Wentworth Close

Wentworth Close is a residential care home that provides accommodation and personal care for up to four people who have learning disabilities and autism. There were four people using the service at the time of inspection. Some had specialist needs related to Autism and behaviours that challenged. People had different communication needs. Most had limited verbal communication and used gestures and body language to make their needs known. The organisation also runs other care homes locally.

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

The registered manager was also the manager of another care home within the organisation and he divided his time between each home. A specialist senior support worker was responsible for the day to day running of the home in his absence.

Although there was generally good communication between senior management, information about one person’s health needs had not been communicated well and therefore not treated as urgent. Feedback from some health professionals highlighted a need for communication to improve. The registered manager responded well to this and systems were immediately set up to improve communication.

There were shortfalls in some areas of record keeping. One person had a health need and there was no risk assessment or care plan to guide staff on how to support the person. Although staff spoke to us about providing person centred care, daily records did not always demonstrate this. It was not evident people had opportunities to go out at the weekends as staff levels did not allow for this to happen.

The service applied the principles and values of Registering the Right Support and other best practice guidance. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. They were encouraged to take part in daily living tasks with support from staff in areas such as laundry, taking dishes to the kitchen and putting their laundry away.

People were supported to maintain their own interests. Staff supported people to take part in choosing activities to meet their individual needs and wishes. One person liked to listen to his record player. Others chose activities including, bowling, using cafes and restaurants, walks in the park and trips to places of interest. Music sessions and aromatherapy was provided at Wentworth.

People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. The home was clean and tidy throughout. Recruitment procedures ensured only suitable staff worked at the service.

Some of the staff knew people from previous placements and had a very good knowledge of them as individuals. People’s care plans were assessed and reviewed regularly. A social care professional told us the,

Staff understood the risks associated with the people they supported. Risk assessments provided further guidance for staff about individual and environmental risks and there were positive behavioural support plans to guide staff in supporting people whose behaviours were challenging. People were supported to receive their medicines safely. Where appropriate, staff supported people to attend health appointments, such as the GP or dentist and appointments for specialist advice and support.

Staff received training that helped them to deliver the care and support people needed. This included specialist training in autism and positive behavioural support to meet people’s complex needs. They attended regular supervision meetings and told us they were very well supported by the registered manager. A staff member told us, “If we need support, we can call management and they are there. It’s one of the best places for support.”

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. There was a detailed complaint procedure, and this was displayed so anyone wanting to raise a concern could do so.

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 Requires Improvement. (Published 25 January 2019).

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Follow up

We will ask the provider to send us an action plan to address the shortfalls found. We will continue to monitor the service until the next inspection. This will be within a year of the publication date of this report.

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 who used the service can live as ordinary a life as any citizen.

Wentworth Close provides accommodation and personal care for up to four people who have learning disabilities and some associated physical and/or sensory disabilities. There were four people using the service at the time of inspection. The building was a purpose built bungalow situated in Bexhill-On-Sea, close to local shops and public transport links. People had their own bathrooms attached to their bedrooms. There was a kitchen, lounge and dining-room for people to relax in. There was also a large garden, with seating areas and raised flower beds for growing vegetables.

This is the service's first inspection. They were previously registered under a different provider; however, the same people were living at the service.

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 2008 and associated Regulations about how the service is run. During this inspection, the registered manager was on long term leave. Therefore, the service was being managed by an interim manager and interim deputy manager. They had been in post for one month prior to the inspection.

We were told during inspection that the service had been through a difficult period of losing staff. As a result, some areas, such as activities, staff support and meetings had lapsed. The new interim management team had identified a lot of areas for improvement. Some had already been addressed, whilst others, such as activities and communication tools for people, required more time to be implemented and imbedded into everyday practice. Mental capacity documentation did not reflect the views of the person or how the decision was made that they lacked capacity. Some people could not make decisions related to restrictive practices, such as locks on the main doors. They did not have mental capacity assessments specific to these. However, people were not distressed by these restrictive practices and therefore we considered the impact on them to be low.

Staff understood people and risks to their wellbeing. There were robust risk assessments for people and the environment, which informed ways to keep people as safe as possible. People received their medicines from staff who had appropriate training and their competency regularly assessed. Staff were recruited safely and had a good understanding of safeguarding processes. Although some concerns had been raised by relatives about recent staffing issues, we found there were suitable numbers of staff to meet people’s needs.

Staff had the skills and knowledge to meet people’s needs effectively. They told us that the interim management team had improved the frequency of supervisions and team meetings, which they found helpful in discussing concerns. Staff felt the new induction process allowed them enough time to get to know people, their preferences and routines. Although we identified areas for improvement with documentation, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People’s nutritional needs were consistently met and they were supported to access health and social care professionals to improve their wellbeing.

We observed that people had built good relationships with staff that they were happy to be with and trusted. Relatives felt that staff were kind and caring. People’s independence, privacy and dignity was promoted at all times. Staff also had a good understanding of confidentiality and how to keep people’s information private.

Staff knew people’s communication needs well. Although no official complaints had been received, people and relatives were reminded regularly of the process to follow if they were unhappy with any element of care provided. Staff were responsive to people, their preferences and what made them anxious.

Staff and professionals spoke highly of the new interim management team and felt they had made a lot of positive changes in the short time they had managed the service. The interim management team were aware of improvements needed and had worked hard to address these. They were passionate about improving the lives of people and encouraged team work in managing concerns and generating ideas for the future of the service.

Further information is in the detailed findings below.