78 Park Road provides personal care and accommodation for up to seven people in a domestic care home setting. The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of separate lounge areas and dining room. There was a private garden at the rear of the property. The home provides care for up to seven adults including people with learning disabilities or autistic spectrum disorder. The home is in Hampton, in the London borough of Richmond-upon-Thames.78 Park Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of inspection there were seven people living in the home.
At our last inspection in February 2016 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager. 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 and associated Regulations about how the service is run.
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.
People continued to receive a service that was safe. All aspects of people’s safety were very well managed, including the security of the home, individual risk assessments and medicines management. In addition, robust staff recruitment systems continued to be followed which ensured that people were supported by suitable staff.
The service was well maintained and clean and correct procedures were taken with regard to the storage and handling of hazardous substances. Staff adhered to good infection control practices.
The service continued to provide care that was extremely person-centred and staff were proactive in ensuring people were supported to live fulfilled and meaningful lives. “Person-centred” means that care was tailored to meet the needs and aspirations of each person, as an individual. The vision of the service was shared by the management team and staff and quality audits focused on how the home achieved good outcomes for people.
The provider continued to ensure staff were sufficiently supported to provide a range of excellent social opportunities for people, including work-related activities, community events and hobbies and involved families, relatives and the local community. As a result, people had genuine experience of autonomy and choice, as well as of feeling included in their wider community.
People continued to receive effective care, which was based on best practice, from staff who had the knowledge and skills they needed to carry out their roles and responsibilities. Staff received support and training which enabled them to care and support people effectively. Additional support was provided by external professionals or consultants engaged by the provider.
Staff continued to ensure that people's emotional needs were supported at sensitive moments in their life and had worked closely with them, their relatives and health care professionals to achieve the most positive outcomes for the individual.
Staff displayed a strong team culture and supported each other whilst offering care and support to people that was compassionate and kind. Respect for people’s privacy and dignity was evident throughout the inspection. The manager and staff continued to ensure that people’s consent to care and treatment was always sought in line with legislation and guidance. Decisions made on behalf of people that did not have the capacity to consent were made in their best interests. Staff showed a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).
People continued to be supported to eat and drink enough and maintain a balanced diet, whilst staff respected individual choices based on preferences, culture and faith. Staff continued to support people to maintain good health, have access to healthcare services and receive ongoing healthcare support, which was provided by both community and specialist services, where required.
Quality assurance systems continued to be robust and used regularly by the management team to continuously improve the service. The registered manager had a thorough system in place to ensure audits and quality assurance checks were carried out and included seeking the views and experiences of people, staff and relatives. Continuous improvement was driven by engagement with people using the service and staff.
The registered manager demonstrated an excellent understanding of the needs of people as individuals and a commitment to supporting staff through training and supervision and involving families in putting the vision and values of the service into action. Senior managers had a strong presence in the home through regular visits and provided strong leadership.
There continued to be a strong emphasis on continually striving to improve. The service was able to sustain outstanding practice through regular internal quality assurance processes, providing an open and transparent culture, maintaining links with external organisations relevant to its work and developing its practice through recognised quality accreditation schemes such as accreditation and award with the National Autistic Society and Investors In People (IIP).
The provider also continued to be innovative in how they empowered people, for example through using people who use their services to contribute to the quality assurance checks of the home, in the recruitment process for staff and through using a whole team approach in supporting people with their planned care, which meant that everyone was equally committed to helping people maintain their desired lifestyle.