Ravenscroft House

Ravenscroft House is a supported living service, providing personal care to people living with learning disabilities and autism. At the time of the inspection, seven people were living at Ravenscroft House.

Ravenscroft House is a large house fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a supported living service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People and relatives told us they were very happy with the care and support they received. The staff were exceptionally kind, caring and thoughtful and truly respected people’s privacy, dignity and confidentiality. People were genuinely at the heart of their care and support and they took the lead on decisions about their care, including having a say in which staff were recruited to support them. People were encouraged to be as independent as possible and to develop and retain their independent living skills. Staff were compassionate and sensitive when supporting people with their emotional wellbeing during difficult times of worry and sadness.

Staff knew people exceptionally well including their likes, dislikes, preferences and wishes. They were responsive to people’s care and support needs which enabled people to reach their potential. People enjoyed a variety of activities in the community, which enabled them to develop relationships outside of their home. People and relatives knew how to make a complaint if they needed to and felt confident it would be addressed.

Robust recruitment processes were in place to ensure suitable staff were employed. There were enough staff on duty to meet people’s needs and keep them safe. And ad hoc staff hours enabled people to be supported to attend specific events. Accidents and incidents were investigated by the registered manager to reduce the risk of reoccurrence and identify any learning. Staff understood the provider’s safeguarding policy and referrals were made to the local authority when concerns were identified. Medicines were well managed and staff received regular medicines training.

People were supported to access routine and preventative healthcare services to maintain their health and wellbeing. Staff promptly identified when people were unwell and sought appropriate clinical advice. People were encouraged to choose their own menus and helped with the shopping and cooking. People all had mental capacity to make decisions for themselves and we observed staff obtained consent from people for day to day decisions.

There was a positive, person centred culture within the service which was embedded in staff practice. The registered manager used a range of quality monitoring systems, such as surveys and audits, to help drive improvement. People, relatives and staff spoke highly of the registered manager. Staff felt very well supported by the registered manager who was approachable and available for support and guidance.

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 23 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Ravenscroft House is a supported living service. It is an ordinary house on an ordinary street and the service provides personal care for up to seven people who may have a severe learning disability, complex physical needs, sensory impairments and epilepsy. The service has its own vehicle which supports a variety of activities in the local community and also supports holidays and trips away.

The home had a 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 and associated Regulations about how the service is run.

People were protected from abuse. Staff knew how to identify abuse or potential risks of abuse and understood their responsibilities to report any concerns. Individual and environmental risk assessments had been carried out and measures put in place to mitigate risks to people. There were robust systems in place to effectively manage the ordering, storage and administration of medicines.

The provider had robust recruitment processes in place which ensured only staff who were suitable to work in an adult social care setting were employed. There were sufficient numbers of staff on duty to support people safely and meet their assessed needs.

Staff received an induction before they started work, which included shadowing other staff, and helped to ensure staff were appropriately trained and skilled to deliver safe care.

Staff showed a good understanding of the needs and preferences of the people they supported. People were supported to eat and drink a choice of food and drinks which were sufficient for their needs and that met their dietary requirements.

People and their families were involved in planning and review of their care. Care plans were personalised and support was tailored to their individual needs. There was a strong, visible person centred culture within the home and people were empowered to live their lives in the way that they chose to do.

People’s risk assessments and care plans had been reviewed regularly and any changes to people’s needs were recorded. Staff were knowledgeable about people’s health conditions and any concerns were promptly referred to health care professionals.

Records showed people’s hobbies and interests were documented and staff accurately described people’s preferred routines. Staff supported people to take part in activities both within the home and in the community.

Relatives told us they were very happy with the support their family members received from staff who were very caring. People told us the staff treated them kindly and our observations confirmed they were caring and compassionate, and supported people's emotional wellbeing in creative ways, supporting them to develop confidence and self esteem. Staff went the extra mile to overcome obstacles to help people maintain important relationships and visitors told us they were welcomed at anytime. Staff respected people’s privacy and dignity and encouraged their independence, empowering them to take control of their lives. People’s end of life wishes were discussed with them by sensitive staff.

Staff understood the requirements of the Mental Capacity Act 2005 and best interest decisions were made, where appropriate, and recorded in line with the Act.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS). . These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm. We observed people’s freedoms were not unlawfully restricted and staff were knowledgeable about DoLS.

There were effective quality assurance systems in place to monitor and assess the quality of the service provided. People, staff and relatives were actively involved in the development and improvement of the service.

Incidents and accidents were recorded and analysed, and lessons learnt to reduce the risk of these happening again. Complaints procedures were in place and the service had received one complaint in the past twelve months which had been dealt with appropriately.

The service was well led by a knowledgeable and committed registered manager. There was an open and transparent culture within the home and staff, people and relatives said the registered manager was approachable and supportive. The registered manager understood their responsibility to inform the commission of important events and incidents that occurred within the service, such as safeguarding concerns.

We looked at three people's care records and saw each person's needs were assessed and updated regularly. Care plans contained a risk assessment and we saw these had been reviewed regularly. One person said: "If I need to change anything in my care plan I can talk to my key worker. I have a lot of choice in what I do and staff help me to do it."

We looked at staff training records and saw all staff had received training in safeguarding vulnerable adults. The staff we spoke with were able to identify different types of abuse and were aware of how to report any concerns. The three people we spoke with all told us they would speak to the manager if they felt they were not being treated well by staff or other people who used the service.

Staff told us they were well supported by supervisions and training they received. They said the manager was approachable and always available to talk to. One member of staff said; "The manager covers shifts themselves and understands how to support the people who live here".

We reviewed a number of records relating to the monitoring of the quality of the service. These were consistent and regularly updated.

People's privacy, dignity and independence were respected. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People experienced care, treatment and support that met their needs and protected their rights. The staff involved in food preparation were aware of people's likes and dislikes and produced food that facilitated a healthy balanced diet. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. People were cared for, or supported by, suitably qualified, skilled and experienced staff. There was an effective complaints system available.