Archived: The Bungalow

The 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 a life as any citizen.

At the last inspection in July 2015 the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a strong emphasis on providing person centred care to people which allowed people to lead full and active lives. Risks to people were assessed and centred on the needs and rights of each individual and were designed to promote people’s independence.

Staff had a good understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People who lived in the home were comfortable with the staff who worked there.

There were sufficient staff available to ensure people's wellbeing, safety and security were protected. A robust recruitment and selection process was in place. This ensured prospective new staff had the right skills and were suitable to work with people living in the home.

People were supported by staff with the knowledge and skills required to meet their needs. Staff received support and supervision to enable them to undertake their roles effectively.

Staff supported people in line with the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

We have made a recommendation about how the service uses monitoring devices to check that people are safe at night.

People received care that was responsive to their needs. Staff assessed and reviewed people’s needs to ensure care was planned and delivered in a consistent way. Healthcare plans and risk assessments were well planned to enable people to access the healthcare they needed to stay fit and well.

People were encouraged to maintain a healthy diet and received the support they required to develop their independence skills in this area. The home worked closely with health and social care professionals for those people whose behaviour may challenge the service. These professionals were very complimentary on the support and progress people had made since living in the home.

People were supported as appropriate to receive their medicines safely from staff assessed as competent to do so. Medicines were safely and securely stored at the service.

Staff communicated effectively with people and delivered their care in a friendly and compassionate manner. Care was provided in a way that promoted their dignity and privacy.

The service was well-led with an open inclusive atmosphere. Staff spoke consistently about the service being a good place to work. The provider undertook a range of audits to check on the quality of care provided.

Further information is in the detailed findings below.

The Bungalow provides accommodation and personal care for up to three adults with severe learning disabilities. At the time of the inspection there were three people living at the service.

Bedrooms and facilities at the home are located over one floor. There is a lounge, a kitchen dining room and a small conservatory. All rooms are single occupancy. A bathroom, shower room and appropriate toilet facilities are available. There is a secure garden to the rear of the property.

At the time of our inspection there was a registered manager at the service who had been in post since 2011. 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.

At our last inspection on 8 January 2014, the provider was compliant will all the standards reviewed at the time.

Relatives told us people living at the service received safe care. One relative said, “I have no concerns. I feel sure [my relative] is kept safe”. The staff we spoke with had a good understanding of how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

We saw evidence that staff had been recruited safely. Relatives and staff were happy with the staffing levels at the service and we found that there were sufficient staff on duty to meet people’s needs. We found that staff felt well supported. They received an appropriate induction, regular supervision and could access training when they needed it.

There were appropriate policies and procedures in place for managing medicines and relatives were happy with the way people’s medicines were managed. People were supported with their healthcare needs and were referred appropriately to a variety of healthcare services. A local healthcare professional who visited the service told us the service had, “A caring, thoughtful approach to looking after their clients’ health care needs”.

The relatives we spoke with were happy with the care provided to people living at the home. One relative told us, “The care is excellent. It couldn’t be better”. Relatives told us they were involved in decisions about their family member’s care. We observed that people's needs were responded to in a timely manner and saw evidence that their needs were reviewed regularly. We saw staff treating people with patience, kindness and affection. One person who lived at the service told us they liked their keyworker and the other staff at the home.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service had taken appropriate action where people lacked the capacity to make decisions about their care. Relatives told us staff respected people’s privacy and dignity and encouraged them to be independent.

Relatives were happy with the food provided at the home and a person we spoke with who lived at the home told us they liked the food. We noted that people were supported appropriately with their nutritional needs.

A variety of activities were provided within the home and people were encouraged and supported by staff to access the community on a daily basis.

We saw evidence that the registered manager requested feedback about the service from relatives and acted on the feedback received. The relatives and staff we spoke with told us they felt the service was managed well and they felt able to raise any concerns. We observed staff and the registered manager communicating with people, their visitors and each other in a polite and respectful manner. The registered manager and staff had a caring and compassionate approach towards the people living at the service and the relatives we spoke with told us they were approachable.

The service had a mission statement which focused on communication, therapy and high quality care and we saw evidence that this was promoted by the registered manager and staff. A variety of audits were completed regularly by the registered manager, which were effective in ensuring that appropriate levels of care and safety were achieved and maintained at the home.

We looked at all three care plans. We found these were person centred and up to date. People's needs were assessed and care and support was planned and delivered in line with their individual care plan.

We saw that guidelines were in place for staff for the use of the equipment that was in place. We spoke to staff who were happy that they had the relevant knowledge and training to use the equipment needed.

We found evidence that there was an effective recruitment process in place and found policies to back the process up.

The provider had an effective system in place to identify, assess and manage risks to the health and safety of people using the service and others.

Observations we made demonstrated people living there were comfortable and responded positively with staff members. We saw they liked to move around the home, use their rooms and other communal areas. There were no restrictions noted and staff were seen to encourage people to make choices about what they wanted to do. We saw they listened to people and were able to communicate, as they had a good knowledge and understanding of their needs. A staff member told us, 'I have been doing this job for a long time and you get to know people well, so you tend to tune in.'

We spoke with four support workers during our visit in order to gain their views. Staff were very positive about working in the home and praised the teamwork and supportive atmosphere.

We spoke directly with a relative. They told us they were 'very happy' with the care their relative received.

'They have been so good at moving my relative on'.

'Staff are exceptional. I have every admiration for them'.

'The medical support they give is second to none.'