Background to this inspection
Updated
10 September 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
The inspection was carried out by one inspector.
Service and service type
Swan House 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 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 the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
The people who were using the service at the time of our inspection could not talk to us about their experiences of the care provided. We therefore used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with two relatives about their experience of the care provided. We spoke with four members of staff, including the registered manager, the care co-ordinator and care workers. We also spoke with one visiting healthcare professional.
We reviewed a range of records. This included two people’s care and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
10 September 2019
About the service
Swan House is a residential care home providing personal care to people with learning and/or physical disabilities. The service can support up to six people but at the time of the inspection, five people were using the service.
The care home accommodates people in one adapted bungalow.
People’s experience of using this service and what we found
People using the service at the time of the inspection could not tell us about their experiences of using the service. However, we observed positive interactions between people and staff and people looked comfortable with the way they were being supported.
Relatives gave us consistently good feedback on the service and, the way the staff team had ensured people could stay in the home even when their needs changed. A typical comment was, “My relative had a massive stroke last year and I was so pleased he could stay here rather than having to go to another home.”
There were enough suitably qualified and experienced staff on duty to meet people’s needs and to keep people safe. People received their medication at the right time and were supported by staff who knew them well and how to keep them safe.
The staff had worked well with external health professionals to ensure people received effective care which maintained or improved their health. Staff received training which helped them to deliver effective and personalised care.
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.
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.
Relatives and staff were happy with the way the service was being led and there was a clear culture amongst the staff team in providing high quality person-centred care. Audits and checks were carried out in the home to ensure standards of care were maintained.
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 11 January 2017).
Why we inspected
This inspection was planned as part of our inspection programme.
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.