Archived: All Hallows

Updated 29 May 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. This inspection was planned to check 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

This inspection was carried out by one inspector.

Service and service type

All Hallows 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. The registered manager was absent when we inspected. There was an acting manager providing management support and supervision during their absence.

Notice of inspection:

We gave the service six hours’ notice of the inspection site visit. This was because the service is small and people are often out. We wanted to be sure there would be people at home.

What we did before the inspection.

Before our inspection we completed our planning tool and reviewed the information we held on the service. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people supported by the service and previous inspection reports. We also sought feedback from partner agencies and health and social care professionals.

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. This information helps support our inspections. We used all of this information to plan our inspection.

What we did during the inspection.

We spent time with all five people who lived at All Hallows. Conversation was limited due to people’s complex care and communication needs. We 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 six members of staff including support workers, the acting manager and assistant area manager.

To gather information, we looked at a variety of records. This included care plan and medicine records relating to two people who lived at the home. We looked at two staff files in relation to recruitment and two files to review staff training and supervision records. We also looked at other information related to the management of the service including audits and meetings minutes. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead in ongoing improvements. We also walked around the building to check the home was clean, hygienic and a safe place for people to live

What we did after the inspection.

We had contact with relatives of two people who lived at All Hallows to find about their views of the care and support provided.

Updated 29 May 2019

About the service: All Hallows is a residential care home that provides accommodation and personal care for up to six people with learning disabilities and autism. Five people lived at All Hallows when we inspected. Each person had their own bedroom and shared the lounges, dining room and other facilities. The size of service meets current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life.

The principles and values of Registering the Right Support other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways: promotion of 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.

People’s experience of using this service:

People who lived at All Hallows had limited verbal communication and comprehension. They were not able to converse in any depth with us. We were contacted by two families who were very positive about the care and support staff provided at All Hallows. One relative said, “Despite setbacks, [family member] has made amazing progress since first joining All Hallows and clearly loves and trusts the staff.” We also spent time with people and observed interactions with staff, spoke with social care professionals and looked at comments made on the home’s surveys. This helped us to understand people’s experience at All Hallows.

The registered manager was on long term leave when we inspected. An acting manager was managing the home until the registered manager’s return.

People indicated they felt safe and enjoyed living at All Hallows and staff were kind and friendly.

Care planning involved people, gave them choice and guided staff in how to provide care that met people's needs. Staff supported people to manage risks and to stay safe. Medicines were managed safely and according to national guidance.

People were cared for by staff who had been recruited safely, appropriately trained and supported. Staffing was sufficient to provide safe care. Staff had skills, knowledge and experience to support people with their care and social needs. People had opportunities to be involved in activities and leisure interests of their choice and were known and involved in the local community.

People were helped to eat and drink the right amount to keep them healthy. Meal times were relaxed and organised around people's individual daily routines. People were supported to attend healthcare appointments to assist their health and wellbeing. Staff understood the importance of supporting people to have a comfortable, pain free and peaceful end of life. Their end of life wishes were recorded so staff were fully aware of these.

The house was clean and maintained and staff practised good infection control. People had been able to personalise their rooms with their own furniture and personal effects.

People were helped to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff assessed people's capacity to make decisions and supported them with making decisions. Staff were given guidance in how to manage complaints. Although people were unable to formally complain, information was available for their representatives. Also staff often knew through people’s non-verbal communication when they were unhappy with something.

Staff worked in partnership with other organisations to make sure they followed good practice and

people in their care were safe. The management team used a variety of methods to check the quality of the service. This helped All Hallows to improve and develop good practice.

Rating at last inspection

At the last inspection the service was rated requires improvement (published 19 April 2018).

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. We may inspect sooner if any issues or concerns are identified.

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