Archived: Caprani Care Support Services

Updated 15 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 14 September 2017 and was announced.

Due to the very small size of this home the inspection team consisted of one inspector who was experienced in care and support for people with learning disabilities.

Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. 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 at the inspection.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was reviewed to see if we would need to focus on any particular areas at the home. Prior to the inspection we also contacted three relatives, eight staff and three community healthcare professionals via the use of a questionnaire.

We visited the four people in their supported living home and talked with them to find out about their experiences living there. Due to people’s communication needs we also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed how staff cared for people, and worked together. During the inspection we spoke with three staff which included the registered manager. We also reviewed care and other records within the home. These included four care plans and associated records, four medicine administration records, two staff recruitment files, and the records of quality assurance checks carried out by the staff. After the inspection we contacted relatives of all four people to ask for their feedback about the service.

This was the first inspection of the service since they had registered with the CQC.

Updated 15 December 2017

Sherbrooke is a small family run supported living service based in Banstead, Surrey. The provider is Caprani Care. They personal care for up to four people who have a learning disability, autistic spectrum disorder and mental health support needs.

This inspection took place on 14 September 2017. We announced the inspection so we could gain permission to visit the people who use the service at the house they lived in. This was the first inspection since the service registered with the Care Quality Commission.

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.

There was incredibly positive feedback about the home and caring nature of staff from people and relatives. One relative said, “Our family wish all supported living was managed to Caprani Care standards.” A health care professional said, “The service excels in treating each service user as an individual. There is no one size fits all.” Everyone we spoke with told us they felt the service gave an outstanding level of care and support to people.

The registered manager, who is also the provider, had a clear vision and set of values for this service. These were based on dignity and respect, reflective learning, working together and a commitment to providing quality care and support. They were also focussed on getting to know the people they support and growing the service they received together with them. This compassionate and clear message was clearly shared by the staff team. This had a positive impact across all five of the key questions we asked (Is it safe, effective, caring, responsive, and well led) and the lives of the people who used this service.

The service strived to be known as outstanding and innovative in providing person centred care based on best practice. The registered manager had established a culture that put people at the centre of the service. This resulted in people taking back control of their lives, either from being institutionalised for their whole lives, or overcoming obstacles due to their disabilities. Staff were confident and knowledgeable in their ability to support and care for people. Their passion for supporting people to live a fulfilled life and overcoming obstacles was evident throughout the inspection.

The staff were exceptionally kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff asking people’s advice about how to proceed with tasks, or having a laugh and a joke with them. People were relaxed and happy with the staff and it was clear that caring relationships had developed between them. People’s relationships with family and friends and dramatically improved due to the support and guidance given by the staff.

People’s safety was paramount at Sherbrooke, as was their involvement in keeping themselves and others safe. People’s interests in health and safety had been identified, and training given to equip them with the skills needed to lead on safety checks around the house they lived in. Through an understanding of people and their support needs staff worked with them to manage risks and enable them to live their lives in the way they wanted. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff worked on the premise of how people could be supported to do fun, but risky activities, rather than trying to stop people doing things they liked.

Although there was a small staff team there were sufficient staff deployed to meet the needs and preferences of the individual people that they supported. The provider had implemented a values based recruitment process. This ensured that staff were not only safe to work with people, but also shared the visions and values of the service. The staff team were very positive about their enjoyment of the job and the people they supported.

Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. People and their relatives were also given training, so they understood what to look out for and who to tell. This promoted their independence by making them less vulnerable when out in the local community, or attending social events.

People’s medicines were effectively managed, and their use was regularly reviewed to see if they were actually needed. Through professional involvement many people’s medicines had been reduced, or stopped completely. This was especially apparent with behaviour modifying medicines. Staff had an exceptional knowledge of learning disabilities and mental health conditions. This resulted in people understanding and managing their own emotions, with minimal use of medicine compared to what they had needed in their past.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). Staff championed people’s rights, making sure that all decisions put the person at the centre. Staff clearly understood the principles of the MCA, and were confident in challenging outside agencies when these were not applied. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

Staff supported people with their dietary needs which improved their physical health and their understanding of how what they ate could affect their lives. Through careful guidance and instruction people developed a preference for healthy diets, resulting in all four of them reducing weight and becoming more active. People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. People’s health was seen to improve due to the care and support staff gave.

Care plans were based around the individual preferences of people as well as their medical needs. People were really involved in their care plans. Plans were in a format that best suited the person they were for. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods, recorded in the care plans matched with what we saw on the day of our inspection.

People having a fulfilled life was at the core of this service. Through careful and innovative planning people were able to overcome obstacles and access to activities that met their needs and enhanced their lives. Many of the activities were based in the local community giving people access to education, work, making friends and meeting new people. Involvement in local neighbourhood meetings also led to a better understanding of learning disabilities by people in the local community.

People had the opportunity to be involved in how the home was managed. Regular house meetings took place to give people a chance to have their say. Surveys were completed and the feedback was reviewed, and used to improve the home and the people’s experience of living there.

People had a very positive experience being supported by Sherbrooke. They were supported by staff that really enjoyed their job; who ensured that people lived in a safe home; which gave effective care; by caring and passionate staff; who responded to people’s needs and really involved them in their care and support. The registered manager gave an outstanding level of leadership to make people’s lives happy and fulfilled. A relative said, “It seems that a small well run provider like Caprani is very much the standard all providers should strive for.”