Archived: RNID Action on Hearing Loss 13 Wilbury Gardens

This is one of a number of services provided by Action on Hearing Loss formerly The Royal National Institute for Deaf People (RNID), enabling flexible short- and long-term support for people of all ages. This includes residential care, supported housing accommodation, and community services for people who are deaf, deaf and blind, and who have a hearing loss and additional support needs.

RNID Action for Hearing Loss 13 Wilbury Gardens is registered for up to eight people. It provides care and personal support to people who have a hearing loss and who may have other additional needs such as a learning disability and/or autism or where people are living with dementia. At the time of the inspection, seven people were living at the service. The service is in a large adapted detached house, arranged over three floors accessed by a passenger lift. There were two communal lounges, a communal dining area with an adjoining conservatory and garden for people to use.

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

People told us they felt cared for by staff. Genuine relationships had developed between people and staff and we observed friendly interactions between staff and people. We observed people were relaxed and comfortable in the presence of staff. We observed that the home had a friendly, relaxed and homely atmosphere.

A person said, “I like the staff, they help me and the people I live with, I’m happy here.” Another person told us, “It’s perfect I love it here. I’m really happy here, I want to stay here for life.”

People received high-quality care that met and exceeded their needs. Staff, including managerial staff, were passionate about person-centred care. They were responsive to people's needs and strove to provide personalised care which was focused on supporting people to achieve their goals and wishes. The management and staff team went above and beyond to ensure that people's wellbeing, independence and happiness was at the heart of the service.

Staff promoted and encouraged people to have as much independence as possible. People chose how to spend their day and they took part in activities in the service and were supported to access the community and pursue interests. People were encouraged to maintain relationships that were important to them. This was recorded within people’s care plans. Family and friends were able to visit freely without restriction.

People continued to feel safe and there were enough staff to support them. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place. A person told us, “It was too difficult for me to live at home, I know I’m safe here.” A relative told us, “The main concern for a relative of someone in care is ‘Are they Safe’. Safe from harm from the outside world, and safe from harm or abuse within the care residence. I do feel that [Person] is safe, which for me is a huge comfort.”

Staff and people told us they were able to give their views on the service and we saw examples of people being engaged in aspects of the service such as recruitment. Staff told us they felt supported. The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.

People were being supported to make decisions in their best interests and to be included in making decisions affecting their care such as developing their care plan with staff. The staff had received training in the Mental Capacity Act 2005 (MCA). People were supported to access independent advocates.

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 and relatives knew how to make a complaint and people felt confident that their feedback was listened to and acted upon.

People told us they received help they needed with their medicines in a way that was timely and reflected their communication and support needs, our observations confirmed this.

People were supported by staff that were competent and confident in their work due to completing mandatory training and specific training to meet people needs, in particular reflecting the varied communication needs of people. A support worker told us, “We have lots of training, mandatory and additional. The training we get reflects the needs of the people.” Staff told us they felt well supported, had regular supervision and annual appraisals.

People were treated with respect. People’s privacy was upheld, and their dignity was maintained.

Care plans guided staff about people’s needs, preferences and how to meet them, for example communication, emotional wellbeing and health conditions such as diet and nutrition. Additional support plan guidance was written by staff for individuals who find it difficult to manage their health conditions such as diabetes.

Recruitment processes continued to be robust, checks were carried out and references were collected to ensure new staff were safe to work within the care sector. People were involved in the shortlisting, interview and selection process.

Accidents and incidents were recorded, and steps continued to be taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment were managed. Staff knew how to keep people safe in an emergency such as a fire.

Medicines continued to be managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People had enough to eat and drink and had choice in what they ate and drank. Staff accommodated any specific dietary requirements, such as for diabetes, or preferences such as being vegetarian or religious requirements were met.

Health and social care were accessible for people and appointments were made for regular check-ups as needed. External professionals we spoke with gave positive feedback about how staff worked in partnership with them.

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 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection on our website at www.cqc.org.uk.

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.

This is one of a number of services provided by The Royal National Institute for Deaf People (RNID), enabling flexible short and long term support for people of all ages. This includes residential care, supported housing accommodation, and community services for people who are deaf, deaf and blind, and who have a hearing loss and additional support needs.

