Background to this inspection
Updated
18 October 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.
We carried out a scheduled inspection of Cleveland House on 10 and 22 August 2018. This inspection was unannounced and carried out by one inspector.
Before the inspection we reviewed relevant information that we had about the provider. Healthwatch and the local authority confirmed they had not heard anything adverse about the service.
We also received a provider information return (PIR) from the service. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with six staff members including care workers and maintenance staff, the deputy manager and the registered manager. We also spoke with four relatives.
It was not always possible to speak to everyone and ask direct questions about the service they received because of people’s learning disabilities. However, people could express how they felt about where they were, the care they received and the staff who supported them through non-verbal communication. We observed interactions between staff and all the people using the service as we wanted to see if the service communicated and supported people in a way that had a positive effect on their wellbeing.
We looked at three people’s care plans and other documents relating to their care including their risk assessments and medicine records. We looked at other documents including three staffing files, meeting minutes, health and safety documents and quality monitoring audits.
Updated
18 October 2018
Cleveland House is a care home, providing accommodation and support for up to 11 people with a learning disability and people with autism. At the time of our inspection 11 people were living in the service.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. This service provides personal care. 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.
The service had a registered manager in post. 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 our last inspection on 23 and 28 October 2015 the service was rated ‘Good’ overall. At this inspection, we have rated the service 'Good' overall.
Safeguarding procedures were in place and staff demonstrated a clear understanding of what abuse was and how they would know if people were at risk of harm through changes in their behaviour. The service had detailed risk assessments in place to guide staff. People were supported to take positive risks whilst being kept safe from harm. The overall health and safety of the service was overseen by staff and people to encourage a sense of independence and people truly felt this was their home. The service provided information relating to infection control in an accessible format. Staff were recruited safely to ensure they were suitable to support people with learning disabilities and staffing levels were sufficient. People’s medicines were managed safely by staff who had received appropriate training and people were supported to understand their medicines where possible.
Staff received a detailed induction and completed ongoing training to allow them to provide high quality support. The service worked well with health and social care professionals and promoted healthy living through encouraging people to exercise and have a healthy diet. Staff understood the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. As people were not able to provide consent to the care and treatment they received, the appropriate authorisation procedures had been completed. These are referred to as the Deprivation of Liberty Safeguards (DoLS). The service had been designed with the needs of people in mind and people had choice around how they wanted their home to look. This is in line with the values that underpin the 'Registering the Right Support' and other best practice guidance.
Observations and records confirmed the service worked in a person-centred way and people’s individual preferences and support needs were understood by staff. People were observed to be able to approach staff at any time for support and staff were seen to be caring in their responses. People had a great deal of independence and were supported to build their confidence by engaging in a variety of activities and doing things they had never done before. The service aimed to protect people from discrimination by encouraging a culture of learning and celebration around different cultural backgrounds. People were empowered to make their own choices and improve their quality of life by being involved in making decisions about the care and support they received. Advocacy services were made available to help people have their views and wishes heard. The service promoted people’s privacy and dignity and treated people with respect.
Staff demonstrated an understanding of the individual needs of people, particularly around how best to communicate and respond to them. The service ensured all information was available in an accessible format for people with learning disabilities. The service completed pre-admission assessments to ensure they could meet people’s individual needs. The service had a complaints and compliments procedure in place and all complaints had been fully investigated and actioned.
People, relatives and staff felt supported by the registered manager and the provider and there was a clear understanding of the values of the service evidenced throughout the inspection. The provider and the registered manager ensured there were effective quality assurance systems in place to monitor the running of the service. The service evidenced that they responded to feedback to improve the service and they ensured people received high quality care and support.