This unannounced inspection of Baytrees took place on 17 and 18 June 2015. The service offers accommodation and support to four people who may have learning disabilities or autism. The primary aim at Baytrees is to support people to lead a full and active life within their local communities and continue with life-long learning and personal development. The home is a detached house, with a substantial rear garden, within a residential area, which has been furnished to meet individual needs.
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.
People and relatives told us they trusted the staff who made them feel safe. Staff had completed safeguarding training and had access to current guidance. They were able to recognise if people were at risk and knew what action they should take to protect them. People were safeguarded from the risk of abuse. Staff had responded appropriately to safeguarding incidents to protect people. The provider had made changes to people’s care as a result of incidents to safeguard them.
People’s safety was promoted through individualised risk assessments. Risks had been identified, and plans were in place to manage these effectively. Staff understood the risks to people’s health and welfare, and followed guidance to safely manage them.
The registered manager completed a daily staffing needs analysis to ensure there were always sufficient staff with the necessary experience and skills to support people safely. Whenever possible the registered manager and staff worked together with people to identify in advance when their needs and dependency were likely to increase.
People were cared for by staff who had undergone the required pre-employment checks to ensure their suitability and had received an induction based on the social care industry requirements. The induction also took into account the specific needs of the people cared for by the service, including autism and epilepsy. Staff had the required training updated in accordance with the provider’s policy. The provider supported staff to meet people’s needs with an effective programme of induction, supervision and appraisal. Staff were encouraged to undertake additional relevant qualifications to enable them to provide people’s care effectively and were supported with their career development.
Medicines were administered safely in a way people preferred, by trained staff who had their competency assessed by the registered manager.
People were actively involved in making decisions about their care and were asked for their consent before being supported. Relationships between staff and people were relaxed and positive. Staff engaged with people to identify their individual needs and what they wanted to achieve in the future. Staff showed flexibility and creativity in supporting people to become more independent. People were encouraged to be as independent as they were able to be, as safely as possible.
Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to support people who do not have capacity to make a specific decision. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made on their behalf. People were supported by staff who supported them to make day to day decisions.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide a lawful way to deprive someone of their liberty, where it is in their best interests or is necessary to protect them from harm. The registered manager had completed the required training and was aware of relevant case law. The registered manager had taken the necessary action to ensure people’s rights were recognised and maintained.
People were provided with nutritious food and drink, which met their dietary preferences and requirements. People were supported to eat a healthy diet of their choice.
There was a friendly and relaxed atmosphere within the service, where people were encouraged by staff to express their feelings, whilst respecting others. People told us that when they had a problem or were worried they felt happy to talk with any of the staff. Whenever people had raised concerns or issues prompt action had been taken by the registered manager to address them.
People’s dignity and privacy were respected and supported by staff, who were skilled in using individual’s specific communication methods. Staff were aware of changes in people’s needs, which were reported to relevant healthcare services promptly where required.
The provider had deployed sufficient staff to provide stimulating activities for people. The activities programme had been revised, and there were a range of events arranged. This ensured people were supported to pursue social activities which protected them from social isolation.
People told us they knew how to complain and that the registered manager encouraged them to raise concerns. When complaints were made they were investigated and action was taken by the provider to make improvements where required.
Staff had received training in the values of the provider as part of their induction, which were discussed during all team meetings. People, their relatives and staff told us the service was well managed, with an open and positive culture. People and staff told us the registered manager was very approachable, willing to listen and make any necessary changes to improve things for people.
The registered manager provided clear and direct leadership and effectively operated systems to assure the quality of the service and drive improvements.
People’s needs were accurately reflected in detailed plans of care and risk assessments, which were up to date. These plans contained appropriate levels of information. For example, if a member of staff from another service arrived to provide support in response to staff absence after reading these plans they would be able to support people safely. Throughout the inspection the registered manager and staff were able to find any information we asked to look at promptly.
People’s and staff records were stored securely, protecting their confidential information from unauthorised persons, whilst remaining accessible to authorised staff. Processes were in place to protect staff and people’s confidential information.