CHAD - Cordingley House

Updated 17 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

A site visit took place at Cordingley House on 12 September 2018 and was announced. We gave notice of the inspection because we needed to seek the permission of people who lived there and let them know that we would be spending the day in their home. The inspection was conducted by one adult social care inspector. We contacted family members by telephone on 18 and 19 September 2018.

Prior to the inspection we reviewed all the information we held about Chad Ltd - Cordingley House, including any statutory notifications that the provider had sent us. Notifications are made to us by providers in line with their obligations under the Care Quality Commission (Registration) Regulations 2009. These are records of incidents that have occurred within the service or other matters that the provider is legally required to inform us of.

In addition, we contacted four local authority commissioners to obtain their feedback about the services. We also asked the provider to complete a Provider Information Return (PIR) prior to the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. All this information informed our planning of the inspection.

As part of the inspection we spoke with two people living at Cordingley House and four family members to gather their views. We spent time with the four people who lived at Cordingley House and observed their daily life. In addition, we spoke with five members of the care staff team, the service manager and the registered manager who is also a director of the company. We contacted five external healthcare professionals who were involved in supporting a person who used the services. We received a response from one social worker. We reviewed a range of care records and information kept regarding the management of the service. This included looking at two people’s care records, two staff files and records relating to quality assurance.

Updated 17 October 2018

This inspection took place between 12 and 19 September 2018 and was announced. We previously inspected the service in January 2016 and rated the service as good overall with an outstanding rating in the responsive key question. At this inspection we found that the service had improved further and was outstanding overall.

Chad Ltd – Cordingley House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service provides support to four adult males who have a range of health needs including an autistic spectrum disorder.

The service also provides care and support to two people living in two ‘supported living’ settings, so they can live in their own home as independently as possible. These people’s care and housing is provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at their personal care and support only.

This care service has 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 can live as ordinary life as any citizen.

The established registered manager remained in post. A registered manager is a person who has registered with 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. The registered manager was supported by a service manager who was in the process of applying to become a registered manager.

The senior staff including the registered manager had extensive experience of working with people who had an autistic spectrum disorder or a learning disability. The management team strived for excellence within their team and had themselves researched career progression and engaged in opportunities to develop. Cordingley House had acted as a model of best practice for a similar local service.

People benefitted from a very reliable and consistent team of dedicated staff who told us they were proud to work for the provider and loved their jobs. This made the atmosphere in the home and the supported living settings very relaxed which in turn reduced episodes of behaviour which may have challenged the staff and put people at risk.

The quality assurance framework in place across the services was robust. The service manager and registered manager conducted daily, weekly and monthly audits that were systematic and meaningful. They ensured the service continued to provide excellent quality and safe care. The records kept of these checks demonstrated that they were methodically undertaken and where issues were identified, prompt action had been taken.

Record keeping in all aspects of the service was to a high standard. We found the staff strived to ensure all records were detailed, current and legible. The provider ensured that they held a relevant and accurate record of the care and support people had received in the past and at present.

The provider offered plenty of opportunities for people, relatives and staff to talk to them about the service. Staff and ‘Resident/Relative’ meetings were held regularly and minutes were recorded. People, family members and staff were actively encouraged to contribute to decisions made about the services. The staff also gave family members regular updates about their relatives in relation to their health, progression and social activities. A recent annual satisfaction survey took place which we saw was overwhelmingly positive.

The provider had made a real effort to successfully develop and improve the service further. For example, they had invested in bespoke training and development for all staff and had enthused staff to significantly enhance people’s support plan and risk assessment documentation. The provider had a clear vision for the service and they put people at the heart of it.

The service manager and senior care staff had continued to build on the personalised support plans which were already in place. We saw people’s needs had been holistically assessed and were constantly reviewed and changed to meet people’s varying individual needs and abilities. This had taken place with the total involvement of the person, their family members and external professionals. Support plans were person-centred, comprehensive and extensively described people’s life history including their family, friends, school life, social life, employment, interests and hobbies.

The staff continued to encourage and promote activities which inspired each person to participate in pastimes that were important and meaningful to them. People had their own unique activity plan which empowered them to get involved in social activities that they were interested in. The staff ensured people were afforded the chance to pursue education and work. We saw people had achieved dreams and ambitions. Staff also ensured group activities were arranged to maintain people’s links with their local community and provided an opportunity for social interaction with family and friends outside of the services.

There continued to be no complaints about the service. This demonstrated that people and their family members remained entirely pleased with the service provided.

People told us the staff were very nice to them. Throughout the inspection we saw staff displayed exceptionally kind, caring and compassionate attitudes and they treated people with the utmost dignity and respect. The staff were highly motivated and worked very well together as a team. We found staff were committed to making the lives of the people they supported as enriched and fulfilled as possible.

The provider’s equality and diversity policy was fully embedded into the service. The care and support delivered reflected people’s diverse needs and greatly considered their age, gender, culture and abilities.

People were content during our inspection. Two people told us they were very happy and that they loved living at Cordingley House. We observed people to be familiar and at ease with the staff. Robust policies and procedures were in place to assist staff to safeguard people from harm. The staff we spoke with fully understood their responsibilities with regards to protecting people and their rights.

The staff continued to have high regard for the risks people faced in their lives. The risk assessments in place were extremely person-centred, detailed and robust. Lessons learnt from incidents were a fundamental part of the continuous improvement and development of further preventative measures. The local authorities who commission the services told us they had no concerns about this provider.

The provider completed regular checks of the premises, equipment and utilities in line with their landlord responsibilities. Staff were aware of their responsibilities to report any defects and we saw minor issues had been addressed promptly.

Cordingley House was nicely decorated with modern adapted facilities to promote independence. There was ample communal space as well as private bedrooms. Pictorial signage used around the home helped people identify where things were for themselves. People had individually decorated bedrooms which were filled with their personal items. Any changes to the home or contents was well thought out and staff managed this effectively to avoid causing distress to people.

Medicines were managed safely and appropriately and they were stored securely and in an organised manner. Medicine administration records were accurate and detailed. We saw staff followed best practice guidance in relation to infection control and prevention. We observed people and staff in the kitchen, making meals and there was a high regard for safety, hygiene and areas for potential cross contamination.

Staff files showed the recruitment process continued to be safe and robust. Staff training was up to date and bespoke training had been devised and delivered. Staff had embraced the opportunities presented to them by the provider to progress their careers and had achieved qualifications in health and social care. There remained a great mix of experience, skills and knowledge amongst the staff team.

There were ample staff employed to manage the services safely, consistently and effectively. Each person had a key worker who took overall responsibility for keeping their records up to date.

Staff supervision and appraisal meetings were routinely held to formally discuss any issues, share best practice and develop staff’s skills and knowledge. We saw these were thoroughly documented. Staff told us they felt extremely valued by their managers and co-workers and that there was an open, friendly and honest culture, where they did not feel afraid to discuss anything.

Staff promoted a healthy diet and prepared well-balanced meals for people. Wherever possible, staff supported people to get involved with making meals. Staff encouraged family style mealtimes and we saw people engaged with this in a positive and interactive manner. One person had specific diverse dietary needs and the staff made certain these were meticulously met.

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 embedded in the service supported this practice. Staff supported people to make decisions when they could but where necessary, a best interests decision was made. We saw these included the people, their family members, staff and an external health or social care professional.

The