Archived: The Old Dairy

About the service

The Old Dairy is a residential care home providing personal care to people with learning disabilities and/or autism. The service can support up to four people. At the time of the inspection three people were living at the home.

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.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the team leader at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People’s experience of using this service and what we found

People told us they were happy, felt safe. Relatives said that staff had a good understanding of their loved one’s needs and preferences. Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.

Mental capacity assessments and best interest paperwork was in place for areas such as personal care, medicines and finance. Consent for care and treatment had been sought from people. Where people were not able to give consent assessments and meetings had been held to ensure care was delivered in their best interests. Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards inclusion and enabling people to learn essential life skills. Equality, Diversity and Human Rights were promoted and understood by staff.

People, professionals and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging.

People received pre-admission assessments and effective person-centred support. The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

Care plans were personalised and updated in response to people’s changing needs. Staff listened to what people wanted and acted quickly to support them. Staff looked to offer people solutions to aid their independence and develop their skills.

Leadership was visible and promoted good teamwork. People, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities. The registered manager, team leader and staff team worked together in a positive way to support people to achieve their own goals and to be safe.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the registered manager was keen to make changes that would impact positively on people's lives.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 8 June 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.

This inspection took place on 4 May 2016 and was unannounced.

At the last inspection in March 2016, we identified that improvements were required in relation to recording of how risks were managed and to ensure the provider was operating within the conditions of their registration. At this inspection we found the provider had taken action to address these issues.

There was a registered manager in post 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 and associated Regulations about how the service is run.

Plans to manage risks people faced contained up to date information and provided clear guidance to staff on the support people needed. Staff demonstrated a good understanding of people’s needs and how to safely manage the risks they faced.

The registered manager was no longer providing support to a person who lived in separate accommodation nearby. The provider had amended their registration and support for this person was being managed from a different service operated by the provider.

People who use the service were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I like the staff, they are the best thing about living here” and “I am very happy living here. I like the staff, they are kind to me”.

People told us they felt safe when receiving care and were involved in developing and reviewing their support plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. People were confident that any concerns they raised would be taken seriously and investigated.

Staff understood the needs of the people they were supporting. People told us staff provided support with kindness and compassion.

Staff received training suitable to their role and an induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

There was a strong management team in the service and the registered manager was clear how they expected staff to support people. The provider assessed and monitored the quality of care and took action to address shortfalls that were identified.

This inspection took place on 11 March 2016 and was announced. We told the provider two days before we visited because the location is a small service for people who are active in their local community. We wanted to make sure people would be at home during our visit and staff would be available to support the inspection.

There was a registered manager in post 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 and associated Regulations about how the service is run.

Plans to manage risks people faced had not always been reviewed to ensure they provided up to date information and guidance to staff on the support people needed to stay safe. Despite this lack of review of the assessments, staff demonstrated a good understanding of people’s needs and how to manage the risks they faced.

The staff team was supporting one person who had moved out of the service to their own home. This service had been set up to ensure the person received a consistent service from staff who knew them well. However, the provider was not registered to provide this type of service from The Old Dairy.

People who use the service were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I like living here. Staff have helped me settle in and have treated me very well” and “I like the staff and get on well with them”.

People told us they felt safe when receiving care and were involved in developing and reviewing their support plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were supporting. People told us staff provided support with kindness and compassion.

Staff received training suitable to their role and an induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

There was a strong management team in the service and the registered manager was clear how they expected staff to support people. The provider assessed and monitored the quality of care and took action to address shortfalls that were identified.

People who used the service told us they were satisfied with the service they received. Staff supported people and met their needs. One person who used the service said "I like it here" and a visitor told us 'they are good staff.'

People told us that staff treated them with dignity and respect. One person said 'this is my bedroom, I like it like this.' We saw staff speaking and responding to people in a kind and respectful manner. One visitor told us 'it has a nice atmosphere, it feels homely.'

The care records showed us that people's health needs had been assessed before they came to live in the home. These records included information from health and social care professionals which helped ensure people got the care and treatment they needed.

The home provided nutritional meals and the menu included meals selected by people who lived in the home. The service and the building were monitored and risk assessed to ensure they were suitable for the people who used them.

The evidence we collected showed us the service kept people safe and met their care needs.