Background to this inspection
Updated
4 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector
Service and service type
1-4 Windsor Drive 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we looked at the information we had received about the service since the last inspection. This includes notifications and information from other agencies and professionals.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with the registered manager, the regional operations manager, the provider’s head of quality assurance and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with four members of staff and a visiting professional. We met and observed staff interaction with all of the people living there, although one person did not want to speak with us. Most of the people living at 1-4 Windsor Drive had limited verbal communication. People were able to understand our questions and responded in their own individual way.
We looked around the bungalows. We looked at records relating to the service including staff recruitment files, rotas, medicine administration, care plans and daily records, audits and monitoring reports.
After the inspection –
We continued to seek further information from the provider and registered manager about the service. The registered sent us a range of information about the service including training data and quality assurance records. One person who used the service sent us an e mail.
We spoke with one relative on the telephone and one professional who had a knowledge of the service. We also received e mails from three relatives, seven care staff, and one health professional.
Updated
4 January 2020
About the service
1 – 4 Windsor Drive is a residential care home providing personal care for up to 12 people with learning disabilities such as autism, and physical disabilities. At the time of this inspection there were nine people living at the service. Accommodation is provided in four linked semi-detached bungalows situated on the outskirts of Dawlish within easy walking distance of local amenities.
The service was registered prior to the guidance 'Registering the Right Support was published. However, the service has been developed 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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
The service is registered for the support of up to 12 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the design of the bungalows which gave the impression of a four small bungalows on a residential housing development with no outward signs that it was a care home. There was a strong focus on treating each person as an individual, and supporting people to participate in their local community.
People’s experience of using this service and what we found
Since the last inspection many changes and improvements had been made in all areas of the service. A new registered manager was appointed who has supported and inspired the staff team to bring about positive changes. Staff told us they felt valued and they were enthusiastic and proud of their achievements. Comments from staff included, “There is more continuity with staff members and a passion for what they do because they are valued within their role. The standard of the care is brilliant as the people here now genuinely care”. A relative told us, “We as [person’s] family are really happy to see the improvements which make [person’s] life so much more enjoyable.
People were supported by an exceptionally caring staff team. The staff team demonstrated passion and determination to help people overcome barriers and lead more active and fulfilling lives. In the past year people had been supported to achieve positive changes in their lives, such as overcoming agoraphobia, obtaining pets, and making plans to achieve their hopes and dreams in the near future. A person who used computer technology to enable them to communicate told us, “I am excited about (living) here and I like all staff member(s)”.
People were safe. There were sufficient staff with the skills and knowledge to give people the support they needed, at the right times. Care had been taken when recruiting new staff to ensure they were entirely suitable for the job. The number of permanently employed staff had increased, and the level of agency staff had decreased. This meant people received support from a consistent staff team they knew and trusted.
Measures were taken to minimise risks to people’s safety. Risks to people’s health and safety were assessed and staff knew how to support people to remain healthy and safe. Medicines were stored and administered safely. Staff understood how to keep people safe from infection. The accommodation and equipment were well maintained, checked and serviced.
Staff understood the support each person needed. Care plans had been improved in the last year to provide greater detail about all aspects of the support each person needed. Staff understood each person’s individual style of communication and they were working to improve this through projects, training and communication ‘Champions’.
Staff had worked with a range of professionals to improve peoples’ health and comfort. Peoples’ social needs were met through a better understanding of the things people enjoyed doing. Staff supported people to go out, participate in clubs and activities, and keep in touch with friends and family. People were encouraged to retain and gain independence, for example by involvement in meal planning, shopping and meal preparation where possible.
The service was well-led. There were checks and measures in place to ensure all aspects of the service were running smoothly. The provider, registered manager and staff team reviewed the service regularly and consulted with people who used the service, friends and family to consider any improvements needed.
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.
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 19 December 2018).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.