Rafael Home

Updated 17 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 one inspector.

Service and service type

Rafael Home 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 was unannounced.

What we did before the inspection

We looked at the information we held about the service, including previous inspection reports and statutory notifications. Statutory notifications contain information providers are required to send us about incidents and other significant events that take place within 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.

During the inspection

We spoke with four people who used the service and three members of staff, including the deputy manager. We also spoke with the registered manager. We looked at three people’s care plans, two staff files and a range of other records including health and safety checks, policies and incident records. During the inspection we carried out observations of staff providing support to people.

After the inspection

We contacted two professionals who were familiar with the home to ask for their feedback about the service.

Updated 17 December 2019

About the service

Rafael Home is a residential care home providing personal care to six people with learning disabilities at the time of the inspection. The service can support up to six people in one adapted building.

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 and what we found

People received support from staff who were extremely caring, valued people and treated them with respect. Staff demonstrated a high level of empathy, understood people very well and gave priority to the things that were most important to people. Staff used a variety of imaginative methods to support people to express their views and make choices about their care and lifestyle. The service used technology in an innovative way so people could independently complete tasks they would otherwise need staff support for. Staff respected people’s right to privacy and supported them to understand how and when their personal information would be shared, with their agreement.

People’s care and support was highly responsive and tailored to their needs. The provider made adjustments where required to ensure people had equal opportunities to receive care and support that met their needs and to be involved in planning their care. The provider identified people’s needs around end of life care in a person-centred way. People received support to identify and achieve their goals and there were many examples of the positive impact this had had on people’s lives. Staff worked closely with people to make sure they understood the information they received. The provision of activities was exceptionally good and people had many and varied opportunities to pursue their interests, try new things and do their own research into activities they wanted to do. People had the support they needed to maintain relationships with their families and make new friends. Staff supported people to be an active and valued part of their community and practise their religious beliefs. The service was highly responsive to people’s concerns, feedback and complaints.

The service had an empowering culture that promoted respect and inclusion, helped people understand their rights and made people feel valued. People were supported and encouraged to speak up about anything they were unhappy with and their feedback was used to continually improve the service. There was a clear leadership structure and staff understood their roles. There were systems to monitor quality and continually improve the service. This had led to a number of improvements which resulted in the rating being raised from good to outstanding. The provider worked to strengthen the service’s links with the local community to give people better opportunities for social inclusion. The provider worked well in partnership with others and the service was seen as a role model for several areas of good practice.

There were robust processes to protect people from the risk of abuse and to record and learn from incidents. People were safe because risks were assessed and managed in a person-centred way. Staff made sure the home environment was safe and hygienic. Medicines were managed safely. There were enough suitable staff to care for people safely.

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’s needs were comprehensively assessed and staff supported people in line with relevant guidance and expert advice. Staff received the support and training they needed to provide effective care. People’s health and nutrition needs were met and staff worked well with healthcare services to provide consistent care. The home environment was suitably decorated and adapted to meet people’s needs.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was good (published 5 May 2017).

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.