The inspection took place on 17 May 2017. The inspection was unannounced. Bewick House is a residential support home based in Darlington. The home provides personal support for people with learning disabilities who also experience mental ill health. It is situated close to the local amenities and transport links. The service is registered to provide support to six people and on the day of our inspection there were six people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 last inspected the service in January 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ overall. The atmosphere of the home was vibrant, homely, warm and welcoming. People who used the service were relaxed in their home environment and visitors offered praise of the service and were always welcomed.
Without exception people were empowered on a daily basis to have choice and control over their lives from being supported by person centred approaches. Person centred is when the person is central to their support and their preferences are respected.
The home was extremely person centred, inclusive and was underpinned by a genuine desire to offer a quality personalised service.
Visiting professionals offered praise of the service and especially the person centred values and support offered to people.
People were empowered to forward plan goals and to achieve them to improve their quality of life.
We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness. We saw staff being respectful, considerate and communicating exceptionally well with people well.
Support plans were developed in partnership with people and not for people and these set out exactly how people liked to be supported and what goals they wanted to achieve.
People’s support plans were written in plain english and reflected the person centred values of the home. They included targets that people wanted to achieve and a ‘one page profile’ that made use of, personal history and described individual’s support needs. These were regularly reviewed; and people were always at the centre of the process.
People were encouraged to have their say and get involved in engagement opportunities with advocacy organisations on wider issues such as the ‘transforming care agenda’ that is tailoring services in the community for people who are currently in long stay hospital and treatment centres across the UK.
People were supported to play an active role within their local community by making regular use of local resources, clubs and amenities.
People were equal partners and fully involved in all aspects of the staff recruitment process.
People influenced how the home was run by voicing their opinions regularly and these were acted upon.
Support plans contained person centred risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm to enable them to do the things they wanted to live their lives fully.The support plans we viewed also showed us that people’s health was monitored and referrals were made to other health support professionals where necessary, for example: their GP, community nurse or optician.
People were enhancing their wellbeing on a daily basis by taking part in flexible person centred activities both at home and within the local community. Activities encouraged and maximised peoples independence and impacted positively on people’s lives.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. The home was truly reflective of what people liked and people were in control of this and chose daily what they would like to eat and were involved in shopping and preparing food.
An accessible complaints and compliments procedure was in place. Providing various ways for people to access information on what to do if someone wished to make a complaint and what they should expect to happen next.
The compliments that we looked at were praising the support staff, management and the service as a whole.
People had their rights respected and regular access to advocacy services.
People were supported to maintain their independence with dedicated one to one support.
People were supported to be active in their chosen religion both at home and in the community.
Without exception support staff told us they felt extremely supported to carry out their role and to develop further and that the registered manager led by example, was person centred focussed, supportive and always approachable.
Throughout the inspection we saw that people who used the service and staff were very comfortable, relaxed and had an extremely positive rapport with the registered manager and also with each other. Our observations during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs on a one to one basis in a person centred way.
When we looked at the staff training records, they showed us staff were supported and able to maintain and develop their skills through training, and development opportunities were accessible at this service. The staff we spoke with confirmed they attended a range of valuable learning opportunities. They told us they had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their support practice and identify further mandatory and vocational training needs. We also viewed records that showed us there were robust recruitment processes in place.
Medicines were stored, managed and administered safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and how this was monitored.
We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views about the support and service they received at meetings and via surveys.