Girling Street

We found the following examples of good practice.

The service had policies and procedures to assist the registered manager and staff to manage any risks associated with the COVID-19 pandemic.

The service had made adjustments to the entrance and exit routes to accommodate a Personal Protective Equipment (PPE) area for staff to don and doff (put on and take off) PPE.

There was sufficient supply of PPE for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training on the use of PPE, and we observed it being worn correctly during our visit.

A programme of regular COVID-19 testing for both people living at the service, their visitors and staff was in place. All visitors, including healthcare professionals were subject to a range of screening procedures, including a temperature check, screening questionnaire, showing evidence of vaccination and a negative lateral flow test before entry into the service was permitted.

People living in the service and their relatives were supported to maintain contact, with visiting available at all times.

There was clear signage and information in place at the service to remind staff of their responsibilities. Additional COVID-19 pictorial and ‘easy read’ information was available for those people who preferred this format of communication.

Daily cleaning schedules were in place and tasks were completed by staff including two hourly cleaning of frequently touched areas.

At the last inspection in April 2015 the service was rated as ‘Good’ in four of the key questions we ask and overall. The key question of Responsive was rated as ‘Outstanding.’ At this inspection we found that the provider had sustained these ratings.

Girling Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Girling Street accommodates up to five people in a mid terrace house situated centrally within the town of Sudbury. The service was situated within close proximity of the shopping town centre.

The registered manager at Girling Street was also the registered manager at another of the providers locations, which was situated a third of a mile from Girling Street. The two services share the same staff team and many of the non service user specific records we looked at, such as team meeting minutes were the same across both services. Therefore there are similarities in the inspection reports for both locations. We inspected the other service the day after the inspection at Girling Street.

The care service had 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 lived as ordinary a life as any citizen.

People continued to be provided with regular opportunities to express their wishes, aspirations and preferences regarding how they lived their daily lives. People were supported to make their own decisions about the care and support they received. Regular meetings continued to be held between people and their keyworker to ascertain their individual thoughts and choices. People continued to be supported to access a wide range of personalised activities and social opportunities. Staff supported people to access the local community and encouraged activities which promoted their independence.

Staff continued to demonstrate a good understanding of safeguarding and how to report concerns. Sufficient numbers of staff continued to be in post and rotas were written around the needs of the people who lived at the service. Recruitment procedures continued to be effective and thorough. This included pre-employment checks to ensure new staff were suitable to work at the home. Staff had a good understanding of risks associated with people's care needs and how to support them.

Medicines continued to be stored and administered safely, and people received their medicines as prescribed. Weekly and monthly audits were carried out of medicines to ensure they were managed in line with good practice guidelines. Infection control practice was good and helped to reduce the risks associated with poor cleanliness systems.

Good leadership continued to be in place that provided staff with the necessary support and training to make sure people received good quality care. The service had good links with external healthcare professionals. People received necessary support from these services when they needed help. Appropriate records were kept of any appointments people attended.

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 received a service that was caring. Staff knew people's needs well and were responsive and supportive. Staff treated people with dignity and respect. Staff sought to gain people's views.

Some people who used the service were not able to tell us verbally about their views and experiences so we used observation and interaction to gain an understanding of their care and support.

We looked at the care and support records for two people who used the service, records relating to consent and the safeguarding of vulnerable adults from abuse, staff training and support and quality assurance checks.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

Staff had received a range of training to protect people who used the service from harm. They were aware of the action they needed to take if they suspected abuse had taken place.

We found that the service had suitable arrangements in place to assess people's mental capacity to make decisions for themselves.

The service had policies, procedures and quality monitoring in place to ensure systems were working well. People were provided with care and support that ensured their welfare and safety.

Is the service effective?

People's assessments showed that their care and support was planned and delivered in a way that ensured that their needs were being met.

Individualised care meant that people were fully involved, where possible, in choices and decisions about their lives. This made their care and support more effective as it enhanced their wellbeing and independence.

Is the service caring?

We saw positive interaction between staff and people who used the service. Staff spoke with people in a caring, respectful, considerate and encouraging way.

Staff had a good knowledge of people's likes and dislikes, their everyday needs and their personalities. People's preferences and diverse needs had been recorded in their support files and care and protection was provided in accordance with their wishes.

Is the service responsive?

Regular checks on the needs of people who used the service were undertaken to ensure there were sufficient staff on duty with the rights skills to respond to people's needs appropriately.

The service offered a range of activities for people to enjoy. These had been developed from listening to the views of people who used the service and information from people who knew them well.

The service worked well with other agencies. A range of health and social care professionals from the community were involved in people's care. This showed that people received their care in a joined up way.

Is the service well-led?

A comprehensive quality monitoring process and on-going improvement plan was in place. Regular care reviews showed that the service put people's needs first and staff training and supervision ensured that staff were able to support them appropriately.

The service was well-led as it was continually improving in its care provision and in the environment to make Girling Street a good place to live and work.

One person told us, 'I like living here and the staff help me and are kind to me.' Another person told us, "I am looking forward to my holiday at Centre parcs.'

We saw several examples where staff supported and cared for people in a dignified and respectful way. We found that the service was meeting the personal, emotional and healthcare needs of people who used the service. We found that medication was being administered safely to people and managed effectively.

We found that staff were appropriately recruited and inducted into the service and there was an appropriate and effective system in place to manage complaints.

We spoke with one member of staff and one person who used the service during our inspection in February 2013. We were told that the staff training had 'Greatly improved and that they had lost count of the courses they had attended recently'.