Archived: Littlecroft

Updated 14 February 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.

This inspection took place on 8 and 9 January 2018 and was unannounced. The inspection was undertaken by one adult social care inspector.

Before the inspection we reviewed information we kept about the service, this included notifications of incidents. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plans to make.

During the inspection we used a range of methods to help us make our judgements. These included talking to two people who used the service, interviewing five members of staff, pathway tracking three people's records (reading people’s care plans, and other records kept about them). We reviewed other records about how the service was managed including records about the operation of the medicines system, three electronic staff personnel files, and records about the quality assurance systems for the service.

After the inspection we contacted three professionals who were external to the service and three relatives of people who used the service for their feedback.

Updated 14 February 2018

This inspection took place on 8 and 9 January 2018 and was unannounced.

Littlecroft 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.

Littlecroft provides accommodation for up to three people with a learning disability and complex needs. The service uses three detached bungalows with gardens. There were three people living at the service at the time of our 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.

There was 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.

Some people who lived at Littlecroft had limited communication skills meaning we were unable to gain some people’s verbal views on the service. We observed staff interactions and spoke with two people who lived there. We observed that people were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. We also spoke with people’s relatives and staff to understand their experiences.

The service provided an extensive range of personalised activities chosen by people to participate in. People were encouraged and supported to take up both paid and voluntary job opportunities in their local community. One person had received recognition in their local newspaper following work they had undertaken with an animal rescue. People told us they were supported to achieve their goals and aspirations and to live happy and rewarding lives.

There was a positive atmosphere within the service and it was noticeable that staff and management put people at the centre of the service. Staff were enthusiastic and passionate about the service. Comments included, “I believe people receive very good care and support here. Everything we do here is individualised to the people who live here.”

People were supported by a stable and consistent staff team who had received training specific to their needs. Staff told us they enjoyed their work and were well supported through supervision, appraisals and training. New staff received an induction, which incorporated the care certificate. All staff received an appraisal of their work. Staff comments included, “Green Light are a good employer, we have a strong stable team and we are well supported in our roles”, "The training is very good. We are always doing training and we are encouraged to do further training when it’s required to meet the needs of the people we support". A healthcare professional commented “As a company Green Light regularly book epilepsy awareness training from Cornwall Foundation Trust – this is a mandatory training for all carers of [person’s name] because [person] has rescue medication prescribed.”

Staff demonstrated a good depth of knowledge about the people they cared for and responded appropriately as people's needs changed. Staff spoke positively about the people they supported and were motivated to provide an individualised service in line with people's needs and goals.

People had a care plan that provided staff with direction and guidance about how to meet people’s individual needs and wishes. Care plans were regularly reviewed and any changes in people’s needs were communicated to staff. For example, one person was reported as sometimes having a deterioration in mood and a change in the way they communicated following events associated with a medical condition. This was made clear in the person’s care plan to ensure staff were sensitive and knowledgeable in how best to communicate with the person after an event.

Care plans were presented in written and pictorial formats to enable people to read their plan and be involved in any changes or updates. Details of how people wished to be supported with their care needs were highly personalised and provided clear information to enable staff to provide appropriate and effective support.

Medicines management systems were robust. People told us they felt safe with the staff who supported them. Staff were confident about the action to take if they had any safeguarding concerns and were confident the registered manager would follow up any worries they might have. Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence. For example, we saw risk assessments regarding appropriately supporting people to access their local community as well as keeping safe in their home environment.

Staff were recruited safely, which helped ensure they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

People were involved in choosing the staff that supported them. Efforts were made to match staff with people by identifying any shared interests and hobbies. For example, staff told us that you had to be fit to work at Littlecroft because people tended to be active and enjoy outdoor pursuits such as surfing and coastal walks.

The service offered flexible support to people and were able to adapt in order to meet people's needs and support them as they wanted. For example, by providing more or less support according to what each person wanted and at times which suited the individual.

People and their relatives were encouraged to be involved in the planning of care. Senior management, staff and relatives regularly discussed how to best support people living at the service. Relatives’ commented, “Staff keep me informed regularly and I am easily able to speak with anyone should I need to. My [relative] has the best possible quality of life possible with [their] needs living at Littlecroft. I am so grateful and thankful he is lucky enough to have a place there” and “Littlecroft is an excellent place. My [relative] is so well looked after. Staff are professional and kind; they help my [relative] to achieve without taking over, they support him and maintain a caring calm atmosphere for him.”

There were regular feedback opportunities for people to give their thoughts on how the service was working. This enabled people and their relatives to comment on the service independently. Feedback received from relatives of people supported at Littlecroft confirmed family members felt involved and an integral part of their relative’s care team. This was important because all three people supported at Littlecroft wanted involvement of their family to one degree or another in their care package.

The service was well led and staff were motivated and keen to ensure the care needs of the people they were supporting were met. The management team had a clear set of values which was also apparent in our discussions with staff. There was a positive culture within the staff team and staff spoke positively about their work. The registered manager spoke highly of the staff team describing them as committed and enthusiastic in their approach to work. Staff told us they felt involved in the development of the service and that management listened to any ideas and suggestions they had and took them on board.

Comprehensive quality assurance processes were regularly undertaken to ensure management were aware of how the service was operating, and were able to implement changes to keep the quality of the service high. This included internal inspections of all aspects of the running of the service which highlighted any areas that required action. Accidents and incidents were accurately recorded and reported and any lessons learned were shared with staff. The service learned from any mistakes and used these as an opportunity to raise standards. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.

The service sought the views and experiences of people, their families and the staff in order to continually improve the service. People who used the service and their relatives told us the service was well led and they felt actively involved in arrangements for their and/or their relative’s support package. A relative commented, “Staff keep me informed regularly and I am able to speak with anyone should I need to easily. My son has the best possible quality of life possible with his needs living at Littlecroft and I am so grateful and thankful he is lucky enough to have a place there.”

The service worked successfully with healthcare services to ensure people's health care needs were met and had supported people to access services from a variety of healthcare professionals including GPs, dentists, psychological services, occupational therapists as well as other specialist medical services to provide additional support when required. Health and social care professionals were positive about the service, comments included,“In my opinion people I have worked with who live at Littlecroft are well supported” and “The carers we have met know and understand [person’s name] well. They appear caring and supportive of him and ‘allow him his space’.”

People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Approp