Lavanda Villa

About the service

Lavanda Villa is a residential care home specialising in autism care and was providing personal care and support to 4 people at the time of the inspection. The service can support up to 4 people.

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

Right Support

The service gave people care and support in a safe, clean, well equipped, well-furnished, and well-maintained environment that met their sensory and physical needs. Staff supported people to access health and social care support, which included a regular review of their prescribed medicines. Staff supported people with their medicines safely. Positive relationships had developed with local health care providers, who provided timely support, considering people’s emotional and sensory needs for planned appointments.

The service encouraged people to be involved fully in discussions about their care and support, holding a weekly meeting for people to decide on activities and meals. People were supported by staff to pursue their interests and hobbies.

Right Care

People received kind and compassionate care. Staff understood and responded to people’s individual needs. Staff received training on how recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff completed specialised training on learning disabilities and autism.

Some people communicated non-verbally, for example through body language, sounds, pictures and symbols. They could interact with staff and others involved in their care and support because staff had the necessary skills to understand them. Staff, relatives, and people worked together to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them were involved in planning their care. The service evaluated the quality of support provided to people, involving the person, their families, and other professionals as appropriate. The service valued and acted upon people’s views.

People appeared relaxed within their home and in the presence of staff. We observed them being supported to make decisions about their day that included meals, activities, and health needs. 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 Good (published 11 August 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe, effective, and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lavanda Villa on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ People understood the importance of wearing masks when they were attending appointments and the importance of good hygiene. Staff supported people safely, maintaining social distancing as far as possible and wearing their Personal Protective Equipment (PPE) in line with national guidance.

¿ The environment was clean and airy. Robust cleaning procedures were implemented and carried out by staff several times a day. The registered manager carried out audits to ensure infection control processes and cleaning was done to a high standard.

¿ There were permanent staff working at the service and contingency planning was in place to ensure shifts could be covered in case staff had to self-isolate.

¿ People had individual bedrooms and bathrooms which, should they have to isolate, they could do this effectively.

¿ Risk assessments were carried out for people and staff to establish the level of risk to each individual and to identify if further measures were needed to keep people and staff safe.

¿ A robust package of policies, procedures and guidance had been developed by the provider which the registered manager had successfully implemented at the service.

Further information is in the detailed findings below.

The service can accommodate up to four people living with a learning disability or autistic spectrum disorder. The accommodation is arranged over two floors with accessible outside space. At the time of this inspection there were four people living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the overall rating of good although we found improvements were needed to safeguard the way people’s finances were managed. However, there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is still rated good:

People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe. Processes were also in place to ensure risks to people were managed safely.

There were enough staff, with the right training and support, to meet people’s needs and help them to stay safe. The provider carried out checks on new staff to make sure they were suitable and safe to work at the service.

Systems were in place to ensure people received their medicines in a safe way and people were protected by the prevention and control of infection.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People received care and support that promoted a good quality of life and was delivered in line with current legislation and standards.

People were supported to eat and drink enough. People were actively involved in choosing what they ate and helped to prepare meals for each other. Risks to people with complex eating needs were being managed appropriately

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

The building provided people with sufficient accessible space, including a garden, to meet their needs. The service operated in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

The service generally acted in line with legislation and guidance regarding seeking people’s consent. More work was planned however, to ensure best interest decisions were recorded for financial expenditure where people did not have capacity to understand or manage their own money.

Staff provided care and support in a kind and compassionate way. People were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to participate in activities, both in and out of the service.

Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

Work was underway to develop new care plans that would support people at the end of their life to have a comfortable, dignified and pain free death, if the need arose.

There was strong leadership at the service which promoted a positive culture that was person centred and open. Arrangements were in place to involve people in developing the service and seek their feedback.

Systems were in place to monitor the quality of service provision and to drive continuous improvement.

Opportunities for the service to learn and improve were welcomed and acted upon, and the service worked in partnership with other agencies for the benefit of the people living there.

Further information is in the detailed findings below.

This meant that the provider could not fully evidence the service had effective processes in place to promote effective infection control.

We imposed a compliance action and told the provider they needed to make improvements. The provider submitted an action plan in December 2013, which stated they had implemented improved systems to ensure the identified areas had been addressed and that compliance would be achieved by the end of December 2013.

When we visited the home on 8 January 2014, we spoke we spoke with the registered manager who told us what improvements had been made to address the standards of cleanliness and hygiene. We also saw evidence of the work that had taken place to address the identified issues. There was new flooring within the lounge area, which continued through to the hallway, stairs and up into one of the bedroom areas. We saw that seals around sinks and shower trays had been replaced and that the home appeared clean and free from odour. This meant that people were better protected against the risks of infection within the home.

The two most vulnerable people we observed, clearly communicated through their body language or Makaton (sign language) that they were satisfied with the care and support they received. We observed that all were offered support that ensured their individual needs were met and independence encouraged. Staff were friendly and respectful in their approach and interacted confidently with people, respecting the individual's dignity and skilled at communicating effectively with them.

However we found the service did not have an effective system in place to maintain appropriate standards of cleanliness and hygiene. We found two malodourous carpets and found seals around sinks and showers were cracked.

We saw that people's bedrooms had been personalised with pictures and objects of each person's interests and taste. One person told us they were happy. One member of staff said, 'lately there have been improvements to maintenance which has been very positive.' We noted that regular safety checks were carried out and recorded in relation to the building, including fire drills.

The staff on duty were polite and respectful in their approach to people and engaged effectively with them, supporting them in planning care needs and making decisions about how they spent their time. One person said "I'm allowed to go swimming which I really enjoy." It was evident from the care records and our discussions with staff, that there was an appreciation of the need to be flexible in providing care to allow for people to make alternative choices at times.

We spoke with one person currently living at the home and observed a further two people. One person said, "I like everything about being here, they look after me really well." We observed that other people were settled and relaxed, engaged in arts and crafts or listening to music.