1 & 2 Hedgerows

Updated 4 December 2019

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

This inspection was carried out by a single inspector.

Service and service type

1 & 2 Hedgerows 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.

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 site visit took place on 18 October 2019 and was announced. This was because the service provides short residential stays only and we needed to be sure the registered manager and or staff would be available.

What we did

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 registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

At the time of our inspection no one was booked to use the service. We therefore spoke with three relatives by telephone to seek their feedback about the service following our inspection. We also met and spoke with the registered manager, deputy manager and three support workers. We reviewed a range of records including four people’s care plans and records and two staff recruitment, training and supervision records. We also reviewed records used in managing the service for example, policies and procedures, monitoring records and minutes of meetings.

Updated 4 December 2019

About the service

Hedgerows is a residential care home that provides short stay accommodation and personal care support for up to five adults with learning disabilities and/or autism. The service provides planned respite care and emergency short stays for people when required. At the time of our inspection there was no one booked to use the service. There are approximately 40 people who use the service as and when required.

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

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. There was a strong and visible person-centred culture within the staffing team, with staff going above and beyond their roles to ensure people were treated equally and fairly. Staff supporting people and had a genuine passion for the care and support they provided. They demonstrated an in-depth knowledge of the people they supported and were fully aware of people's likes, dislikes and preferences. An equality, diversity and human rights approach to supporting and caring for people was evidently well embedded in the service and staff exceeded their roles to promote this. People were treated exceptionally respectfully and without discrimination.

Relatives spoke highly of the service and the care and support provided. People were protected from avoidable harm and abuse and relatives told us they felt their loved ones were safe and well supported. Safeguarding and whistleblowing policies and procedures were in place and staff were aware of the procedures and how to keep people safe. Risk assessments enabled staff to manage identified risks whilst ensuring people’s rights and independence was promoted and respected. Positive risk taking was supported and encouraged in line with the principles of Registering the Right Support (RRS) to help people learn new skills and enjoy accessing community services.

There were arrangements in place to manage medicines safely and staff followed appropriate infection control practices to prevent the spread of infections. Appropriate recruitment checks took place before staff started work. There were sufficient staff available to meet people's needs. Staff had good skills, knowledge and experience to support people appropriately. Staff were supported through induction, training and supervision and personal professional development was supported.

People were supported to meet their nutritional needs and to maintain a balanced diet ensuring continued well-being. 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 support this practice.

The home environment was clean, homely and suitably adapted to meet the needs of the people using the service. People had access to health and social care professionals as required. People were supported to access community services and to participate in activities of their choosing that met their needs.

Complaints were managed and responded to appropriately in line with the provider’s policy. There were systems in place to assess, monitor and improve the quality of the service. The register manager and staff demonstrated a strong commitment to provide person centred and high-quality care driven by good engagement with relatives and working cohesively with health and social care professionals to achieve best outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (Report was published on 12 December 2016).

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.