Background to this inspection
Updated
29 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was completed by two inspectors.
Service and service type
SeeAbility - Fir Tree Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We asked for feedback from the local authority and professionals who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We were unable to seek people’s views of the service, so we observed their interactions with staff in the communal areas of the home and during medicines administration. We spoke with one person’s relative. We spoke with three support workers, the housekeeper, assistant physiotherapist, the deputy manager and the registered manager. We also spoke with a complementary therapist who was visiting people.
We reviewed a range of records. This included two people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision and variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We spoke with a further two relatives and a quality assurance officer from the local authority. We also received written feedback on the service from a GP. We continued to seek clarification from the provider to validate evidence found.
Updated
29 February 2020
About the service
SeeAbility - Fir Tree Lodge is a residential care home on one level, which is fully accessible. People have access to their own garden and a communal garden. It provides personal care and accommodation to young adults with a physical disability, learning disability, sensory impairment and autism spectrum disorder.
The service has been developed 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 service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. This is larger than current best practice guidance. However, the size of the service potentially having a negative impact on people was mitigated by the building design fitting into the residential area. Staff were also discouraged from wearing anything that suggested they were support workers when coming and going with people. Staff ensured people were able to access and be part of their local community.
People’s experience of using this service and what we found
A relative told us "It's a home. Everyone gets on with each other wonderfully." Another told us, “We can come any time and there is the same lovely atmosphere.”
The provider had robust processes in place which ensured people received their medicines safely. Staff assessed potential risks to people and measures were in place to manage them safely. There were sufficient numbers of competent staff rostered to keep people safe and to meet their needs. The provider had appropriate processes, polices and staff training in place to keep people safe. People were protected from the risk of acquiring an infection.
People’s needs were assessed and the delivery of their care reflected good practice guidance and legal requirements. People were supported by well trained and competent staff, who had the required skills and knowledge to deliver people’s care effectively. Staff offered people a choice of nutritious food and drinks. People were supported to access a range of internal and external health services as required. People’s needs were met by the design and decoration of the premises.
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.
Staff treated people kindly and compassionately. They cared about people and were concerned for their welfare. Staff respected people’s human rights and endeavoured to involve them in as many decisions as possible. Staff promoted people’s privacy, dignity and independence.
People’s care was planned to ensure it was personalised and reflected their preferences. People participated in a range of activities both inside the service and in their local community. They were supported to maintain relationships which were important to them. Staff used technology to promote people’s independence.
Processes were in place to monitor the quality of the service provided and to continuously drive improvements. The provider investigated and acted upon any complaints received from relatives on people’s behalf. The registered manager sought the views of people’s families and staff on the service and promoted engagement with the local community.
The registered manager created a positive and person-centred culture focused on providing people with person centred care. Staff understood their role and responsibilities. The provider worked with local statutory and non-statutory services to improve people’s care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (05 March 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.