We carried out a review of the data available to us about Five Penny House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Five Penny House, you can give feedback on this service.
Five Penny House is a purpose built house, providing support to people living with a learning disability and physical disabilities. It was registered to support up to six people. Six people were using the service at the time of inspection. Staff supporting people did not wear a uniform or any identifying clothing that suggested they were care staff when coming and going with people, and people were supported to have access to local community facilities and services.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can 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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
There was a new registered manager at the home who had just completed their application process with the Care Quality Commission. They had a clear vision and values and had already made positive changes at the service.
Medicines were stored safely and staff were trained to administer them correctly. We found records relating to 'as and when required' medicines needed to be improved and the registered manager actioned this immediately.
Staff knew people well and supported people in line with the person’s preferences and wishes.
There were enough staff to support people and staff were always visible. Staff received support and a variety of appropriate training to meet people’s needs.
Individualised risk assessments were in place. Staff were confident they would raise concerns to safeguard people. Robust recruitment and selection procedures ensured suitable staff were employed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported to access healthcare services if needed. People were supported to have enough to eat and drink and staff were trained to support people who had different dietary needs.
Interactions we saw between people and the staff team were positive. We saw people given immediate reassurance when they became anxious or distressed.
Care plans were person centred and people were involved in their reviews where they were able. The service actively supported people to engage with advocacy services if this was needed.
People were supported to engage in activities they enjoyed, and we saw the service promoted people accessing local community facilities and supporting them to go on trips and holidays.
There were systems in place for communicating with staff, people and their relatives to ensure they were fully informed. This was via team meetings, phone calls and emails. People had good links to the local community through regular access to local services.
Audits and monitoring systems were used effectively to manage the service and to make improvements as and when required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published July 2017).
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.
At the last inspection in May 2015 the service was rated Good. At this inspection we found the service remained Good.
There was a registered manager at the service. 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.
Medicines were administered safely and stored securely. Accidents, incidents and safeguarding concerns were recorded and dealt with appropriately. Staffing levels were appropriate for the needs of people who used the service. Risk assessments relating to people's individual care needs and the environment were reviewed regularly.
Staff received appropriate training and support. 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 supported to have enough to eat and drink and attend appointments with healthcare professionals.
There was a welcoming and homely atmosphere at the service. People were at ease with staff. Staff knew how to communicate with people. Staff treated people with kindness and compassion.
Staff had a clear understanding of people's needs and how they liked to be supported. People's independence was encouraged without unnecessary risks to their safety. Support plans were well written and specific to people's individual needs.
Staff felt the service was well managed. Staff described the manager as approachable. There was an effective quality assurance system in place.
Further information is in the detailed findings below.
The inspection visit took place on 5 May 2015. This was an unannounced inspection which meant that the staff and provider did not know we would be visiting.
We last inspected the service on 4 November 2013 and found the service was not in breach of any regulations at that time.
Five Penny House is a purpose built detached property which provides accommodation, personal care and support for up to six people with complex needs such as learning and / or physical disability. There were lounges, a dining room and a large accessible kitchen and six bedrooms. Each of the bedrooms were individually decorated.
There was 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.
There were currently four people living at Five Penny House with plans for two other people to move into the service in the near future.
We observed the care and support the four people received as due to the nature of people’s disability, people could not communicate directly with us. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.
The staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that three staff routinely provided support to four people during the day with two staff being available throughout the night.
There were policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application for a DoLS authorisation should be made and how to submit one.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff had also received more specific training in managing the needs of people who used the service such as person centred support and allergen awareness.
We saw people’s care plans were person centred and people had been assessed. The home had developed person centred plans to help people be involved in how they wanted their care and support to be delivered. We saw people were given choices and encouraged to take part in all aspects of day to day life at the home from watching a film together to helping to make the evening meal. Everyone had undergone a person centred review recently where themselves, staff, family and social workers were involved in reviewing their support and planning actions and outcomes for the future.
The service encouraged people to be as independent as possible. People were supported to be involved in the local community as much as possible and were supported to access facilities such as the local G.P, shops and leisure facilities if they so wished.
We also saw a regular programme of staff meetings where issues where shared and raised. The service had an easy read complaints procedure and staff told us how they could recognise if someone was unhappy and what measures they would take to address any concerns. This showed the service listened to the views of people.
There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development.
People who wanted to were encouraged to help prepare food with staff support and on the day of our visit one person helped prepare some flapjacks. We saw people had nutritional assessments in place and people with specific dietary needs were supported. We saw from support records and talking with staff that specialist advice was sought quickly where necessary not only for nutritional support but any healthcare related concerns.
We saw staff supporting people with dignity and respect. We saw staff were caring and helped people in all aspects of their daily living with kindness. There was lots of laughter and caring physical interaction that was appropriate between staff and people using the service.
We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure the service and equipment was safe for people and staff. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.
We saw that the registered manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.
Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.
We spoke to staff and found that they were very knowledgeable about people's likes and dislikes and how they wished to be supported. We were able to see how people's skills and independence were promoted.
We saw examples of decisions that people had been involved in making and we could see the procedures which staff followed where people did not have the capacity to make decisions for themselves. We found that the care records contained evidence to confirm that the person and their relative or advocate had been involved in drawing up the plan of care and keeping it up to date.
Where people were highlighted as being at risk, for example, with diabetes, care plans had been developed. We found that care records contained up to date assessments, care plans and risk assessments. We found that care plans were reviewed monthly.
We saw that people who used the service had a choice of food and drink and were involved in menu planning and shopping for food.
During our inspection we were able to see that there was enough staff on duty to meet the needs of people.
We saw that records were stored safely, however still accessible to staff when needed.
We found that people were treated with dignity and respect. We saw there was a friendly and relaxed atmosphere between people living and working at the home. We observed staff interacting well with people and supporting them which had a positive impact on their wellbeing.
We found the premises that people, staff and visitors used were safe and suitable and that people were cared for and supported by suitably qualified, skilled and experienced staff. We also found that staff were appropriately supported in relation to their responsibilities which enabled them to deliver care and treatment safely and to appropriate standards.
We found there was an effective complaints system in place at the home.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time of the inspection.
Throughout our visit, we observed the positive way that staff interacted with people using the service. We saw all staff treat people with respect and courtesy.
We observed staff encourage people to make their own decisions, from what activities to get involved with, to what drink or condiments people wanted to have with their lunch. Staff used their knowledge of the person to interpret body language and limited verbal communication, to take note of people's opinions, choices and preferences. During our visit, we saw that staff actively engaged everyone in conversations and activities, tailored to the needs of the person.