High Cross House

High Cross House is a care home for people who may have a learning disability or autism. The service was registered for up to 9 people; 9 people lived there at the time of our inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

People and their relatives told us they felt safe and supported. Risks were assessed and managed to ensure people could safely participate in activities that they enjoyed.

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 were able to receive visitors without restrictions in line with best practice guidance.

Right Care:

People were safeguarded from abuse and avoidable harm. There were sufficient numbers of suitable staff and the provider operated safe recruitment processes. Staff supported people in line with their individual preferences and agreed care plans.

People were supported to receive their medicines safely and were protected from the risk of infection as staff followed safe infection prevention and control practices.

Right Culture:

There was a positive and open culture at the service and systems were in place to provide person-centred care. People and staff were involved in the running of the service and the provider worked in partnership with others to achieve good outcomes for people.

The quality of care was monitored and lessons were learned when things had gone wrong.

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 29 January 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We completed a focused inspection to review safe, caring and well-led only.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for High Cross House on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation in relation to the provider's responsiveness to environmental/premises concerns.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

People could control who accessed their own bedrooms, which reduced the risk of others accessing their private space. This reduced the risk of cross infection between bedrooms.

Risk assessments were in place for people considering visits into and outside of the home to reduce risk to them.

People and staff were regularly tested for COVID-19. Visitors were also tested before interacting with people to reduce the risk.

Checks were made on the environment to ensure safe infection control practices were followed.

High Cross House is a residential care home registered to provide accommodation and personal care to nine younger people who have a learning disability. On the day of the inspection the home was fully occupied.

High Cross House consists of nine single occupancy bedrooms. The two-storey property consisted of a lounge, dining room, kitchen and bathrooms. Access to the first floor was via stairs. People had access to a garden at the rear of the property.

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

People told us they felt safe living at the home. Risk assessments were in place to mitigate identified potential risks to people. People were supported by sufficient numbers of staff who had been recruited safely. Hygiene standards were maintained to ensure people’s health and wellbeing. People received their medicines as directed by the prescriber. The registered manager was aware of their responsibility of learning when things went wrong to avoid a reoccurrence.

People were aware of who was running the home. Systems were in place to obtain people’s views with regards to how the home should be managed. The provider engaged with external professionals to ensure people were provided with the appropriate support. The culture of the home was warm and welcoming, promoting equality and diversity. The provider’s governance was effective to ensure people receive the appropriate support when needed. The registered manager demonstrated a good understanding of the duty of candour.

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 (September 2017)

Why we inspected

We received concerns in relation to the management of medicines and people’s care needs. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for High Cross House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in August 2015, the service was rated Good. At this inspection we found the service remained Good.

High Cross House provides accommodation and personal care for up to nine people who have a learning disability. On the day of the inspection there were eight people in residence.

The home had a registered manager who was present on the day of the inspection. 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 felt safe living in the home and staff knew how to protect them from the risk of potential abuse. Staff were aware of how to reduce the risk of harm to people. People were supported by sufficient numbers of staff who had been recruited safely. People were assisted by staff to take their prescribed medicines as directed by the prescriber.

People were cared for by skilled staff who were supported in their role by the registered manager. People were encouraged to make their own decisions to ensure they received a service specific to their needs. People had access to food and drinks at times that suited them. Where needed people were assisted by staff to access relevant healthcare services to promote their physical and mental health.

People were supported by staff who were kind and caring. People’s involvement in their care planning ensured they received a service that reflected their preference. People’s right to privacy and dignity was respected by staff.

People’s involvement in their care assessment ensured they received a service the way they liked and they were supported to pursue their chosen social activity. People felt confident to share any concerns they had with the registered manager or staff and could be assured their concerns would be listened to and acted on.

Systems and practices enabled people to express their views about the service provided to them. People and staff were aware of who was running the home and staff felt supported by the registered manager to carry out their role. The provider had systems in place to monitor the quality of service provided to people.

People told us they were happy with the care they received. One person told us, 'I am happy living here because we all get on with each other'. Another person said, 'I like all the staff here, not just one'.

People told us they were involved in the planning of their care and support. We saw that people were offered choices around what they wanted to do and their choices were respected.

We saw people getting the care they had agreed to receive by staff who promoted their independence.

People told us they chose what to eat and drink and we saw that people were supported to eat and drink a healthy and balanced diet that met their individual needs.

People were protected against the risk of abuse because staff were aware of how to identify and report concerns about people's safety and welfare. The provider also had systems in place to ensure that staff were suitable to work with the people who used the service.

We saw that improvements had been made to the way that medicines were stored and administered, which meant people were protected against the risks associated with medicines.

During our inspection we saw that people were supported to make decisions and were involved in the planning of their care. We saw that people were supported to engage in appropriate community activities and that their independence was promoted.

We observed people receiving care and treatment by staff who had the required knowledge and skills to provide the level of care that people required. Care records were accurate, up to date and were stored securely.

We saw that there was an effective complaints system in place which people using the service and their relatives were aware of.

We identified some problems with the way that medicines were stored and administered, but improvements were made by the registered manager during our inspection.