Mulberry Court

We found the following examples of good practice.

There was a clear procedure in place to safely welcome visitors to the home. Visitors were asked to sign in, show evidence of taking a Lateral Flow Device (LFD) test, their vaccination status and have their temperature taken. There was a supply of appropriate personal protective equipment (PPE) and clear guidance posters on how people could keep themselves and others safe and minimise the risk of cross infection. PPE complied with current government standards and was used in line with government guidance.

People were cared for by staff trained in safe infection, prevention and control, (IPC) practices. Staff regularly undertook refresher training that covered infection prevention and control processes. Staff spoke knowledgably about the risk of cross contamination and followed current IPC guidelines to help keep people safe.

We met four people and spoke with one person and one relative during the inspection. People told us they enjoyed living at Mulberry Court. One person told us, “We are all coping with it all day to day. We have lots of new staff, any problems at all we would speak up.” We discussed the wearing of PPE, one person replied, “We wear a mask when we go shopping, to keep everyone safe.”

People understood the constraints COVID-19 had placed on them. One person said, “We have been a bit restricted because of COVID-19. I’ve had my jabs and I’m getting out and about a bit more now which is good.” A relative told us, “It has all been very good…they are testing all the time and the staff are always wearing their masks all the time. It’s clean and hygienic, we are very happy with everything. We have been kept well informed, especially with the visiting and testing.”

There was a clear system in place to ensure people and staff received their tests in line with government guidance. People living at Mulberry Court, and the staff team, were fully engaged in both the COVID-19 vaccine and testing programmes. The service ensured people and relatives were kept informed of the current COVID-19 guidelines.

People had individual COVID-19 risk assessments. The service was working within the principles of the Mental Capacity Act 2005 (MCA) in relation to all COVID-19 processes.

The premises and equipment were visibly clean and all areas were well ventilated and uncluttered to ensure people’s safety. The service had robust cleaning systems in place with scheduled daily, weekly and monthly cleans and frequent high touch point cleaning for high risk areas such as door handles, handrails and light switches. Cleaning products used were in line with government guidelines and were effective against COVID-19.

Policies and procedures were in line with current government guidance and used to inform staff, people and their families. Governance arrangements ensured that IPC policies and procedures were met.

We found the following examples of good practice:

The home had a robust procedure for visitors to help reduce the risk of infection. This included a health questionnaire, temperature check and supply of personal protective equipment (PPE). In addition, all visitors, apart from emergency services personnel, were subject to a rapid Covid-19 test, which indicated a positive or negative test result within 30 minutes.

The home was visibly clean throughout. The cleaning schedule included general cleaning and high touch point areas such as light switches, handrails and door handles. Specialist cleaning products were used to minimise the risk of infection. The manager completed spot checks to monitor standards.

The home regularly tested people and staff in line with the government’s testing programme. People and staff were currently Covid-19 free.

People had individual Covid-19 risk assessments. The manager had purchased buffs (a tube of cloth) as some people struggled with face masks. They had also produced an easy read booklet to help reassure people who might feel anxious seeing staff in PPE. Reasonable adjustments had also been considered for staff who were potentially more at risk of the virus due to health conditions, age and/or their ethnicity. This included changes to their shifts.

Staff had a plentiful supply of PPE and were observed wearing this appropriately during the inspection. The provider had ensured all staff had received training in donning and doffing of PPE and lateral flow testing. Monthly infection prevention and control audits were carried out by the manager and action taken where necessary.

The home understood the importance of helping people and staff to maintain their mental wellbeing. Activities to help people remain healthy and stimulated included crafting, films, baking and walks. A telephone and tablet were available to ensure people could stay in contact with family and friends when visits were not possible. Staff were provided with resources to help maintain their mental wellbeing and regular contact was made with them if they needed to self-isolate. The manager told us they felt very supported by the provider.

Mulberry Court provides care in two bungalows for up to 12 people. During our inspection there was 11 people accommodated at the service. The buildings had been purposely built to provide housing for people who needed support to remain as independent as possible.

Rating at last inspection:

This was the first inspection on the service since a change in registration in 2017.

Why we inspected:

This was a scheduled inspection.

People’s experience of using this service:

Some people had lived there for a number of years and had varying degrees of support needs including learning disabilities, autism and communication difficulties. Therefore, some people were not able to tell us about their experiences of life at the service. We used our observations of care and our discussions with relatives and staff to help form our judgements.

People had good community networks which were personal to them. This included, links with local church’s, day services. People had been supported to develop and maintain positive relationships, including the use of technology to keep connect with family and friends. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people to learn essential life skills. Staff encouraged positive risk taking so people could experience new things and develop wider opportunities. This had led to people feeling fulfilled and living an active life.

The service met the values that underpin the 'Registering the Right Support' and other best practice guidance such as 'Building the Right Support'. These values include choice, promotion of independence and inclusion. Also, how people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There were a range of checks in place to ensure the safety of the homes. There were systems in place to manage infection control, and staff were aware of their responsibility in regards keeping the homes clean and infection free.

Comprehensive individual care plans were in place which include information such as likes dislikes, people who they wished to be involved in their care. This was described as people’s circle of support. The care plans addressed what each person liked to do, people who are important to them and who would be able to advocate on their behalf.

People were supported to make choices and staff supported people in the least restrictive way as possible. This was kept under review. Staff were aware of the legislation to protect people’s rights in making decisions.

Accidents and incidents were monitored to identify and address any patterns or themes. Learning from incidents was shared with the staff team. Records demonstrated that when an incident or accident occurred staff reported these to their management team to monitor.

Although there were sufficient staff available to support people, there was a high turnover of staff. The registered manager told us there was a current staffing crisis but they ensured sufficient staff were on duty with the use of agency staff. Relatives commented that they felt their relatives were safe, but concerned about the high turnover of staff. Staff said they felt well supported by the management team and senior staff overseeing the service.

Staff received supervision in line with the provider’s policy, staff felt supported and able to request a supervision if they needed one. Staff told us they were able to speak to their management team as they operated an open-door approach.

People had good health care support from professionals. When people were unwell, staff had raised a concern and taken action with health professionals to address people’s health care needs. Staff followed guidance provided to support people with their care.

A full description of our findings can be found in the sections below.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk