The Terrace

Updated 19 May 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Terrace is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Terrace is a care home without nursing care. 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with six members of staff including the nominated individual, registered manager, training manager, and support workers. We carried out observations of care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included one care record and two 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality audit records. We spoke with four relatives about their experience of the care provided.

Updated 19 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

The Terrace is a residential care service which can accommodate up to six people with learning disabilities or autistic people. Six people were using the service at the time of the inspection. People who used the service had a self-contained apartment which consisted of a kitchen, lounge, bedroom and bathroom.

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

People were safeguarded from the risk of abuse; staff understood how to protect people from avoidable harm. Risks to people were assessed and managed to keep people safe. Staff were recruited safely, there were sufficient staff to meet people’s needs and provide meaningful activities. Medicines were managed safely. Infection prevention and control systems were in place and staff wore personal protective equipment. Accidents and incidents were monitored, with action taken to mitigate risks and reduce incidents.

The registered manager had governance systems in place to maintain and improve the quality and safety of the service. Effective monitoring was in place so that lessons were learnt when things went wrong. Staff felt supported by the manager and were involved in driving improvements. People had strong links within the community. There was an open and transparent culture, people using the service were involved in planning their care and support.

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.

Based on our review of key questions Safe and Well Led, the service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture

Right support

The model of care and setting maximises people’s choice, control and independence. People were involved in planning their care and future goals. Staff supported people with independent living skills and people chose their own activities daily. People had their own living area, which they were involved in decorating to their individual likes. People had strong links to the community and they were supported to maintain family relationships.

Right Care

Care was person centred and promoted people’s dignity, privacy and human rights. People chose and purchased their own meals and chose when they wanted to eat. Staff communicated with people in a respectful and caring way. Care plans and risk assessments were person centred and staff were trained and knowledgeable in meeting peoples individual needs.

Right culture

The ethos, values, attitudes and behaviours of the leaders and care staff ensured people using the service led confident, inclusive and empowered lives. There was an open and transparent culture and there was a homely atmosphere. People told us they were supported by the registered manager. Staff supported people to achieve their individual aspirations. Quality assurance and audit systems were in place to maintain and continuously improve quality and safety of the service.

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 08 February 2019)

Why we inspected

The inspection was prompted in part due to concerns received about management and safety in the service. A decision was made for us to inspect and examine those risks. We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

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.