Background to this inspection
Updated
3 December 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
This inspection took place on 3 November 2016 and was announced as we wanted to make sure the registered manager was available. It was conducted by one inspector who was experienced in care and support for people with learning disabilities.
Before the inspection, we reviewed all the information we held about the provider. This included information sent to us by the provider in the form of notifications and safeguarding adult referrals made to the local authority. A notification is information about important events which the provider is required to tell us about by law. We contacted the local authority quality assurance and safeguarding team to ask them for their views on the service and if they had any concerns, no concerns were raised.
Before the inspection, the registered manager completed a Provider Information Return (PIR). This 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.
We used a number of different methods to help us understand the experiences of people who used the service. We spoke with three staff members, the registered manager, the residential services director, three relatives and the chief executive. We contacted three health and social care professionals.
We spent time observing care and support provided throughout the day of inspection, at lunch time and in the communal areas. We reviewed a variety of documents which included two people’s support plans, risk assessments, and peoples medicine administration records (MAR). We also reviewed four weeks of duty rotas, some health and safety records and quality assurance records. We also looked at a range of the provider’s policy documents. We asked the registered manager to send us some additional information following our visit, which they did.
The service was registered on 1 January 2015 and this was its first inspection.
Updated
3 December 2016
Long Barn is a supported living service for up to six people with a learning disability, autism, communication needs and challenging behaviours. At the time of the inspection, there were six people living at the service. The service consisted of a main house where four people shared a kitchen and communal living area and a further two self-contained flats on site for which the other two people lived in.
People had significant communication needs. People mainly used body language, gestures or sounds to communicate, some people could use a few key words to communicate their needs.
There was a registered manager in post. 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.
People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant and accurate records. However where some people had an as required medicine, there weren't always guidelines in place to tell staff when and how people should have them. We have made a recommendation about this in the report.
There were sufficient staff to keep people safe. There were recruitment practises in place to ensure that staff were safe to work with vulnerable people.
People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.
Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks such as personal care, activities, health conditions, and the environment and they were updated frequently. The registered manager ensured that actions had been taken after incidents and accidents occurred.
People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people were assessed to lack capacity to make some decisions, mental capacity assessment and best interest meetings had been undertaken. Staff were heard to ask peoples consent before they provided care.
People had sufficient to eat and drink. People were offered a choice of what they would like to eat and drink. People’s weights were monitored on a regular basis to ensure that people remained healthy.
People were supported to maintain their health and well-being. People had regular access to health and social care professionals.
Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place to meet people’s needs. There was an induction programme in place which included staff undertaking the Care Certificate. Staff received regular supervision.
People were well cared for and positive relationships had been established between people and staff. Staff interacted with people in a kind and caring manner.
Relatives and health professionals were involved in planning peoples care. People’s choices and views were respected by staff. Staff and the registered manager knew people’s choices and preferences. People’s privacy and dignity was respected.
People received a personalised service. Care and support was person centred and this was reflected in their care plans. Care plans contained sufficient detail for staff to support people effectively. People were supported to develop their independence.
There were activities in place which people enjoyed. People were supported to increase their independence by staff supporting them in household tasks and attending activities outside such as college.
The home listened to staff and relative’s views. There was a complaints procedure in place. There had been no complaints since the last inspection. The registered manager supported people to make complaints when necessary.
The management promoted an open and person centred culture. Staff told us they felt supported by the manager. Relatives told us they felt that the management was approachable and responsive.
There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The registered manager understood the requirements of CQC and sent in appropriate notifications.