About the service 9 Victoria Street is a residential care home providing personal care for up to 16 adults or children aged 13 to 17 years who may be living with a physical disability, sensory impairment, learning disability or on the autistic spectrum. At this inspection there were six adults receiving care at the service.
This is a large service which was registered before the development and publication of Registering the Right Support and other best practice guidance. This states that people who use the service should be supported to 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. This means that people using the service should live as ordinary a life as any citizen.
The service a large home for the support of up to 16 people, which is larger than current best practice guidance for this service type. However, there were only 6 people using the service and the size of the service having a negative impact on people was mitigated to some extent, by the building design fitting into the residential area. There were deliberately no overt identifying signs externally, to indicate it was a care home.
People’s experience of using this service and what we found
The service continued to be safe. The provider’s safeguarding, staffing, medicines and risk management arrangements for people’s care, helped to protect them from the risk of harm or abuse. The provider took action for people’s safety when things went wrong at the service and to prevent any reoccurrence.
The service was now effective. Enough improvement was made to fully ensure this. People’s capacity to consent to their care was now consistently considered in line with the law. People were supported to make their own decisions and have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
People’s care needs were effectively accounted for. Staff supported people to maintain or improve their health and nutrition, through consultation with relevant external health professionals when needed. This included timely support and relevant information sharing, if they people needed to move between services for care and treatment. People’s needs were largely met by the adaptation of the premises. Work was in progress to further ensure this through the use of additional signage for people’s orientation.
The service continued to be caring. People received care from kind, caring staff, who treated them with respect and ensured their dignity, equality and rights in their care. Staff knew people well; how to communicate with them and understood what was important to people for their care. People were actively informed, involved and supported to understand, agree and make ongoing decisions about their care and future living arrangements.
The service was now personalised. Enough improvement was made to fully ensure this. People received planned, co-ordinated care, that was now consistently inclusive and person centred. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Outcomes for people therefore reflected the principles and values of Registering the right Support and other best practice guidance.
Complaints were now managed in line with the provider’s policy. Concerns and complaints were listened to and used to inform service improvements when needed for people’s care. The service does not provide end of life care. However, staff took account of people’s preferences and choices relating to end of life care as appropriate. People received the right support to enable them to cope with grief and loss when needed.
The service was now well led. Enough improvement was made to fully ensure this. The provider now sought regular opportunities to engage with and seek the views of people, staff and relevant parties, to effectively inform and ensure the quality and safety of people’s care and to drive service improvement.
Management and staff understood their role and responsibilities for people’s care. Operational management arrangements helped to ensure effective communication, record keeping, safe information handling and excellent partnership working for people’s care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 June 2018) with two breaches of regulation. 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. The provider was therefore no longer in breach of regulation.
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.