This inspection took place on 18 and 19 June 2015 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service. There was a manager registered with the Care Quality Commission (CQC); they had been registered since 13 March 2013. At the last inspection on 10 July 2013, the registered provider was compliant with all the regulations we assessed.
Roxby House is a care service providing accommodation and personal care for up to thirty younger adults with a learning disability and autistic spectrum disorder. There were twenty eight people living at the service on the day of our inspection. Roxby House consists of four separate units.
Each unit provides either individual or shared occupancy flats for between two to four people. The single occupancy flats are fully equipped and comprise of a kitchen, lounge/diner, bedroom and en-suite bathrooms which includes either a shower or bath depending on the individual’s needs. The shared flats comprise of; a communal kitchen, lounge/diner, toilet, laundry and bathroom and shower room; some also have a conservatory. Each person has their own individualised bedroom. Every unit has access to a patio or garden area. People who use the service have access to the facilities on site which include; a café, sports hall, farm, woodland area, cycle track, sensory room, computer room, gardening, woodworking, music room, hydrotherapy pool and hairdressing salon.
An outstanding feature of Roxby House was the time spent developing the service, using innovative and flexible ways to support people to move forward. They were seen to constantly adapt and strive to ensure people were able to achieve their full potential. Over a period of time we have seen people be supported to develop and move on to more independent living..
We found personalised programmes and flexible staffing enabled people to learn to live as independently as possible with the minimum of support. This was based on the philosophy of the organisation ‘fitting a service around you, not fitting you within a service’.
There was a strong person-centred culture apparent within the service. [Person centred means care is tailored to meet the needs and aspirations of each individual]. People told us they felt included in decisions and discussions about their care and treatment. Staff described working together as a team, how they were dedicated to providing person-centred care and helping people to achieve their potential. Staff told us the registered manager led by example, had a very ‘hands on’ approach and was visible within the service, making themselves accessible to all.
The people who used the service had complex needs and were not all able to tell us fully about their experiences. We used a Short Observational Framework for Inspection [SOFI] to help us understand the experiences of the people who used the service. People’s language difficulties meant we were only able to speak with five people who used the service and have limited discussions with them.
We observed staff treated people with dignity and respect and it was clear they knew people’s needs well.
We found staff were recruited in a safe way; all checks were in place before they started work and they received an induction. Staff received training and support to equip them with the skills and knowledge required to support the people who used the service. Training was based on best practice and guidance, so staff were provided with the most current information to support them in their work. There were sufficient staff on duty to meet people’s health and welfare needs.
People’s nutritional needs were met and they had access to a range of professionals in the community for advice, treatment and support. We saw staff monitored people’s health and responded quickly to any concerns.
Systems were in place to protect people from the risk of harm or abuse. Staff had received training in dealing with concerns and complaints and knew how to report any concerns. Medicines were ordered, stored, administered or disposed of safely. Personalised support plans had been developed to ensure people received their medicines in line with their preferences.
We saw people had assessments of their needs and care was planned and delivered in a person-centred way. Throughout our inspection we saw the service had creative ways of ensuring people led fulfilling lives and they were supported to make choices and have control of their lives. People
participated in a range of personal development programmes. They accessed a range of community facilities and completed activities within the service. They were encouraged to follow and develop social interests and be active and healthy.
Care plans had been developed to provide guidance for staff to support in the positive management of behaviours that may challenge the service and others. This was based on best practice guidance and least restrictive practice to support people’s safety. The guidance supported staff to provide a consistent approach to situations that may be presented, which protected people’s dignity and rights.
People lived in a safe environment that had been designed and adapted to meet the specific needs of people who used the service. Staff made sure risk assessments were carried out and took steps to minimise risks without taking away people’s right to make decisions. There was a system of audits, checks and analysis to identify shortfalls and to rectify them so the quality of care could continually be improved and developed.