Archived: Swiss Cottage

Updated 11 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 19 and 20 April 2016 and was unannounced. The inspection was completed by one adult social care inspector. We did not request a Provider Information Return (PIR) at the time of our visit. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We gathered this information on the day of our inspection.

Before this inspection we looked at the previous reports and notifications received by the Care Quality Commission (CQC). A notification is information about important events which the agency is required to send us by law.

During the inspection we spoke with three people, the registered manager, one member of senior staff and three staff. We reviewed six people’s support plans and six medicines administration records (MARS).

We reviewed two staff recruitment files, the induction process for new staff, training and supervision records and quality assurance audits. We also looked at the provider’s policies and procedures, maintenance records, staff rota for the 28 February to the 17 May 2016 and complaints records. During the inspection we spent time observing staff interactions with people.

Following the inspection we spoke with a health care professional.

This service was last inspected on 19 September 2014 where no concerns were identified.

Updated 11 June 2016

This inspection was announced and took place on the 19 and 20 April 2016.

Swiss Cottage is a residential care home without nursing situated within a detached residential property on the outskirts of Basingstoke town centre. Swiss Cottage specialises in providing short to mid-term support to enable people to regain and maintain their independence before moving to more independent living accommodation.

Swiss Cottage is comprised of two floors containing individual bedrooms with communal areas including bath and shower rooms, toilets, two kitchens, a dining room and two living room areas. Outside is a large fully enclosed garden with fish pond and greenhouse as well as a large car parking area to the front of the service.

People who receive this care service live with long term enduring mental health conditions including paranoid schizophrenia and psychosis.

At the time of the inspection the service was providing personal care to six people. Care was available and provided by rehabilitation recovery workers who will be referred to as staff throughout this report.

Swiss Cottage has a registered manager in post. 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.

People using the service told us they felt safe. Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

People's safety was promoted because risks that may cause them harm had been identified and managed safely. Appropriate behaviour and medical condition related risk assessments were in place to keep people safe.

Recruitment procedures were completed to ensure people were protected from the employment of unsuitable staff. New staff induction training was followed by a period of time working with experienced colleagues. This ensured staff had the skills and confidence required to support people safely. There were sufficient numbers of staff employed to ensure that people's individual needs were met.

Contingency plans were in place, known by staff and evidenced in their practice to ensure the safe delivery of care in the event of adverse situations such as a fire, flood or power loss at the home. The registered manager was also qualified to be deployed to deliver care if staff were ill and unable to work.

People were protected from unsafe administration of their medicines because staff were trained effectively and had the competency to do so regularly assessed.

Staff had completed mandatory training to ensure they could prompt people to take their medicines where required and where they administered people's medicines this was carried out safely. People were encouraged to take steps to eventually enable them to self-medicate and become more independent. Where people did self-medicate processes were in place to ensure this was risk assessed appropriately. Staff skills in medicines administration were reviewed on a regular basis by the registered manager to ensure they remained competent.

People were supported by staff to make their own decisions. Staff were knowledgeable about the actions to take to ensure they met the requirements of the Mental Capacity Act (MCA) 2005. The registered manager and staff identified and evidenced they would work with health care professionals when required to assess people's capacity to make specific decisions for themselves.

Staff sought people's consent before delivering their care and support.

People were supported to eat and drink enough to maintain a balanced diet. People were encouraged to participate in identifying their menu choices, purchase the appropriate items and then prepare with support. A cooking club was created in the home to support people in preparing and cooking healthy and nutritious meals.

People's health needs were met to maintain their safety and welfare. Staff and the registered manager promptly engaged with other healthcare agencies and professionals to ensure people's identified health care needs were met.

Staff demonstrated they knew and understood the needs of the people they were supporting. People told us they were happy with the support provided. The registered manager and staff were able to identify and discuss the importance of maintaining people's respect and privacy at all times. People were encouraged and supported by staff to make choices about their care including how and what care they required.

People had support plans which were personalised to their needs and wishes. They contained detailed information to assist staff to provide support in a manner that respected each person's individual requirements and promoted treating people with dignity. People were encouraged to be involved in preparing their support plan and these were subject to regular reviews and when people’s support needs changed.

People knew how to complain and told us they would do so if required. Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way. People and staff were encouraged to provide feedback on the quality of the service during regular support plan reviews and quality assurance questionnaires.

The provider's values included the right for people to: experience individual-centred care; be treated compassionately; work together with staff to ensure their wellbeing and; be supported with the planning of their future. Staff were knowledgeable about how they were expected to deliver care and staff demonstrated these principles. People told us these standards were evidenced in the way that care was delivered.

The registered manager and staff promoted a positive culture which focused on providing individual person centred care. People were encouraged to raise concerns with staff and the registered manager if required.

The registered manager provided positive leadership which instilled confidence in staff and people using the service. The registered manager had informed the CQC of notifiable incidents which occurred at the service, allowing the CQC to monitor that appropriate action was taken to keep people safe.

People and staff told us the service had a confident registered manager. Staff told us they felt supported by their colleagues, senior staff and the registered manager.

The provider carried out regular quality monitoring to assess the quality of the service being delivered.