Carricks Brook

Updated 12 January 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 checked 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 inspected Carricks Brook on the 2 October 2017; the inspection was announced. The provider was given 48 hours’ notice because the location is a small care home for people with autism, autistic spectrum disorders and learning disabilities. We needed to be sure that people would be available and that our presence would not unsettle people or their routines. The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we checked the information that we held about the home and the provider. The provider had completed a Provider Information Return (PIR). This 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. This included previous inspection ratings and statutory notifications sent to us by the registered manager that tell us about incidents and events that had occurred at the service. A notification is information about important events the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.

During the inspection we observed care and activities in the lounge, kitchen and outdoor spaces. We spoke with five people and six staff, and saw how they were supported during the day and with meal times. There were no visitors during the inspection. We contacted three relatives, commissioners and local authority quality teams during the inspection process so that we could further understand their experiences and those of people who could not talk with us. We have included their feedback in the main body of the report

We looked at records and care pathway tracked people living at the service. This was so we could look at people’s care planning in depth and match this with their experiences and our observations. We looked at five staff files, four care plans including positive behavioural risk assessments, medication administration record (MAR) sheets, incidents and accidents, policies and procedures and quality assurance information.

At the last inspection on the 24 May 2015 the service was rated as ‘Good’.

Updated 12 January 2018

This inspection took place on 2 October 2017 and was announced. Carricks Brook provides accommodation and care for up to 12 people, specialising in care for adults with autism, learning disabilities and challenging behaviour. On the day of the inspection, 11 people were living at the service.

The service had a registered manager in post, who was present during 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 a legal responsibility for meeting the requirements in the Health and Social care Act 2008 and associated Regulations about how the service is run.’

At the last inspection on 24 May 2015, we had no concerns and the service had an overall rating of ‘Good.’ At this inspection, we found that the service remained Good.

People and relatives told us that the service was safe. People were protected from risk of harm and abuse because they were encouraged to think about and express what made them feel safe and staff understood and were confident on how to report and respond to any concerns. Incidents and risks to peoples’ wellbeing and their independence were assessed, recorded, reviewed and lessons acted on. People were encouraged to be involved in how staff supported them when they experienced behaviours that could put them or others at risk of harm. Staff used communication tools to help people understand and communicate how they felt before, during and after the behaviour and any restraint that was used to reduce the risk to their or another’s wellbeing.

Relatives and staff told us there were suitable levels of skilled staff available to meet people’s needs safely. The provider had safe recruitment procedures in place to ensure people were supported by caring and responsible staff. People received their medicines safely and staff were trained and competent in the administration, ordering, storage and auditing of medicines.

People told us that staff were trained and helped them with what they needed. One person told us, “We go out together, they helped me get a gaming chair and they help with things at home”. Another person told us that staff were, “There when they needed them”. Relatives told us that staff were skilled and well trained in the needs of people with autism. Staff were supported to develop their skills and knowledge effectively through training and told us they were well supported by regular supervision and appraisals with their manager. One staff member told us, “I have monthly supervisions which are beneficial; you need to discuss things and be open”.

Staff understood that the needs and capacity of people with autism and additional needs such as dementia changed and always sought consent when supporting people with their care needs. Staff had received training on the Mental Capacity Act (MCA) 2005 and understood the principles and importance of gaining consent.

People’s nutritional needs were met and they had sufficient control over their food and drink choices. People were supported to maintain good health and had access to healthcare professionals. A relative told us their relation was, “Always fit and healthy”. All health appointments with, or visits by health care professionals were recorded and acted on.

People and their relatives told us and we saw that the staff were caring and respectful. One person told us, “They’re nice staff here”, and a relative told us, “They are caring and look after my loved one.” Care and support provided was personalised and met peoples’ diverse needs. People and their relatives were included in the assessment of their needs and development of care plans. One relative told us, “The staff surprise me with new ideas. My relative now has varied interests and they are well engaged with them. They are now trying drama and singing. It all adds to enrichment”.

People were encouraged to be as independent as possible and had access to meaningful leisure, vocational and educationally based activities in the community. The service worked with health and adult social care professionals to ensure they could meet people’s needs responsively.

Relatives, staff and responses from adult social care professionals in the annual Carricks Brook survey confirmed that they felt the service was well led. People and relatives had regular contact with the registered manager and the provider. One professional praised how easy it was to access key staff at the service. Satisfaction surveys were consistently positive and relatives were consulted when policies changed, for example safeguarding. The service communicated well with relatives, other professionals and within its own systems.