Big Blue Door

Updated 6 November 2019

The inspection

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.

The inspection team

This inspection was completed by one inspector.

Service and service type

Big Blue Door is registered to provide personal care to adults with learning disabilities. 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

We gave the provider 24 hours’ notice of the inspection because the service is small and we wanted to be sure the manager would be in.

What we did before the inspection

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.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We observed interactions between staff and people using the service, spoke to the relatives of three people, the registered manager and two members of staff. We reviewed the recruitment records of two staff members and the care records of two people. We also reviewed a sample of the services policies and procedures.

Updated 6 November 2019

About the service

Big Blue Door provides personal care, day care and respite care to children and young adults with learning disabilities, autism and physical disabilities. In this service CQC regulates the personal care provided to adults. At the time of inspection there were six adults receiving personal care, including overnight respite. The respite service is registered for personal care rather than residential care because the service is mainly provided to children and is regulated by Ofsted. This means CQC do not regulate the premises in this service. The most recent Ofsted report can be viewed at https://reports.ofsted.gov.uk/provider/2/SC489038

People’s experience of using this service and what we found

The provider ensured people received safe care from suitably recruited staff. People had been supported to manage the risks they faced in person-centred ways which upheld their rights. Relatives were confident that people were supported safely and protected from avoidable harm and abuse. Staff provided safe support with medicines including for some people whose routines were very complex.

The provider assessed people's needs thoroughly, involving other professionals and families which helped ensure they were confident they could meet people's needs. The provider ensured staff had been provided with training suitable to their roles including a thorough induction and regular refresher training. When required specialist trainers had been brought in to train on the management of some long term conditions. Staff said they felt they had been given the right training and support to care for people effectively. The registered manager and seniors provided regular supervision for staff. Supervision is a one to one meeting to consider the development needs and progress of staff. Staff also felt able to rely on each other for support and guidance.

Relatives praised the kind and caring attitude of the staff. Staff were committed to providing high-quality care which reflected people's preferences and upheld their dignity. Staff took time to understand how to communicate with people and ensured they built up rapport over time which helped to include people in decision making about their care. Staff were knowledgeable about how to support people when they experienced distress and followed good practice guidance in relation to positive behavioural support.

People received highly person-centred care which reflected their needs and preferences. Relatives told us the provider had been involved in reviews and updates about people and care was amended to reflect any changes to people's needs and preferences. Relatives had also been involved in recruitment, which had helped ensure families could identify staff they felt would be most appropriate. The provider had a complaints procedure which they followed when required. Relatives told us they had not felt the need to complain formally but any concerns they may have had been addressed in a timely way.

The provider remained committed to providing high-quality, person-centred care. Staff said they felt the service was well managed and they understood the aims and values of the organisation. Regular audits of care practices and records helped maintain consistency and quality of care. The registered manager addressed any concerns as they arose through supervision and other staffing procedures where necessary. Families told us they felt fully engaged with the service. The provider continued to work with partner organisations develop and improve care.

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

Rating at the last inspection

The last rating for this service was good. Published (June 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.