RNID Action for Hearing Loss is registered for up to eight people. It provides care and personal support to people who have a hearing loss and who may have other additional needs such as a learning disability or where people are living with dementia. There were six people living at the service and five were present during the inspection. The service is in a large detached house, arranged over three floors accessed by a passenger lift. There was a communal dining and lounge area with an adjoining conservatory and garden for people to use. Long term care and respite care was provided.

There was a registered manager for the service. 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.

People told us they felt safe. One person told us they felt safe because, “The staff walk around and check we are alright. There’s also a buzzer I can press.” Detailed risks assessments had been completed and been reviewed. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

People told us staff were kind and caring. One person told us, “It’s great. It’s a happy home and we have lots of fun. It’s much better now in the last two years. It’s the new manager.” One member of staff told us, “It has a homely feel. It’s not institutionalised; everyone is free to do what they want. It’s really home.” People were cared for by staff who had been recruited through safe procedures. Staffing levels were monitored to ensure there were enough staff to meet people’s care and support needs. Recruitment checks such as a criminal records check and two written references had been received prior to new staff working in the service. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

Medicines were stored correctly and there were systems to manage medicine safely. Audits and stock checks were completed to ensure people received their medicines as prescribed. People were able to self-medicate through a risk management process.

There was a maintenance programme in place which ensured repairs were carried out in a timely way. External contactors were used for service checks and repairs. Regular tests and checks were completed on essential safety equipment such as emergency lighting, the fire alarm system and fire extinguishers.

People told us they had felt involved in making decisions about their care and treatment and felt listened to. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments were detailed and reviewed regularly to give clear guidance for care staff to follow. People’s healthcare needs were monitored and people had been supported to access to health care professionals when they needed to. People had been supported to join in regular activities if they wished to.

Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They felt they knew people’s care and support needs and were kept informed of any changes. One member of staff told us, “They are really good at communication, and providing one-to-one meetings. They are aware of people’s needs and try to meet them.” They confirmed that they felt valued and supported by the managers, who they described as very approachable. They told us the team worked well together. One member of staff told us, “It’s a fantastic place to work.” Another member of staff told us, “It’s a great place. I would live here and let any of my relatives live here”.

People’s nutritional needs had been assessed and they had a selection of choices of dishes to select from at each meal. People said the food was good and plentiful. People’s individual’s dietary requirements had been considered and provided for, and people were regularly consulted about their food preferences.

People were comfortable talking with the staff, and told us they knew who to speak to if they had any concerns. They had regular opportunities to comment on the care and support provided.

People told us they felt the service was well led. One person told us, “It’s great. It’s a happy home and we have lots of fun. “One member of staff told us, “(Registered manager’s name) is very enabling and promotes people’s (staff) strengths. She is upbeat and positive. It’s such a positive service. It’s a nice place to work. It’s got a good vibe.” Senior staff carried out a range of internal audits, including care planning, checks that people were receiving the care they needed, medication, and infection control. They were able to show us that following the audits any areas identified for improvement had been collated into an action plan, work completed to address any shortfalls and how and when these had been addressed.

We observed staff interacting with people in a friendly and relaxed manner. We saw that staff communicated with people using British Sign Language (BSL) and Sign Supported English (SSE) and we observed care records that included words and pictures.

We saw care records were developed in partnership with people who used the service and we saw that people were able to participate in the running of the home and decisions made. We saw that people who lived at the home were able to develop life skills and be empowered to exercise their independence where possible.

One person told us "The staff are lovely. I go to the shops to buy my papers. Staff have helped me to be more independent." Another person told us "I have choices. I'm happy here." We observed people communicating openly and saw from the way that people interacted they were happy in their environment and that staff were focused on delivering care with respect and dignity.

This told us people had been able to express their views about the care provided if they wished to, and where possible people who used the service and their representatives had been involved in making decisions about their care and treatment.

People’s care and treatment had been planned and delivered in line with their individual care plan. One person who used the service commented “The staff are wonderful, but very busy. It’s good that two staff work here that are deaf, because using sign language with them is easier.”

The service’s own care workers and regular bank staff had a good understanding of people’s care needs and had received training and support to meet people’s care needs. People knew who to talk with if they had any concerns about the care provided. One person who used the service commented, “I can talk to my link worker if I have a problem.”

The provider had systems in place to quality assure the care provided.