We carried out a review of the data available to us about Callisto on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Callisto, you can give feedback on this service.
Callisto is a small residential care home for two people with learning disabilities and/or mental health conditions. Accommodation is provided in a semi-detached building with a small garden area and some parking.
People’s experience of using this service and what we found
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 were being supported by staff who had been recruited safely and had been trained effectively. Staff were aware of the different types of abuse and what action to take if they were concerned. There were sufficient numbers of staff on duty. Medicines were managed safely with safe systems in place to order, store, administer and dispose of medicines. Risks had been identified and risk management plans were detailed and reviewed.
People had their needs assessed which included their healthcare needs. Support was provided to access health services where needed. 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.
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. People chose how they wanted to live their life and were supported to buy their own food and carry out light domestic activities.
People had their own care plans which were easy read and had pictures to support people to understand them. Communication needs were assessed and recorded in care plans, people had communication protocols in place where appropriate. People had opportunity to engage in social activity and access local services such as the leisure centre. One person had a voluntary job which they did once a week.
Systems were in place to monitor the quality of the service and make improvements where needed. The provider had a good oversight of the service and monitored outcomes. There was a registered manager in post who encouraged staff to share their views. Staff were supported to provide effective care and support. Feedback was gained from people to help develop the service. Partnerships had been maintained with many local healthcare professionals to make sure people got the care and support they needed.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
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 3 March 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.
The registered manager became registered in November 2016. ‘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.’
Quality assurance systems were in place but the monthly audits were not consistent with inspection findings. Some records needed updating for example positive behaviour management plans. Where people had capacity, their consent was not always gained to deliver care and treatment. The registered manager informed us following our visits that records were reviewed and how action plans were to be followed.
The people we asked said they felt safe living at the service. One person said the staff made them feel safe. The staff on duty were knowledgeable about the safeguarding of vulnerable adults procedures.
Care plans were in place. They were person centred and included the person’s likes and dislikes. One person on a transition visit said once they had moved into the home they would be seeking employment. Risks were assessed and where they were identified action plans were developed on minimising the risk.
Medicines were administered by the staff. Medicine administration charts were signed to indicate the medicine administered. Protocols were in place for medicines to be administered when required.
A member of staff was on duty at all times and on call procedures were in place for staff to gain support. Recruitment procedures ensured the staff employed were suitable to work with vulnerable adults. New staff received an induction to prepare them for the role they were employed to perform. Staff attended training set by the provider and specific training needed to meet people’s needs. For example, autism, dementia and during induction mental health awareness training was provided.
People told us they made their own decisions. They said they made decisions about their meals and activities. They said the staff were caring and their rights were respected. Members of staff were able to describe how they ensured people felt that what they said mattered to them.
People said they were accompanied on healthcare visits. Staff documented the outcome of the visits and these reports showed people had regular appointments with their GP, dental check-ups and there was input from specialists such as psychiatrists.
We found that people's health and welfare needs were being met and that support given was individualised and person centred.
Evidence informed us that systems were in place to protect people from possible abuse and that staff had an awareness of safeguarding issues. The home was found to be clean and hygienic.
We found that staff received appropriate training and support to be able to meet the needs of people living there.
We found the quality of the service was being monitored and systems were in place to ensure people's welfare and safety needs were met.
Both people said they liked the staff and they were looked after well. They said they were not expected to do anything they did not want to do. People were able to make their own minds up.
We observed care delivered with good humour and a balance between wanting people to be safe but respect for their rights. People appeared happy and comfortable. Staff supported people to have their medicines safely. The service had enough staff with the right skills and experience to support people. People's records and those to run the home were kept confidential and held securely.
People told us they were given lots of information about the home before they decided to move in. They said they were able to tell staff what support they needed and how they wanted to live their lives. They said they helped complete their own support plan, which explained their needs, wishes and aspirations. People told us they were supported to bring their own furniture and personal possessions with them when they moved to Callisto. They said they could choose the colour schemes of their bedroom.
People told us they liked the staff. They said they were friendly, helpful and supportive. They said staff had helped them to settle into their new environment. People said they felt safe and were looking forward to developing their interests within the local community. They said they had recently changed their GP and were beginning to find out about the local area.
People told us they would inform staff or the provider if they were not happy with any aspect of their care. They said staff regularly asked them if they had any ideas about developing the service. They said they had filled in a questionnaire about their experiences and views of the service they received. The feedback showed people were happy with the staff and the way in which they were supported.