Reach Lower Cippenham Lane

Updated 29 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

Reach Lower Cippenham Lane is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

Our inspection was informed by evidence we already held about the service, which included information received about the service since the last inspection. We also checked for feedback we received from members of the public, local authorities and clinical commissioning groups (CCGs). We contacted health and social care professionals who work with the service. We checked records held by Companies House, the Information Commissioner’s Office, the fire brigade and the Food Standards Agency.

The provider was 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 three people who lived at the service and observed four more people’s interactions with staff. We received feedback from two relatives. We observed people’s dining experience. We spoke with eight employees including two operations managers, the registered manager, the deputy manager and four care workers.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment, supervision and performance appraisal. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We used this evidence as part of the inspection process and ratings. We received written feedback from health and social care professionals.

Updated 29 January 2020

About the service

Reach Lower Cippenham Lane is a residential care home providing personal care to 12 adults at the time of our inspection. The service can support up to 12 people with learning disabilities or autism spectrum disorder. The building is a converted residential house with a ground and first floor and adapted facilities.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Twelve people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were protected against abuse and neglect. People's risks were satisfactorily assessed. There was enough staffing deployed. The building was clean and tidy with appropriate cleaning to prevent infections. Clinical and general waste storage conditions on the outside of the home required closer monitoring to mitigate any risks. Accidents and incidents were logged. Improvements to the storage of refrigerated medicines were made as part of the inspection.

People's preferences were assessed and documented. Staff support was appropriate and showed that the training, supervisions and performance appraisals were up to date. People received enough food and drink. Any healthcare issues were referred to external healthcare professionals. The service was compliant with the provisions of the Mental Capacity Act (2005).

Staff were kind and caring. We received positive feedback from health and social care professionals when we approached them for their views. There was good engagement between staff and people who lived at the service. There was evidence of people's and relatives' involvement in the care planning. Reviews were undertaken regularly. People's dignity and privacy was respected.

People's care plans are very person centred and people's preferences were detailed and documented. Complaints were appropriately documented and managed. People had access to an active social life, both within and external to the care home. Plans were in place for end of life care.

There is a positive workplace culture; staff said it was a great place to work. The provider and the registered manager had implemented robust quality assurance systems. Actions were taken when improvements were required. There was good engagement with people, relatives and staff. There were positive remarks about the management team; staff said they felt supported and listened to.

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 good (last published 2 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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