Calvert House

Calvert House is a purpose-built residential home providing personal care and support for up to eight people, with acquired brain injury, mental health support needs and learning disabilities. At the time of inspection there were five people living in the home. There were eight self-contained units, people had a bedroom, living area and bathroom. Six units also had a small kitchen area. There was a communal lounge and large kitchen and gardens.

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 registered manager 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

Safeguarding policies and risk management procedures helped protect people from the risk of harm and abuse. Medicines were safely managed stock checks had not been accurate in the past, this had been addressed by the new manager before the inspection. Staff had been recruited safely. Enough staff were on duty. There was a system to ensure safe staffing levels were maintained.

People's needs had been assessed and plans of care developed to meet these. People were supported by staff who had received training and support to fulfil their roles. People's nutritional needs had been met, however menus reviewed showed very repetitive meals with limited nutritional value. This was in the process of being addressed. People had regular access to health professionals with support if they preferred this. People's ability to make decisions had been properly considered and recorded. 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.

People were supported by kind and caring staff who understood how to support people respectfully. People were supported to maintain and develop their independence. Some people were actively preparing to move in to more independent accommodation in the community.

People received person centred care which was responsive to their needs. Care records included details about people's experiences and lifestyle choices. Staff were respectful of people's choices and had received equality and diversity training. People's care needs were kept under review and updated in response to change. People were supported to engage in activities they valued.

The service had clear values and a commitment to providing high-quality, person-centred care. Staff were clear about their roles and the standards expected of them. Staff felt valued by the management team. Governance systems were in place to monitor the quality of care provided and records maintained. Regular team meetings and partnership working with the wider organisation ensured people were kept informed. People were able to provide their views on the care they received through a variety of formats.

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

Rating at the last inspection

The last rating for this service was Good (Published 11 January 2019)

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.

At the last inspection on 04 July 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Calvert House is registered to provide accommodation for up to eight people who require help with personal care. The service provides care and support for people with an acquired brain injury, physical disability, sensory impairment and mental health conditions. The home is purpose built and accommodation is provided in single en-suite rooms. There is a through floor passenger lift. The home is situated near to Leyland town centre. There were five people living at the home at the time of our inspection.

There was a registered manager in place. 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 2008 and associated Regulations about how the service is run.

We looked at the recruitment of two staff members. We found appropriate checks had been undertaken before they had commenced their employment, confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived with physical disabilities, acquired brain injuries and mental health problems . We found staff were knowledgeable about the support needs of people in their care.

We found the registered manager had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The environment was maintained, clean and hygienic when we visited. We spoke with two people who lived at the home who both said they were happy with the standard of hygiene at the home.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. Staffing was also provided to enable people to access the community.

We found equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People told us they enjoyed the activities organised by the service. These were arranged both individually and in groups.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy and had no complaints.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

We found people had access to healthcare professionals and their healthcare needs were met. Records confirmed the service sought guidance and support from healthcare professionals when appropriate.

We observed staff supporting people with their care during the inspection visit. We saw they were kind, caring, patient and attentive.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. We found people were satisfied with the service they received.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them, the manager and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe living at the home. Safeguarding procedures were in place and staff were fully aware of actions they needed to take, should they be concerned about someone's safety. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the possibility of risks to people and helped the service to continually improve.

Plans of care and risk management plans were in place. People were not put at unnecessary risk, but also had access to choice and remained in control of decisions about their care.

The provider had implemented plans in case of emergency situations and staff had received training to help ensure people's safety if an emergency arose.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. People said their current needs were being fully met by a kind and considerate staff team. We established that a range of external professionals were involved in the provision of care. This helped to ensure people received the correct health care to meet their needs.

Those working at the home told us they received plenty of training and gave us some good examples of courses they had completed.

We saw from records that people were making progress toward the goals they had set in re-learning life skills.

Is the service caring?

We spoke with people who used the service and their relatives. We asked them for their opinions about the service and the staff. We received consistently positive feedback. One relative commented: "Staff know people very well. They're always very pleasant".

When speaking with staff it was clear that they genuinely cared for the people they supported. People who used the service and their relatives, completed an annual satisfaction survey. Where shortfalls or concerns were raised these were taken on board and dealt with. People's preferences, interests and goals had been recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

We noted that staff responded to the needs of people in a timely fashion and anticipated their needs well. This was because staff members were familiar with the needs of those in their care and had developed a good understanding of those living at Calvert House.

People knew how to make a complaint if they were unhappy and felt they would be listened to, should they wish to make a complaint or raise any concerns.

Is the service well-led?

The service had a quality assurance system in place and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff felt well supported by the management and told us they could approach the manager with any problems or for guidance and advice. It was evident people who used the service and their relatives trusted the staff team and management.