of care and support provided was ‘outstanding’ and their family members flourished at the home. The home had a family atmosphere and staff and people trusted each other and took an interest in each other’s lives and families.

People were safe at the home and the staff knew how to reduce the risk of them coming to harm. A relative said, “I have absolute peace of mind because my [family member] is at the home.” There were always enough staff on duty to keep people safe . People had their medicines on time and all areas of home were clean and tidy. Menus were flexible and based on people’s likes and dislikes.

People’s care plans were personalised and reviewed and updated as necessary. Staff respected and celebrated people’s culture and diversity. People were supported to live the lives they wanted, develop their hobbies and interests, and, as far as possible, take control over their own lives.

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.

The registered manager provided excellent leadership at the home. They involved people, staff, and relatives in the way it was run and kept them up to date with progress and changes. They were proactive and ensured their regulatory responsibilities were met promptly and efficiently. Staff were well-trained and understood people’s needs and the support they required.

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 (based on an inspection on 07 February 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.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated them with respect, kindness and dignity.

People had plans of care in place that were focused on them as individuals. This allowed staff to provide consistent support in line with people’s personal preferences. People and their relatives felt they could raise a concern and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the home. People, their relatives and staff told us that they felt confident that they could approach the manager and that they would listen. There were quality assurance systems in place to monitor and review the quality of the service that was provided.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People told us they felt safe. Relatives also thought people were safe in the service.

Staff had been aware about care plans, and support plans had been written for people with particular needs. Some plans did not contain sufficient detail to promote people's welfare.

People had not always received medical treatment when they had potentially serious accidents. This meant that they were not fully safe in the service.

Is the service effective?

People's health and care needs had been assessed and care plans were in place.

Although peoples' needs had been assessed and included in care plans, more detail was needed in some plans to ensure people got the right care. Plans had been reviewed regularly. Relatives told us that they had not been invited to reviews of the care of their relatives.

This did not entirely confirm that the service had always been effective in meeting people's needs.

Is the service caring?

Two people told us that staff had supported them properly. The relatives we spoke with said that staff were friendly and caring. One relative said, 'yes, staff are excellent.'

We saw staff being friendly and helpful to people during the inspection.

Relatives told us they had been supplied with an annual satisfaction survey. This meant they were able to comment on the service provided.

Is the service responsive?

No one said they needed to make a complaint. Relatives told us when they told staff about anything that had concerned them, it had been put right.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

The service had systems to check that care was of good quality. This needed to be extended to ensure that all services were fully checked.

Staff received supervision to check their competence and provide them with support. There was no system in place to give staff the opportunity to provide feedback their views of the quality of the service to management, so their knowledge and experience had not been fully taken into account.

Staff told us that the manager was positive and supportive to them.

We saw that the home was clean and staff understood their responsibilities in minimising the risk of cross infection.

We looked at recruitment records and saw all necessary checks were made to ensure that suitable people were recruited.

The home operates an open culture where concerns and complaints are supported to ensure that people using the service are listened to and receive the support they need in a way they want.