An Caladh House

Updated 16 March 2019

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 is 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 7 and 8 January 2019 and was announced. One inspector carried out the inspection.

Some of the people who used the service had complex needs which limited their verbal communication. This meant they could not always tell us their views of the service. We spoke with two people, carried out observations and spoke with three of their family members. We spoke with the registered manager, deputy manager, area manager, senior compliance officer, three staff and two health and social care professionals. We looked at the care records of five people who used the service and the personnel files for three members of staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Before we visited the service we checked the information we held about this location and the service provider, for example, inspection history, statutory notifications and complaints. A notification is information about important events which the service is required to send to CQC by law. We contacted professionals involved in caring for people who used the service, including commissioners and safeguarding staff. We also contacted Healthwatch. Healthwatch is the local consumer champion for health and social care services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work. Information provided by these professionals was used to inform the inspection.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Updated 16 March 2019

This inspection took place on 7 and 8 January 2019 and was announced. This was to ensure someone would be available to speak with and show us records.

An Caladh House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

An Caladh House accommodates up to ten people with learning disabilities in one adapted building. On the days of the inspection there were ten people using the service.

The care service has been developed and designed 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like 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.

At our last inspection we rated the service good. At this inspection we found the service had improved to outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The service was exceptionally person-centred and delivered support in a way that met people’s individual needs. Person-centred means the person was at the centre of any care or support plans and their individual wishes, needs and choices were considered.

Without exception staff and management worked in a way that put the needs of people first. Support plans were written in an extremely sensitive and thoughtful way that reflected people’s life history, and likes and dislikes in great detail.

The service went the extra mile to protect people from social isolation and was extremely responsive to people’s individual needs.

The service went over and above complying with the Accessible Information Standard (AIS). Pictorial information was used to support people to communicate and to provide steps for them to follow to increase confidence and promote independence.

There was a strong emphasis on continuous improvement and research was carried out into best practice. Governance was extremely well embedded in the running of the service.

The service had a positive culture that was person-centred and inclusive. Family members spoke very highly about the management team. Staff were highly motivated and proud to work for the service.

The service worked well in partnership with other health and social care professionals to improve outcomes for people.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people and described potential risks and the safeguards in place to mitigate these risks. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding adults.

Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed. The manager and staff were working with healthcare professionals to reduce people’s needs for psychotropic medicines. Psychotropic means medicines prescribed to alter behaviour, perception or mood.

The home was clean, spacious and suitable for the people who used the service. Appropriate health and safety checks had been carried out.

There were enough staff on duty to meet people’s needs. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were supported in their role via appropriate training and regular supervisions.

People were supported 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 were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People and family members were aware of how to make a complaint.