Conquest House

We found the following examples of good practice.

The service was only receiving essential visitors at the time of our inspection. Any person entering the building washed their hands-on entry, had their temperature taken, completed a health questionnaire and wore full personal protective equipment (PPE).

People living in the service had been separated into ‘bubbles’ of no more than four people. Each bubble had their own communal area, which included a living and dining space, and their own allocated staff. Only senior staff could move between the bubbles, and adhered to their PPE policy, including fully donning and doffing between areas. This means completely removing and disposing of PPE, hand washing and sanitising before reapplying PPE.

The registered manager had developed social stories for people living in Conquest House on topics related to COVID-19 to supported people’s understanding. Staff had also used visual prompts for people using pepper on their hands, to show how germs spread and to explain why staff now had to wear face masks. People were also given the option to wear face masks themselves if they wanted to.

Multiple entrances were used for entry and exit, with a one-way system in place. The service had a large communal garden which had been utilised to provide activities for people to use. There was a large marque for outdoor activities.

The building was clean and free from clutter. At the time of inspection maintenance staff were on site cleaning and re-painting communal areas. We also observed staff cleaning communal areas and bathrooms and ensuring that areas regularly touched by hands were disinfected.

The registered manager told us that they were working collaboratively with colleagues from the Local Authority and CCG (Clinical Commissioning Group) and were well supported as a result.

The care home accommodates 10 people in the main part of the house and one person in a self-contained flat within the same building. The home provides care and support to people with autism, learning disabilities and mental health conditions. Nursing care is not provided.

The unannounced inspection took place on 13 November and 11 December 2017.

At the time of the inspection there was a registered manager. However they were no longer working at Conquest House. A new manager had been appointed and was in the process of applying to become the registered manager. 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.

Staff had taken action to minimise the risks to people. Risk assessments identified risks and identified how to reduce them where possible. Staff had been assessed as competent to administer medication. Staff followed the correct procedures when administrating, recording and storing medication so that people received their medication as prescribed. Staff were aware of the procedures to follow if they thought anyone had been harmed. Information was not always available about people’s history or mental health support needs.

Staff were only employed after they completed a thorough recruitment procedure. There were enough staff on shift to ensure that people had their needs met in a timely manner. Staff received the training they required to meet people’s needs and were supported in their roles.

The CQC is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider had completed capacity assessments and DoLS applications. The provider could demonstrate how they supported people to make decisions about their care and the principles of the MCA were being followed.

Staff were kind and caring when working with people. They knew people well and were aware of their history, preferences, likes and dislikes. People’s privacy and dignity were respected and promoted.

Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed. People were provided with a choice of food and drink that they enjoyed. People were given the right amount of support to enable them to eat and drink.

There was a varied programme of activities including in-house group activities, one-to-one activities, entertainers and trips out. Staff supported people to maintain their interests and their links with the local community to promote social inclusion.

Care plans gave staff the majority of information they required to meet people’s care and support needs. People received support in the way that they preferred and met their individual needs.

There was a complaints procedure in place and people and their relatives felt confident to raise any concerns either with the staff or manager. Complaints had been dealt with appropriately.

There was an effective quality assurance process in place which included obtaining the views of people that lived in the home and their relatives and the staff. Where needed action had been taken to make improvements to the service being offered.

This unannounced inspection took place on 7 March 2016.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 scheme is run.

People had their needs assessed and reviewed so that staff knew how to support them to maintain their independence. Peoples support plans were completed and reviewed with them.

The risk of harm for people was reduced because staff knew how to recognise and report abuse. There was a sufficient number of staff to meet the support needs of people living in the home. Satisfactory pre-employment checks were completed before staff employed to support people in the home.

People were supported to be as safe as possible because assessments had been completed for all risks and how they were managed. This meant staff had the information they needed to reduce risks.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and could describe how people were supported to make decisions.

People were supported to take their medicines as prescribed and medicines were safely managed.

An effective induction process was in place to support new staff and further training was provided to ensure all staff had the necessary expertise.

People had sufficient food and drink of their choice throughout the day. People were supported by kind, caring and happy staff. People’s privacy and dignity was respected by staff.

A range of audit and quality assurance procedures were in place. These were used as a means of identifying areas for improvement and also where good practice had been established. Information to assess the quality of the service was gained through residents’ ‘Your Voice’ meetings, quality questionnaires and staff meetings.

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the home safe, effective, caring, responsive and well-led?

We spoke with five people who lived at the home. We also spoke with the manager and three other members of staff. We looked at written records, which included people's care records, medication systems and quality assurance documentation.

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary, please read the full report.

Is the home safe?

The accommodation was warm, clean and properly maintained. People were protected by safe recruitment practices.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the home effective?

People we spoke with were satisfied with the care and support they received. No one raised any concerns with us.

People were cared for by staff who were properly trained and supported to develop professionally. People were treated with respect and were encouraged to promote their independence and community involvement. People were given information and support to help them understand the care and support available to them.

Is the home caring?

We spoke with five people who lived at the home. One person said to us, "I like living here, but I'm working towards living somewhere more independent. Staff are helping me do that." Another person said, "I like going out with the staff. The staff are very nice."

We witnessed the care and attention people received from staff. All interactions we saw were respectful, encouraging and friendly. There was a relaxed atmosphere throughout the home and a good rapport between staff and the people who lived there.

Is the home responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Where people did not have the capacity to give consent, we found the provider acted in accordance with legal requirements. Care plans and risk assessments were informative, up to date and regularly reviewed.

Three staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service.

Is the home well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

Staff knew when people were providing agreement and consent to their care and also understood when a person communicated that they did not want the care. One relative we spoke with said, "They always ask my daughter before providing her care and support if it is "Alright." People's mental capacity to provide consent had been assessed for those people who required this.

Care plans we reviewed were detailed and provided staff with sufficient guidance and information that would allow any member of staff to care for that person. One relative we spoke with said, "I couldn't wish for a better place for my son to be. The staff are all very good at managing his expectations."

Building maintenance and checks of power supply systems and utilities such as water were carried out. This meant that people were cared for in a safe and well maintained environment. People who needed care to be provided in an easily accessible location had the things they needed put in place.

Records viewed evidenced to us that statutory inspections such as those for Legionella bacteria, portable and transportable (PAT) testing of electrical equipment and fire regulatory authority checks had all been satisfactorily completed. Records we asked for were provided promptly. We saw that all records were held in a secure location.

All of the staff we spoke with clearly knew each person who used the service well and how to meet that person's care and support needs whilst ensuring, as much as practicable, that people were offered independence in everything they did or aspired to do.

The provider had robust systems in place which ensured people's finances were managed effectively. All of the staff we spoke with were able to describe how the safeguarding of vulnerable adults (SOVA) was maintained and also the reporting process if they needed to raise a SOVA concern. Most of the staff we spoke with knew they could also contact the Care Quality Commission (CQC) if they needed to.

Staff were supported with an effective and regular appraisal and supervision process which enabled them to develop and also gain additional health care qualifications including specialist care provision such as diabetes and dementia care.

During our review of records and meetings held at Conquest House we noted that the provider used different methods to identify ways of improving the service including an annual satisfaction survey for relatives and representatives of people who used the service. The manager also demonstrated to us the 'Your Voice' meeting records for people who used the service with an aim to continually improve their care.